Aim and objective:
Water pipe (WP) smoking is a significant leisure activity among young people in Iran that is on the rise. The purpose of this study was to identify the role of socio-demographic factors associated with WP smoking among male adolescents in Iran.

Methods:
The study used a cross-sectional design. It included 730 high school male students (grades 10-12)recruited through multi-stage random sampling conducted in 2017 in the Hamadan city of western Iran. The self-administered questionnaires included information on demographic variables and behavioral risk factors related to WP smoking. Statistical analyses were executed using SPSS version 22 summarizing descriptive statistics and conducting inferential statistics through multi nominal logistic regression modeling.

Results:
The mean (SD) ages of the students and at WP smoking initiation were 16.41(0.84) and 13.31 (2.43), respectively. The distribution of never, ever and current WP smoking were 37.3 %, 35.3% and 27.4%, respectively. We found that ever cigarette smoking (OR=5.34; 95% CI [2.66, 10.73]) and WP smoking family (OR=2.41; 95% CI [1.32, 4.40]) were significantly associated with ever WP smoking. WP smoking friends (OR= 0.50; 95% CI [0.35, 0.72]) had protective role on ever WP smoking. Also, the variables18 years of age, studying in technical fields, ever and current smoking of cigarettes and family usage of WP smoking were significantly associated with the current usage of WP smoking.

Conclusion:
The results indicated that the prevalence of ever and current WP smoking were high in Hamadan city. Thus, designing and implementing interventions for increasing students’, friends' and family's awareness regarding the harms of WP smoking and cigarette smoking facilitating behavior change in this direction is necessary.

Funding:
This study was supported by Hamadan University of Medical Sciences, Hamadan, Iran.