The Knowledge and Awareness about the Effect of Narguile Smoking on Male Reproductive Health and Fertility among College Students at University of Karbala

Abstract

Objective: This study evaluates medical students’ knowledge and awareness about narguile (hooka or shisha) smoking effects on male reproductive health.

Study Design: Descriptive cross-sectional study
Place and Duration of Study: This study was conducted at the General Medicine, Dentistry, and Pharmacy Colleges at University of Kerbala from 1st March 2025 to 1st November 2025.

Methods: A descriptive cross-sectional survey and included 102 male students. The smoking behaviors, knowledge of fertility risks and perceptions of awareness campaigns were assessed.

Results: 56.9% of included students were smokers and 27.5% were cigarette smokers. 76.5% of students were aware of hookah effect on male fertility. Only 52% were aware of its’ effect on reproductive hormones, and 57.8% knew that it would affect sperm quality. The peer factor had influenced 40.2% of the smokers, and 87.3% recommended awareness campaigns more; only 17.6% had consulted health care professionals.

Conclusion: As a sizeable number of students knew that hookah smoking reduces male fertility, however, the knowledge gap is considerably high with respect to its’ specific effect on male hormones and sperm quality. The high number of smokers among students and the peer pressure, as well as the belief that smoking hookah is safe, show the necessity of health education programs and smoking cessation programs at universities.