Driver in-vehicle cell phone use presents a dangerous distraction for adolescent drivers for whom motor vehicle crashes represents the leading cause of death. We used the National Young Driver Survey (NYDS), a nationally representative (N = 5665) cross-sectional study of adolescent driving behavior, to examine potential psychosocial correlates of cell phone use while driving (CPWD). Results indicated that stronger beliefs about the advantages of abstention from CPWD were associated with less frequent CPWD, adjusted OR: 0.46 95% [CI: 0.40–0.53]), while stronger beliefs about the disadvantages of abstention were associated with more frequent CPWD, adjusted OR: 1.41 95% CI: [1.21–1.64]. In the absence of strong advantage beliefs, disadvantage beliefs did not have a meaningful association with less frequent CPWD. Almost 30% of adolescents held weaker advantage beliefs coupled with stronger disadvantage beliefs, placing them most at risk. These findings offer guidance for a wide range of intervention and health promotion efforts.