Water-pipe smoking (WPS) has become popular in many Middle Eastern countries, especially among university and high school students of both genders. Reports show that the prevalence of WPS among Palestinian youth is increasing. However, there is little data that focuses on the pattern of WPS among Palestinian university students. The aim of this study is to explore the prevalence of, and factors affecting WPS among students at a major Palestinian university. A self-administered questionnaire was distributed to a random sample of university students. It included items addressing demographics, water-pipe use and patterns of utilization. Participants represented all disciplines of study, both males and females and all socio-economic classes. The proportion of current WPS was computed and its relation with relevant demographic characteristics was assessed. Almost one fourth (22.8%) of the study sample was identified as current water-pipe smokers. This proportion was significantly higher among males, faculty of humanities and social sciences, cigarette smokers and among students living with friends in rented house. The mean age of starting WPS was 16.6 years for males and 17.6 years for female and 57.9% of WP smokers reported that first experience with WPS was in the company of friends. In conclusion WPS has become significant enough among university students to be of concern and to the focus of future antismoking programs with special attention paid to students living with friends in shared housing situations.

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