Objective: To test the feasibility, acceptability, and efficacy of Get Fit and Quit (GFAQ), a community-engaged, holistic tobacco treatment program for women of childbearing age in a residential substance use disorder treatment facility. Design: A quasi-experimental, one-group, longitudinal design. Setting: A local Young Men's Christian Association (YMCA) location. Participants: Twenty-three women of childbearing age were enrolled in the study. Nearly all (21/23) participants were White, and most were nonpartnered and unemployed. More than one third of participants had more than high school educations, and five (22%) were pregnant at enrollment. Methods: The program was conducted in 10 sessions over 6 months. For each 90-minute session, approximately 45 minutes were dedicated to smoking cessation, and 45 minutes were dedicated to group physical activity. Means and 95% confidence intervals were used to summarize nicotine dependence, expired carbon monoxide, urine cotinine, and exercise self-efficacy at baseline and 5-week, 8-week, and 6-month assessments. Cigarettes smoked per day were summarized using medians and interquartile ranges over time. Program satisfaction and regular exercise were presented as percentages with 95% confidence intervals. Results: Of the 23 women who enrolled in GFAQ, 7 (30%) completed the program. Compared with baseline results, participants who completed GFAQ had lower nicotine dependence and smoked fewer cigarettes per day. Additionally, at 5 weeks, more GFAQ participants exercised regularly (64%) compared with baseline (14%). Most participants viewed the program favorably. Conclusion: Smoking in women of childbearing age with substance use disorders is an important public health issue. GFAQ is a promising intervention for tobacco treatment for this high-risk population, although the number of initial participants who completed the program was low.