Objective To determine the prevalence of smoking among adolescents with asthma and smoking's psychosocial risk factors (environmental smoking exposure, autonomy, depression). Method Participants were 2,039 adolescents with asthma and 2,039 matched controls from the Add Health study. Results The prevalence of ever smoking among adolescents with asthma was 56%. Among ever smokers with asthma, the prevalence of current smoking was 48%, and the prevalence of current smokers having made a recent attempt to stop smoking was 57%. Having parents who have smoked, exposure to friends who smoke, and depression were significant psychosocial risk factors for ever smoking. Asthma and exposure to friends who smoke were significantly associated with current smoking, and attempts to stop smoking were significantly associated with asthma and depression. Conclusions Psychosocial risk factors for smoking among adolescents with and without asthma appear similar. Research on the role of illness in tobacco control is warranted.