Background: Water pipe smoking is increasing in Eastern Mediterranean Region. The

objective of this study was to investigate any relationship between water pipe smoking and health-related quality of life in the general population of Bandar Abbas, Iran. Methods: Using a multistage sampling method, a random sample of 1675 individuals aged 15 years and over was studied from June through July 2007. All eligible participants were interviewed using the Short Form Health Survey (SF-36) questionnaire and a short questionnaire containing items regarding socio-demographic characteristics and water pipe smoking status. To compare SF-36 scores between water pipe smokers and nonsmokers, t-test was performed. In addition, multiple logistic regression analysis was used to determine the influence of water pipe smoking on SF-36 scores after adjusting for other independent variables. Results: In all, 1675 individuals were studied. The mean age of the respondents was 42.1 (SD=16.5) years. One hundred and seventy-two participants (10.4%) were water pipe smokers. There were statistically significant differences between water pipe smokers and nonsmokers on all scales except for role emotional (P<0.001). Logistic regression analysis showed that using water pipe was a risk factor for decreasing Physical Component Summary and Mental Component Summary scores [OR (95 % CI): 2.15 (1.56 – 2.96), P<0.01; and OR (95 % CI): 1.88 (1.36 – 2.60), P<0.01, respectively]. Conclusion: The study findings indicated that people who smoked water pipe carried a higher risk for poorer health-related quality of life