Introduction: Due to the growing trend of hookan smoking as one of the serious threats to health and given that the risk of hookan smoking has not been explained well in the society, this plan aimed at determining predictive factors of water pipe smoking among pre-university students in Yazd.  

Methods: The analytical-descriptive study was done by using the cross-sectional method on 304 pre- university students in the city of Yazd. Sampling was conducted by the multi-stage cluster method. The data were collected by the GYTS questionnaire standard questionnaire of risk and protecting factors of smoking. Finally, the obtained data were analyzed by SPSS 21 software.

Results: The findings of this study showed in total 219 (31.1%) of the students   used hookah. Among the demographic variables, gender, student educational status, fathers’ education, household income, rate of tendency to hookah smoking had a significant relationship with hookah consumption. And, among variables related to individual, family and social risk factors, negative student attitude, sensation seeking, sensitivity to anxiety, anxiety disorder and, irregularities social environmental and impaired psychological school environment were considered as the predicting factors of hookah smoking.

Conclusion: The gained results can contribute to solve the current challenge of the addiction to the smoking through determining the target population in required interventions and future planning.