Objective: No studies have examined the relationship between caregiver beliefs about the risks of smoking to their own health and caregiver beliefs about the effect of their smoking on their child's health. In the current study, we investigated our proposed "risk congruence hypothesis" among caregivers who smoke. Specifically, we investigated whether caregivers' self-perceived risk of smoking is directly associated with their perception of the risks of smoking to their child. Method: The sample consisted of 271 regular smokers ([greater than or equal to] 3 cigarettes per day; M[subscript age] = 32.9 years; 214 women) who were caregivers of children with asthma (M[subscript age] = 4.9 years) who had a recent visit to the emergency room for their asthma. Three constructs of perceived risk were measured via self-report questionnaires assessing both caregiver perception of smoking risk to self and to child: Precaution Effectiveness, Optimistic Bias, and Perceived Vulnerability. Child asthma-related functional morbidity and home and child secondhand smoke exposure were also assessed. Results: Consistent with our risk congruence hypothesis, self-perceived risk of smoking was significantly associated with perceived risk to child, over and above the child's secondhand smoke exposure and caregiver report of child's asthma symptoms (i.e., asthma-related functional morbidity). Conclusions: These findings should be considered in the design of clinical interventions seeking to influence risk of caregiver behavior on child health. (Contains 3 tables.)