Smoking is a major public health issue worldwide. The main objective of our work was to estimate the extent of smoking (hookah and cigarettes) among university students in Tunisia. This was a descriptive online cross-sectional survey of students at Tunis El Manar University in 2022. A total of 210 students were included in the study with an average age of 21.5 years. The prevalence of hookah use was 42.4% (CI95% [36.2 - 49.0]) with a significantly higher prevalence among men (p <10-3).Over a fifth (21.5%) thought hookah was less harmful than cigarettes and 21.2% had no intention of stopping hookah smoking. The prevalence of cigarette smoking was 31.9% (95% CI [25.7 - 38.6]) with a significantly higher prevalence among men (P<0.01). The mean Fagerstrom score was 2.6 ± 2.2.The prevalence of smoking among young students was alarmingly high. Interventions to raise awareness and reinforce existing anti-smoking policies are a priority.
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