Hookah smoking is a form of tobacco use that is growing in popularity in the United States. College-aged students, who are known to experiment with multiple forms of tobacco, are particularly vulnerable to this tobacco trend. There is a common misconception that hookah smoking is not as dangerous as other forms of tobacco, which may help explain the recent uptake of hookah, especially among young adults. However, recent research suggests that, much like cigarette smoking, hookah smoking is associated with adverse health effects including various cancers and respiratory illnesses and that hookah smoking may be as addictive as cigarette smoking. The relationship between perceptions of hookah harm and addictiveness and demographic and tobacco use habits remains unclear in the young adult and college student population. Therefore, the purpose of the current study was to examine factors associated with perceived harm and perceived addictiveness of hookah smoking among young adult college attenders. This information will be useful when developing prevention programs for hookah use aimed at decreasing misconceptions and increasing the awareness of health risks surrounding this type of tobacco use with the ultimate goal of reducing nicotine addiction in an at-risk population.