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Aims To examine the influence of risk perception on intentions to quit smoking and post‐treatment abstinence.

Design Prospective and longitudinal.

Setting United States.

Participants A total of 237 adult smokers (mean age 56 years) receiving medical care from home health‐care nurses. Participants did not have to want to quit smoking to participate, but received cessation counseling within the context of their medical care.

Measurements Three measures of risk perception were given pre‐ and post‐treatment: perceived vulnerability, optimistic bias and precaution effectiveness. Smoking status was verified biochemically at end of treatment and at 2, 6 and 12 months later.

Findings Principal components analysis supported the theoretical discriminability of the risk perception measures, and intercorrelations provided evidence for concurrent and predictive validity. Elevated risk perception was associated with a variety …