Background: In recent years, water pipe smoking has become more common among younger people, which has increased its harmful impact on health. The aim of study to find out prevalence and attitudes of hookah smoking among southern technical university students.

Materials and Methods: This cross-sectional study was conducted at Southern Technical University / Basrah. The estimated sample size was 400 students were selected randomly (By simple random sampling technique) from Southern Technical University students. This study includes students for both sexes of the morning and evening study. The data collect started from October 2023 till the February 2024.

Results: The results of this study indicate that the prevalence of hookah smoking among students was 25.0% smokers. Of 100 smokers, the prevalence is higher in males (61.8%) than females (38.2%). In addition, 72.0% of participants with a family smoker were smokers, compared to 48.3% of non-smokers (p < 0.001). The results found that smokers had significantly lower positive attitudes (58.0%) than non-smokers (97.7%), p-value <0.001.

Conclusions: The study found that a quarter of the participating students were hookah smokers, and their positive attitudes were lower compared to non-smokers. The results of the study suggest creating regulations aimed at stopping the spread of hookah smoking by introducing preventative measures like including hookah smoking education in university curricula and funding hookah smoking research.