Inequalities in cigarette smoking prevalence exist, with smokers more likely to be poor and less educated. Higher socioeconomic status (SES) is associated with higher quit rates. The overall relationship between low SES and poor health, as measured by morbidity and mortality, is well established. However, research indicates that inequalities in health are not explained by SES alone; other variables, such as psychosocial factors, may play a significant role. Williams has developed a conceptual framework to examine relationships among SES, psychosocial factors, and medical care related to health outcomes. According to Williams, the interrelationships among these factors have yet to be determined. As such, the pathways among the variables within psychosocial factors are explored and the authors discuss application to public health nursing practice and areas for future research. Further understanding of these relationships in the context of smoking may inform prevention and cessation strategies.