Firefighters are increasingly aware of their exposures to known and unknown carcinogens they face on the fireground. Beyond those exposures, being a firefighter pulls for an unhealthy environment and unhealthy behaviors that also increase the risk of cancer. This presentation includes an overview of current research on obesity, fitness, nutrition, alcohol use, tobacco use, and sleep in the fire service setting. In addition to risks related to fireground operations, research is increasingly pointing to the importance of modifiable risk factors as key predictors of injury, loss, and development of cancer. Current data suggest that, because of occupational risk factors, the fire service faces high rates of obesity and low fitness, high rates of heavy and binge drinking, poor cardiovascular health profiles, and concerns related to behavioral health. Mitigating these risks necessitates not only individual, but also system level, changes in policies, practices, and cultural norms by fire departments. Improving the readiness of firefighters and decreasing line-of-duty injuries and deaths and the rates of cancer necessitates that fire service leaders be knowledgeable about and engaged in health promotion for their personnel.