Background. Understanding the role of the family in shaping adolescent health risk behaviours has recently been given increased attention. This study investigated association between current smoking and a range of familial factors in a representative sample of Lithuanian adolescents. Methods. Study subjects (N = 3696) were adolescents aged 13- and 15-years from the schools in Lithuania who were surveyed in Spring 2014 according to the methodology of the cross-national Health Behaviour in School-aged Children (HBSC). A standard HBSC international questionnaire was translated into Lithuanian and used anonymously to obtain information about current smoking patterns and family life (family structure, quality of communication in family, parental monitoring, bonding, parenting style, family time, etc.). Logistic regression was used to assess association between smoking and familial variables. Results. The prevalence of current smoking was 16.5 % (20.8 % in boys and 11.9 % in girls; P < 0.001). Adjusting for gender, age and family affluence, adolescents from non-intact families were significantly more likely to be current smokers (OR = 2.10; 95 % CI: 1.74-2.54) compared with intact families. Five independent familial factors were significantly related to increased risk for adolescent smoking: low maternal monitoring (OR = 2.79; 95 % CI: 1.98-3.92), low satisfaction with family relationships (OR = 1.89; 95 % CI: 1.27-2.83), low school-related parental support (OR = 1.40; 95 % CI: 1.01-1.95), easy communication with the father (OR = 0.56; 95 % CI: 0.38-0.80) and often use of electronic media for communication with parents (OR = 0.66; 95 % CI: 0.50-0.88). The last two determinants showed an inverse effect than it was hypothesized. Conclusion. Higher prevalence of smoking among adolescents of Lithuania is associated with a non- intact family structure as well as weaker parental support and bonding. Family life practices are critical components to be incorporated in prevention and intervention programs for adolescent smoking in Lithuania.