Electron beam computed tomography is promoted as a test that may enhance patient motivation to alter cardiovascular risk behaviors. We surveyed a consecutive sample of asymptomatic, active smokers (N = 144) who underwent screening electron beam computed tomography about their current motivation to alter their smoking behavior in the context of their tomography results. Patients with coronary artery calcification (42% of the sample) were more likely to perceive increased cardiovascular risk (42 vs. 13%; p < 0.01). Overall, most patients (59%) rated themselves as more motivated to quit smoking after electron beam computed tomography, but there was no relationship between motivational levels or smoking behavioral change and the presence of coronary artery calcification. In smokers predominantly self-referred for electron beam computed tomography, the presence of coronary artery calcification does not appear to influence motivation for smoking cessation or smoking behavior.