Background: Statin-use and the adoption of healthy lifestyle choices are important components of cardiovascular disease prevention. The nature of the relationship between the former and the latter, and the influence of personal and social factors on this relationship remains unclear. Aim: This research aimed to examine whether statin-use influences the adoption of healthy dietary and exercise choices by changing the way people think of high cholesterol as a risk factor for cardiovascular disease in the context of their social world. Methods: Questionnaires were used to compare the dietary and exercise behaviours; perceptions of high cholesterol; and perceived future risk of cardiovascular disease of statin users and non-statin users recruited in Nigeria and in the UK. In-depth interviews were conducted in each country to explore between group differences and the influence of social factors on statin-use, adoption of a healthy lifestyle choices; perceptions of high cholesterol, future cardiovascular disease risk and availability of social support. Results: A similar proportion of the 148 participants recruited from Nigeria and the 89 participants recruited from the UK reportedly adopted a low-fat diet, 69% and 70% respectively. Reported adoption of healthy exercise behaviours was much lower and notably different between the country samples, 16% and 32% respectively. Statin-use was found to influence the adoption of healthy lifestyle choices in 3 ways: it was found to encourage, hinder, and work alongside the adoption of healthy lifestyle choices. The adoption of healthy lifestyle choices was also influenced by cause-control perceptions, gender, and social factors such as location, preferences and demands of other people, and societal norms such as body image ideals. Conclusion: Statin-use influenced the adoption of healthy lifestyle choices in 3 different ways. Dietary changes were preferred to exercise changes. Illness perceptions and preferences of the individual and their social world influenced statin-use and the adoption of healthy lifestyle choices.