Peers can influence each other's health lifestyle choices. However, limited research informs as to the factors that determine whether and how peers confront one another over their poor health lifestyle choices. We used Newell and Stutman's model of social confrontation as a theoretical framework to predict the manner in which college students will confront each other about their problematic drinking. We focused on the degree to which the legitimacy of discussing the topic and relational intimacy with the target influence decisions about the manner in which the confrontation takes place. Believing that health issues are an individual choice is negatively related to believing one is legitimate when confronting another individual. As predicted, legitimacy and intimacy interact to predict some elements of meta-goals and message characteristics. Individuals who were close, and felt that they were legitimate in confronting the other were more likely to have efficient confrontations and express concern. Implications for future research and designing peer interventions are discussed. (Contains 2 tables.)