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In college, people try different things for the first time in an effort to find who they really are, and for women, smoking is not excluded from the list. 

According to a researchers from the The Miriam Hospital's Center for Behavioral and Preventive Medicine, nearly 25 percent of college women try smoking tobacco with a hookah, or water pipe, for the first time during their freshman year. 

The study was published online by Psychology of Addictive Behaviors. 

According to researchers, there may be a possible connection to alcohol and marijuana use. They found the more alcohol women consumed, the more likely they were to experiment with hookah smoking, while women who used marijuana engaged in hookah smoking more frequently than their peers.

Researchers surveyed 483 first-year female college students about their precollege hookah use. The women were also given 12 monthly online surveys about their experience with hookah smoking. Of the 343 participants who did not report precollege hookah use, 23 percent (79 students) tried hookah tobacco smoking during their first year of college.

An analysis revealed alcohol consumption predicted the likelihood of hookah use, while marijuana use and certain personality styles, such as a higher level of impulsivity and a strong tendency to compare oneself to others, predicted frequency of use.

Researchers say the findings are "troubling." Researchers say although many college students believe hookah smoking is safer than cigarettes, hookah use has been linked to many of the same diseases caused by cigarette smoking, including lung cancer, respiratory illness and periodontal disease. Hookah smoking rates are on par with those of cigarettes, increasingly dramatically among young adults over the last two decades. 

Lead author Robyn Fielder said the increased rates could become a major issue. 

"The popularity and social nature of hookah smoking, combined with the fact that college freshmen are more likely to experiment with risky behavior, could set the stage for a potential public health issue, given what we know about the health risks of hookah smoking," Fielder said. 

According to the American Lung Association, hookah smoking was originated in ancient Persia and India and is a highly social activity during which users smoke tobacco filtered through a water pipe. 

The tobacco mixtures used in the hookahs vary in composition, with some having flavorings and additives, such as candy and fruit flavors, that help disguise the harshness of the smoke. Hookah smokers are exposed to higher doses of nicotine compared to cigarettes, as well as carbon monoxide and a very high volume of smoke, which contains toxic and cancer-causing smoke particles.

Fielder says the findings corroborate prior research showing strong correlations between hookah and other substance use, but their research is the first to show that alcohol and marijuana use are prospectively related to hookah initiation.

"Youth tend to overestimate the extent to which their peers use substances, and because it's important to fit in with one's peers, this can lead to greater risk-taking," said Fielder. "Our research suggests prevention and intervention efforts should jointly target all substance use, including hookah, alcohol, marijuana and cigarettes, to optimize the public health impact."