Setting: Waterpipe smoking is becoming a global health crisis among youth.
Objective: To identify the prevalence of waterpipe use among Iranian university students and to explore perceived reasons for use.
Methods: A random sample of 1024 university students at two major universities in South Iran was enrolled in the study. A three-part questionnaire (baseline data, tobacco smoking status and perceived reasons for waterpipe use) was used. Students filled out the self-administered questionnaire in their classrooms.
Results: The prevalence of waterpipe smoking in the respondents' lifetime and in the last 30 days was 42.5% and 18.7%, respectively. The mean age at initiation of waterpipe smoking was 16.3 ± 3.2 years. Ever smoking was positively associated with age and male sex, whereas no association was found regarding marital status. The highest odds of lifetime waterpipe smoking were observed in students with close friends who smoked the waterpipe (5.94, 95%CI 4.26-8.30). The most important perceived reason for waterpipe smoking as stated by students was enjoyment (55.8%).
Conclusion: Given the alarming prevalence of waterpipe smoking, preventive measures should be adopted among university students taking into account the influence of peers, siblings and parents in the lessening social tolerance of waterpipe smoking.