Background: Several empirical studies have shown the attitude of smokers to formulate judgments based on distortion in the risk perception. This alteration is produced by the activation of the Optimistic bias characterized by a set of the unrealistic beliefs compared to the outcomes of their behavior. This bias exposes individuals to adopt lifestyles potentially dangerous for their health, underestimate the risks and overestimate the immediate positive effects.Objectives: This study aimed to analyze the relationship between Optimistic bias and smoking habits. In particular, it was hypothesized that smokers develop Optimistic illusions, able to facilitate the adoption and the maintenance over time of the unhealthy lifestyles, such as cigarette smoking, and the former smokers could acquire a belief system centered on own responsibility.Patients and Methods: The samples (n=633, female=345, male=288) composed of smokers (35.7%), ex-smokers (32.2%) and nonsmokers (32.1%). Each participant filled out two questionnaires including The Fagerström test and the motivational questionnaire as well as a set of items measured on a Likert scales to evaluate health beliefs.Results: The results confirmed the presence of the Optimistic bias in comparative judgments, and the attitude to overestimate the effectiveness of their preventive behaviors in the smokers.Conclusions: Cognitive bias in risk perception may influence health behaviors in negative way and reinforce cigarette smoking over the time. Future research should be conducted to identify the better strategies to overtake this cognitive bias to improve the quitting rate.