BACKGROUND: Lung cancer survivors are at an increased risk for recurrence and the development of secondary tumors and other comorbid conditions. However, little is known about lung cancer survivors' risk behaviors and the effect of these behaviors on overall health perceptions. OBJECTIVE: The purpose of this study was to describe the prevalence of health risk behaviors among non-small cell lung cancer survivors and their relationship perception to overall health. METHODS: One hundred forty-two survivors of non-small cell lung cancer with a minimum of 5 years disease free completed a battery of questionnaires to assess perception of health status and self-reported risk behaviors (smoking, exposure to secondhand smoke, alcohol use) and weight before and after diagnosis. Urinary cotinine level was used to verify smoking status, and actual height and weight were obtained to determine overweight status (body mass index, ≥25). Descriptive statistics and logistic regression were used to analyze the data. RESULTS: Seventy percent of participants reported their health as good to excellent. Although 81% quit smoking after diagnosis, 13.4% continued to smoke and 28% reported exposure to secondhand smoke. Approximately half the sample (58%) drank alcohol (16.3% quit after diagnosis) and was overweight (51%). A strong agreement between current smoking and exposure to secondhand smoke was observed. In a multivariate analysis, smoking (odds ratio [OR], 7.02: CI, 2.45 to 20.13), exposure to secondhand smoke (OR, 5.37; CI, 2.42 to 11.95), alcohol use (OR, 9.04; CI, 3.28 to 24.92), and overweight (OR, 8.51; CI, 3.44 to 21.10) were independent predictors of perceived poor health status. CONCLUSION: Although most lung cancer survivors have made healthy lifestyle changes, a substantial proportion has not. Our findings suggest the need for multiple risk factor interventions to decrease risk behaviors and improve overall health after a cancer diagnosis.