To enhance our understanding of why lower SES people are less likely to engage in various recommended health behaviours, this qualitative exploratory study investigated attitudes towards health and smoking in fifteen upper SES and fifteen lower SES smokers. A structured open-ended interview explored dimensions of the Health Belief Model (Rosenstock, 1975) within a theoretical context informed by the social structure and personality perspective (House, 1981). Transcribed interviews were analyzed for regularities and themes. Three general attitudes or reasons emerged from the investigation which appear to underlie why lower SES people are less likely to engage in the recommended health behaviour of "not smoking". These are acceptance of lower levels of health, a perceived low effectiveness of engaging in the recommended health behaviour in preserving health and greater situational pressure to engage in the negative health behaviour. Both cultural factors and material circumstances appear to underlie these SES differences in health orientation and the implications for this are discussed.