BackgroundHookah or waterpipe smoking use is a developing trend in the many populations, especially among the young age group. Hookah users are exposed to many of the same toxic compounds or by-products as cigarette users with a higher level of harmful effects.Aim of the studyTo assess frequency, knowledge, attitude health behavior toward the risks and complication of cigarettes smoking and hookah in particular of Al-Kindy medical students.Materials and methodsA cross-sectional study was conducted from December 2022 to April 2023 to assess frequency of Hookah smoking among 507 medical students at Al-Kindy Medical College. An online questionnaire by Google forms was used to collect the data.ResultsThe total participants students were 507 who studied at Al-kindy College of Medicine in different stages. Males were constituted 63.1% and the rest were females (36.9%). Regarding smoking habit, 31.95% (162) of them were smoker and the rest 68.05% (345) were not smoker(p = 0.000). Most of them had mixed type of smoking (cigar, hookah, and vape) (14.19%). (0.000) that it had an effect on general health (46.1%), lung (68.8%), larynx (67.1%), heart, blood pressure, diabetes but not bladder, stomach, COVID-19 transmission. There is a significant increase (63.5%) (p = 0.000) regarding their attitude that hookah had a significant amount of tobacco, no benefit of fruity flavors (62.3%), and no relaxation effect (90.53%).ConclusionsThere is a significant decrease in smoking habits among medical students due to their knowledge of its negative effects on health.