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This study aimed to determine whether significant associations exist between multicultural families and adolescent smoking risks in South Korea. Data from the Korea Youth Risk Behavior Web-based survey from 2016 to 2020 were analyzed. Participants were classified into four family types (South Korean mother–foreign father, South Korean father–foreign mother, both foreign parents, and both South Korean parents) according to their parents' country of birth and smoking was assessed using a self-reported questionnaire. A logistic regression analysis was used to examine the significance of the associations. Overall, 194,259 participants (boys: 94,793, girls: 99,466) enrolled in this study. Adolescents whose parents were born overseas were more likely to smoke than native South Korean adolescents (boys: odds ratio [OR] = 2.61, confidence interval [CI] = 1.79–3.81, girls: OR 3.94, CI 2.42–6.43). When the mother's country of birth was a developing country, there was an increased likelihood of girls smoking, and there was an increased likelihood of smoking among boys when the mother's country of birth was North Korea. When both parents were born abroad, and the mother's country of birth was a developing country, the likelihood of smoking risks among their multicultural teenage children increased. Policies and interventions need to be established and implemented to lower the smoking rate among multicultural teenagers. [ABSTRACT FROM AUTHOR]