Work-related stress and addictive behaviors have been described by several empirical studies as potential impairers for the health, welfare, and safety of workers. With this study, we aimed at describing the relationship between two work stress (Job Strain and Effort-Reward Imbalance) and tobacco consumption indicators among city bus drivers, and their association with traffic incidents registered by drivers along the last 2 years. For this cross-sectional study, the sample included 222 Colombian city bus drivers with a mean age of 41.4 years and driving experience of 18.63 years. A four-section questionnaire was used, and it was composed of individual (professional/demographic) information, Job Strain, Effort-Reward Imbalance, and self-rated health and lifestyle indicators, including the habit of consuming tobacco. Results showed that 21% of city bus drivers are smokers, and that four out of 10 drivers present job strain. Furthermore, significant associations relating smoking and job strain, and between smoking and traffic incidents were found. Finally, through a two-step cluster analysis, two patterns on work-related stress and tobacco consumption were identified for the drivers, finding significant differences in the traffic incident rates registered by each group/cluster of city bus drivers. The development of empirical-based interventions in psychosocial factors and potential sources of stress at work, and the enhancement of healthy lifestyles, including the prevention and treatment of addictive behaviors such as, smoking, are discussed as a way to strengthen the prevention of traffic incidents and the promotion of health among workers in the public transport.