The health burden caused by smoking behaviour among older adults is an uncontrollable problem worldwide. In particular, the trend of smoking among the aging population is rapidly growing. It affects individuals, families, economies, and societies. Changes in health determinants influence the smoking behaviour of older adults who require health promotion so that they can take care of themselves. This cross-sectional study was performed using secondary data from the National Statistical Office of Thailand: Report of a survey of older adults in Thailand in 2017. The present study aimed to examine the health determinant factors associated with smoking behaviour of older adults in Thailand. Data were collected from 32,030 older adults using a structured questionnaire. Multi-level analysis was performed to identify the health determinants of smoking behaviour of older adults in Thailand by controlling the effect of other covariates. The results were presented as adjusted odds ratio (AOR) and 95 % confidence intervals (CI). Among the 32,030 older adults, 15.11% of the respondents were smokers. Factors associated with smoking behaviour of older adults in Thailand were male sex (AOR: 6.36, 95% CI: 5.80–6.94, P-value < 0.001), younger age (AOR: 4.35, 95% CI: 3.59–5.25, P-value < 0.001), currently working status (AOR: 1.40, 95% CI: 1.23–1.59, P-value < 0.001), very good physical health (AOR: 2.64, 95% CI:2.05-3.40, -value < 0.001), alcohol consumption (AOR: 7.06, 95% CI: 6.44–7.43, P-value < 0.001), and participation in group/club activities in the community (AOR: 1.17, 95% CI: 1.08–1.28, P-value < 0.001). There were significant differences in the risk of smoking among the older adults according to their health conditions and socialisation levels. This outcome reinforces the need to be alert for and respond to sex-related differences in the risk pattern and protective factors for smoking in older adults. Thus, it is critical to establish and implement an active and effective tobacco control program to protect the health of older adults, particularly considering Thailand's measures towards chronic disease prevention and increased life expectancy.