Smoking is highly prevalent among prison populations. Adherence to counseling and nicotine replacement therapy predicts successful cessation. The authors examined predictors of ≥ 80% adherence to counseling and nicotine patch in a cessation trial targeting female prisoners. Of the 202 participants included in these analyses, 66.8% were adherent to the patch, 51.2% were adherent to counseling, 16.3% were nonadherent to both, and 45.0% 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. © The Author(s) 2013.