Background:

An extensive literature search revealed that water pipe smoking is an emerging health risk and deserves the attention of health professionals. This study was therefore undertaken to determine the frequency of water pipe smoking among students in college and universities of Pakistan and to assess the practices, knowledge and attitude towards water pipe smoking among them.

Method:

A cross sectional survey was conducted in the College and Universities of Karachi, Pakistan from April 2009 to October 2009. Students were selected through non probability sampling and given self administered questionnaire after the informed consent.

Result:

A total of 422 students participated with response rate of 92.08%.Overall prevalence of water pipe smoking was found to be 45.2 % with current water pipe smokers of 16.5% males and 5.7% females (p=<0.001). About 39.3% (160/407) of them were found to have inadequate knowledge and 64% had positive attitude about water pipe smoking. Inadequate knowledge and negative attitude towards water pipe smoking is significantly associated with current water pipe smoking than former or ever water pipe smokers (p=<0.001).

Conclusion: Inadequate knowledge and social acceptability of water pipe smoking and the male gender are leading to high current smoking tendency among young adults in Karachi, Pakistan