Smoking in combination with other behavioral risk factors is known to have a negative influence on health, and individuals who smoke typically engage in multiple risk behaviors. However, little is known about the clustering of risk behaviors among smokers of varying race/ethnicity. The purpose of this study was to examine patterns of cancer risk behaviors and to identify predictors of multiple risk behaviors in a racially/ethnically diverse sample of individuals seeking smoking cessation treatment. Overweight/obesity, at-risk alcohol consumption, and insufficient physical activity were measured in 424 smokers (African American, n = 144; Latino, n = 141; and Caucasian, n = 139). Results indicated that 90% of participants reported behavioral cancer risk factors in addition to smoking. Approximately 70% of participants were overweight or obese, 48% engaged in at-risk drinking, and 27% were insufficiently physically active. Univariate analyses indicated that race/ethnicity (P < 0.001), smoking level (P = 0.03), and marital status (P = 0.04) were significant predictors of multiple risk behaviors, although only race/ethnicity remained a significant predictor (P < 0.001), when gender, smoking level, age, education, household income, marital status, and health insurance status were included in a multivariate model. Multivariate analysis indicated that the odds of engaging in multiple risk behaviors were significantly higher among Latinos (odds ratio = 2.85) and African Americans (odds ratio = 1.86) than Caucasians. Our findings highlight the need for research aimed at identifying determinants of racial/ethnic differences in multiple risk behaviors and indicate the importance of developing culturally sensitive interventions that target multiple risk behaviors.