BACKGROUND: Heightened distress at the time of a loved one's lung cancer diagnosis may motivate relatives to quit smoking or could undermine cessation. METHODS: Relatives of new lung cancer patients at Duke were surveyed by telephone to assess diagnosis-related depression, distress, and motivation for smoking cessation. RESULTS: Relatives who reported above average avoidant and intrusive thinking patterns, depressive symptoms or worry were more likely to report that the patient's diagnosis increased their intentions to quit than the less distressed. CONCLUSIONS: Interventions are needed that encourage smoking cessation as a strategy for adaptively coping with a loved ones' lung cancer diagnosis.