Heart disease, cancer, stroke, diabetes, and respiratory diseases are the leading chronic diseases worldwide. For American college students, specifically, behavioral risk factors for chronic disease include: insufficient sleep, inactivity, unhealthy eating habits, poor mental health, substance abuse, unhealthy relationships, and unsafe sexual practices. Although little has been reported in the literature, and no national assessment was conducted of college-aged students in India; there is some evidence that that this population may also engage in the behavioral risk factors of alcohol and tobacco use. A convenience sample of English-speaking, college-aged students from a medium-sized, rural university in India and a medium-sized, rural university in the United States participated in a survey about their behavioral health risks for chronic disease. The chronic disease risk factors of substance abuse, physical inactivity, and poor nutrition were similar between the two respondent groups; however, choice of substance to abuse (US- alcohol, India- tobacco) significantly differed between the groups. Health promotion intervention programming for college-age students in both countries would be similar and should focus on decreasing personal risk factors and promoting protective factors for chronic disease prevention.