Smoking is highly prevalent among prison populations. Adherence to counseling and nicotine replacement therapy predicts successful cessation. The authors examined predictors of greater than 80 percent adherence to counseling and nicotine patch in a cessation trial targeting female prisoners. Of the 202 participants included in these analyses, 66.8 percent were adherent to the patch, 51.2 percent were adherent to counseling, 16.3 percent were nonadherent to both, and 45.0 percent were adherent to both. Older age of smoking initiation (p = .01), higher baseline smoking (p = .03), and prior substance abuse treatment (p = .04) predicted counseling adherence. Predictors of patch adherence included greater prior smoking level (p = .07) and more quit attempts (p = .09). The predictors of adherence to both was more prior quit attempts (p = .04). Understanding adherence-related factors may increase effectiveness of cessation interventions. Abstract published by arrangement with Sage Journals.