“…Several studies have demonstrated that cognitive factors such as motivation and self-efficacy predict adherence to pharmacotherapies for smoking cessation and/or to behavioral interventions for addictions (Alterman, Gariti, Cook, & Cnaan, 1999;Joe, Simpson, & Broome, 1999;Simpson & Joe, 2004). In addition, greater adherence to transdermal nicotine replacement has been linked to better treatment outcomes in smoking cessation studies (Cooper et al, 2004;Shiffman, Sweeney, Ferguson, Sembower, & Gitchell, 2008), and there is strong evidence for a relationship between adherence to behavioral treatments and substance-abuse outcomes in general (Simpson & Joe, 2004). To our knowledge, however, the extent to which adherence to pharmacotherapy and counseling mediate the relationship between self-efficacy in quitting, perceived difficulty in quitting, or motivation to quit and successful smoking cessation has not yet been examined.…”