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This study investigates laughter by General Practitioners (GPs) in response to patient laughter in lifestyle behaviour consultations. We examined video-recorded consultations involving 44 patients of four GPs in Australia. After identifying 33 cases of patient laughter, we examined whether GPs laughed in response. We used Conversation Analysis to explore the appropriateness of GP laughter and non-laughter by investigating the talk before and after the occurrence of patient laughter. GP reciprocal laughter was found in thirteen occasions when patients unsolicitedly mentioned their behaviours, laughed and displayed their evaluative stances (whether the behaviours were positive or negative). On twenty occasions, patients laughed in response to GP enquiries, which worked to problematise particular behaviours. In this context, patient laughter was not usually reciprocated (19/20 cases) because reciprocal laughter may risk being interpreted as laughing at the patient, as evidenced by one deviant case. GP reciprocal laughter may be problematic when the behaviour issues are raised by GPs and patients' evaluative stances regarding their behaviour have not yet been revealed. To decide when it is appropriate to reciprocate laughter, GPs should consider the contexts that lead to patient laughter and patients' evaluative stances. • Conversation Analysis is a robust empirical research approach for investigating laughter in lifestyle behaviour consultations. • When patients do not indicate whether the behaviours are positive or negative, GPs' reciprocal laughter may have negative effect. • When patients make jokes about their behaviours, GPs' reciprocal laughter may work to build the patient-doctor relationship. • When the behaviour issue is raised by the patient, GP laughter is less likely to be interpreted as laughing at the patient. • When the issue is raised by the GP, GP laughter is more at risk of being interpreted as laughing at. [ABSTRACT FROM AUTHOR]