Researchers from the Miriam Hospital's Center for Behavioural and Preventive Medicine found the more alcohol girls consumed, the more likely they were to try the hookah, which originated from India and Persia.
Women who used marijuana engaged in hookah smoking more frequently than their peers, according to the journal of Psychology of Addictive Behaviours.
The phenomenon was mostly prevalent among the first year college students.
Many of them also mistakenly believe that hookah is safer than cigarettes, even though its use has been linked to many of the same diseases caused by cigarette smoking, including lung cancer, respiratory illness and periodontal disease.
Hookah smoking is a social activity during which users smoke tobacco filtered through a water pipe. Their tobacco mixtures vary in composition, with some having candy and fruit flavours to help mask the smoke's harshness, according to a Miriam Hospital statement.
"The popularity and social nature of hookah smoking, combined with the fact that college freshmen are more likely to experiment with risky behaviour, could set the stage for a potential public health issue, given what we know about the health risks of hookah smoking," said Robyn L Fielder, from The Miriam Hospital
