There is a growing body of evidence suggesting that negative health lifestyles are the principal social determinants of the mortality crisis in the former socialist states. Little is known, however, about health lifestyles in Central Asia, where the downturn in life expectancy was also experienced. This paper examines health lifestyles in Kazakhstan and Kyrgyzstan in order to fill an important gap in the literature. The data show, consistent with the improved longevity of the Kyrgyz population, that such lifestyles are more positive in Kyrgyzstan despite the somewhat better economic situation in Kazakhstan, where the mortality crisis continues. © 2004 Elsevier Ltd. All rights reserved.