Background: Smoking is a learnt behavior during adolescence and understanding the factor/s associatedwith smoking will assist in identifying suitable measures in combating the rising prevalence of smoking amongadolescents. This research aimed to identify the factor/s associated with smoking among form four students inKota Tinggi, Johor. Multistage sampling was used to select a representative sample of students in 2008 and datawere collected using a self-administered validated questionnaire. This study revealed that the overall smokingprevalence was 19.0% with a significantly higher proportion of male smokers (35.8%) as compared to females(3.15%). Adolescents who were male (aOR 6.6, 95%CI 2.61-16.4), those who had peer/s who smoked (aOR 4.03,95% CI 1.31-12.4), and those who studied in rural areas and Felda Settlements ( aOR 4.59, 95 CI 1.11-18.0; aOR9.42, 95%CI 3.91-29.1) were more likely to smoke in the past one week. On the other hand, adolescents withbetter knowledge on the hazards of smoking and negative attitudes towards smoking were less likely to smoke(aOR 0.51, 95%CI 0.37-0.72; aOR 0.67, 95%CI 0.46-0.99). Future promotional and interventional programmeson smoking should be considered and the above identified risk factors integrated to reduce smoking prevalenceamong students of school-going ages in Kota Tinggi. Johor.