Background: College students are susceptible to cigarette smoking initiation, and those who smoke are at risk for a lifetime addiction. Purpose: This study examined the differences in college student smoker and nonsmoker perceptions about cigarette smoking in relation to emotional benefits, health hazards, self-confidence, and body image. Methods: A cross-sectional study using a convenience sample was conducted. The Attitudes and Beliefs about the Consequences of Smoking (ABC) instrument assessed cigarette smoking perceptions. An independent samples t test and one-way analysis of variance (ANOVA) assessed the differences between smoking status and the 4 ABC subscales. A multivariate ANOVA was conducted to test for the differences between smoking status and gender, as well as other demographic items. Results: Of the 1333 participants, the average age was 21, 63% were female, 69% were white, and 11% were current smoker. The one-way ANOVA revealed a statistically significant difference between smokers and nonsmokers. Multivariate tests indicated a significant effect of smoking status and gender for the 4 subscales. The interaction of smoking status and gender had a significant effect on smoking attitudes. Discussion: College student smokers underestimate the harm of cigarette smoking. Translation to Health Education Practice: Tailored smoking prevention and cessation interventions targeting college students are recommended.