Objective: The authors examined the association between tobacco smoking and suicidal ideation and planning in schoolchildren from 10 countries in Africa, the Americas, and the Western Pacific region.Methods: Data were collected through the Global school-based Student Health Survey (GSHS), a collaborative surveillance project between the World Health Organization (WHO), the United Nations, UNICEF, UNESCO, UNAIDS, and the US Centres for Disease Control and Prevention (CDC).Suicidal ideation and planning, tobacco smoking, and drug and alcohol use were included in log linear models to analyze, separately for each sex, higher order interactions among suicidality and regional and country differences.Results: Schoolchildren who reported suicidal ideation and/or suicidal planning had a higher risk of smoking cigarettes even after controlling for drug and alcohol misuse.Furthermore, analyses indicated higher order interactions between suicidal ideation and planning and countries belonging to different regions with different exposure to tobacco smoking among schoolchildren.Conclusion: Future studies analyzing the mechanism and sequencing of the relationship among suicidal ideation and tobacco smoking should explore cultural factors.