Date of Award

Spring 3-28-2017

Degree Type


Degree Name

Master of Science (MS)


Respiratory Therapy

First Advisor

Dr.Lynda Goodfellow

Second Advisor

Dr.Chip Zimmerman

Third Advisor

Dr.Gerald Zavorsky



Background: Waterpipe (hookah) smoking is gaining in popularity as a form of smoking tobacco. There is a noticeable increase in hookah smoking worldwide, among young adults. There is a growing body of literature that indicates that college students may not be as knowledgeable as should be in making decisions about smoking waterpipes.

Purpose: This study was performed to evaluate the prevalence, knowledge, attitudes and beliefs regarding hookah (waterpipe) use among college-based health care students.

Methods: Participants in this study were chosen based on their readiness and willingness to participate. The questionnaire was distributed by the researcher to graduate students through a link for a web-based survey. A paper copy was distributed in class to undergraduate students only. There were 319 college-based health care students who participated in this study from the following specialties: nursing, physical therapy, respiratory therapy, occupational therapy and nutrition. Data were analyzed using descriptive statistics.

Results: Respondents have used or tried hookah (waterpipe) smoking before (n=156, 49%), while the majority of students who have not tried or used the hookah smoking (n=163, 51%). Students were able to identify health hazards that might result from hookah smoking, for example cancer (n=258, 80.9%), respiratory problems (n=308, 97%), cardiovascular impairments (n=202, 63%), hematological impairments (n= 98, 31%), harm during pregnancy (n=214, 67%), and diarrhea (n=37, 11.6%) as potential health hazard. This study showed that 187 students (58.6%) believed that cigarette smoking is more harmful than water pipe smoking due to the false beliefs that they have. There was also general disagreement regarding students’ attitudes and opinions about waterpipe smoking. Finally, this study showed the reasons why students engage in hookah smoking; for example, (241, 75.5%)of the students reported that the reason for water pipe smoking is an increased opportunity to smoke a water pipe in cafes, etc. Also, students said other reasons like flavor/aroma of Hookah itself (219, 68.7%), and utility of water pipe in leisure & pleasure activities (217, 68%).

Conclusion: This study showed that the prevalence of hookah (waterpipe) smoking is common among students in health care especially in young adults. Further studies are needed to ask more students and at different institutions. Finally, we recommended conducting educational campaigns to increase students’ knowledge and awareness and to correct the wrongs beliefs and attitudes.