The study examines the relationship of family, school and geographic factors in relation to the prevalence of different health risk behaviours among Czech adolescents (aged 15–16 years) based on cross-sectional study design. Risk behaviours such as cigarette smoking, alcohol drinking and marijuana use among adolescents have often been shown to co-occur with each other. Data from the European School Survey Project on Alcohol and Other Drugs 2007 were used. A total of 7616 students from the Czech Republic were analysed in the study. About two thirds of students (63.5%) did not engage in any type of considered health risk behaviour, 21.1% reported one risk, 10.8% two risks, and 4.6% three risks. Thus, in sum 15.4% of Czech, students were engaged in multiple risk behaviour forms. Separate multilevel logistic regression models were performed in order to explore the redistribution of factors on categories of multiple health risk behaviour.