ORIGINAL PAPER Pilot Study of Waterpipe Tobacco Smoking Among US Muslim College Students Cynthia L. Arfken • Wahiba Abu-Ras • Sameera Ahmed Ó Springer Science+Business Media New York 2014 Abstract Waterpipe smoking is common among the young in Muslim-majority countries despite recent Islamic rulings on tobacco. US Muslim college students, especially immi- grants, may be at high risk for smoking, but information is lacking. In this pilot study, respondent-driven sampling was used to sample 156 Muslim college students. Waterpipe smoking was common (44.3 %). Leading motivations to smoke were social and perceived low tobacco harm. Independent risk factors among the Muslim students were perception that friends and other students smoked, and ever drank alcohol. Personal belief that waterpipe smoking is prohibited in Islam was not significant. This pilot suggests that Muslim students are at high risk for waterpipe smoking and more definitive studies are needed. Keywords Waterpipe smoking Á Muslim Á College students Á Religiosity Á Social influences Introduction Waterpipe smoking (also known as Hookah) is centuries-old nicotine delivery system from the Middle East and South Asia. Unlike cigarette smoking, waterpipe smoking often occurs in a social context where the waterpipe is shared with family or friends. Waterpipe use is C. L. Arfken (&) Á S. Ahmed Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Service Drive, Ste 1B, Rm 156, Detroit, MI 48201, USA e-mail: carfken@med.wayne.edu W. Abu-Ras School of Social Work, Adelphi University, Garden City, NY, USA S. Ahmed Family and Youth Institute, Canton, MI, USA 123 J Relig Health DOI 10.1007/s10943-014-9871-x