Based on the concept of perceived behavioral control, we explored the extent to which internal perceived behavioral control [self-efficacy] and external perceived behavioral control [fatalism] contribute to explaining differences in smoking cessation between Arab and Jewish cardiac patients in Israel. Design: In a cross-sectional study of retrospective quota samples of 100 Arab and 100 Jewish male patients, diagnosed with a major cardiac event were interviewed. The questionnaire included demographic background, patients' smoking behavior, Bandura's self-efficacy scale, and a fatalism scale. Results: Of those who smoked before the cardiac event, half [50%, n = 39] of the Arab patients continued to smoke compared with only 19.4% [n = 12] of the Jewish patients. Arab patients reported significantly lower levels of self-efficacy and higher levels of fatalism. Fatalism, but not self-efficacy was significantly associated with continuation of smoking. In multivariate analysis, population group remained the only variable significantly associated with cessation of smoking. Conclusion: The persistence of differences between the two cardiac patient groups suggests that culturally sensitive smoking cessation interventions should be designed for each population and that additional putative explanatory variables should be further examined.