Background:
Tobacco use contributes to more than 6 million annual deaths globally. A growing body of knowledge shows a rise in the use of water pipe tobacco (shisha), spreading from the traditional Eastern Mediterranean and Northern African regions to other parts of the world. We assessed the prevalence of and factors associated with shisha smoking among undergraduate health profession students in the College of Health Sciences, University of Nairobi, Kenya.

Methods:
We conducted a cross-sectional study among final year undergraduate students enrolled in the medicine, nursing, pharmacy and dentistry programmes in August 2014. Students completed a questionnaire adapted from the Global Tobacco Surveillance System. Information on ever and current use of shisha, social demographic variables, alcohol and cigarette use was obtained. Data was analyzed using Epi Info 3.5.1.

Results:
A total of 246 students were interviewed with a mean age of 23 years. Majority were female 145(59%) and in the Medicine program 128(52%). Fifty three (21.5%) of the respondents were current shisha users, 84(34.1%) had ever used shisha in their lifetime and 11(4.5%) were current cigarette smokers. Majority 36(69%) smoked weekly and at entertainment spots 47(89%). Concurrent alcohol and cigarette use among current shisha users was 47(90%) and 8(15.4%) respectively. Factors associated with current shisha use were catholic faith (OR= 2.03; 95%CI 1.04,3.96), residence in a rented house (OR=2.65; 95%CI 1.25,5.61), alcohol use (OR=13.46; 95%CI 5.47-33.06) and family member who smokes shisha (OR= 6.43 95%CI 3.32-12.43).

Conclusions:
The use of shisha as an alternative form of tobacco is high among university students undertaking health professional courses. There is need for initiatives geared towards behavior change among these students to boost tobacco control efforts among the youth in Kenya.