Purpose: The purpose of this study was to investigate the combined influence of smoking and alcohol drinking on suicidal ideation and attempts among Korean adults. Methods: This cross sectional study used secondary data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011. A total of 13,064 adults were included in the study. Logistic regression was used to analyze the combined influence of smoking and alcohol drinking on suicidal ideation and attempts. Results: Persons who smoke and use alcohol were more likely to report suicidal ideation and attempts than those who did not smoke and reported normal drinking. The group who reported both smoking and harmful drinking/alcohol had significantly higher incidence of suicidal ideation and attempts than the comparison group of non-smoking/normal drinking (Suicidal ideation: Adjusted Odds Ratio [AOR]: 2.13, 95% Confidence Interval [CI]: 1.60~2.83; suicidal attempts: AOR: 3.81, 95% CI: 1.60~9.05). Conclusion: Based on the results of this study, smoking and alcohol drinking were individually important health behaviors for prevention of suicidal ideation and attempts. Especially, suicidal prevention programs might be needed for adults who smoke and drink at the same time to decrease suicidal ideation and attempt.