The purpose of this study was to investigate the influence of cigarette smoking on the risk of illegal drug abuse and self-medication, such as the proper use of pharmaceutical products, among high school students.An anonymous, self-administered survey was conducted before and after a lecture on the prevention of drug abuse in a high school located in eastern Hiroshima Prefecture in November 2011. The subjects were classified into three groups according to smoking behavior; non-smokers, former smokers, and current smokers. Significant differences were observed between groups.The rate of recognizing health damage caused by the abuse of stimulant drugs, narcotic drugs or solvents was significantly decreased in the cigarette smoking group. In addition, the rate of intent to use drugs that were considered to be “medications that enable them to stay up all night for days”, “medications that would allow them complete recovery from fatigue” or “medications that would improve their appearance” was significantly increased in the cigarette smoking group. The rate of prescription medication compliance, such as confirming their correct usage or following their prescribed usage was significantly decreased in the cigarette smoking group.An influence against illegal drugs and the awareness of the risks of self-medication were observed in non- and former smokers according to the questionnaire performed after the lecture, but the influence on the cigarette smoking group was minimal. Education promoting medication compliance may be necessary for high school students, especially students who abuse cigarettes.