Evaluates whether asbestos workers who smoke cigarettes, thereby increasing their cancer risk synergistically, differ from asbestos workers who choose not to smoke. Demographic, personality, psychologic, and cognitive differences were examined. Engaging in this highly detrimental health behavior was related exclusively to cognitive factors. Although current smokers were cognitively aware of their added health risk, in comparison to past and "never" smokers, they minimized the salience of awareness by fatalistically attributing their health to chance factors such as luck and by minimizing the dangers of smoking, the benefits of smoking cessation, and their own increased vulnerability to life-threatening illnesses. Results are explained in light of the apparent denial of risk. The need for physician intervention is strongly advocated.