Barriers to Quitting Smoking Among Substance Dependent Patients Predict Smoking Cessation Treatment Outcome

•The Barriers to Quitting Smoking in Substance Abuse Treatment was developed in two studies.•We examined psychometric properties with smokers with substance use disorders.•Factor structure was supported and replicated with excellent internal consistency reliability.•Barriers predicted smoking at 1 month and 3 months after smoking treatment.•Addressing barriers with corrective information in smoking treatment is important.

For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n = 184 and 340). Both components (general barriers, weight concerns) were replicated with excellent internal consistency reliability. Construct validity was supported by significant correlations with pretreatment nicotine dependence, smoking variables, smoking self-efficacy, and expected effects of smoking. General barriers significantly predicted 1-month smoking abstinence, frequency and heaviness, and 3-month smoking frequency; weight concerns predicted 1-month smoking frequency. Implications involve addressing barriers with corrective information in smoking treatment for smokers with SUD.