BACKGROUND: Hookah smoking has become increasingly common among young adults in the United States. College students engage in hookah smoking due to the increased exposure and popularity of hookah bars surrounding college campuses. There is limited information on parental perceptions of college students' hookah smoking. METHODS: Forty-four telephone interviews were recorded and transcribed with parents of college students using a structured interview guide to explore perceptions, beliefs, behaviors, and information seeking regarding hookah smoking. The transcripts were coded and categorized using NVivo software, and emerging themes were uncovered. RESULTS: Parents were lacking in awareness and knowledge of hookah smoking and health consequences. They often equated hookah smoking with bong use from their own college experiences. Although negative effects were equated with cigarette smoking, some parents reported beneficial effects of hookah smoking. Some parents disapproved of their college students smoking hookah, whereas others felt it was important that they try new behaviors in moderation. The varying responses indicate that parents were not receiving consistent messages, if any, regarding hookah tobacco smoking. CONCLUSIONS: Informing parents of current novel risky behaviors such as hookah smoking is necessary as they are trusted sources of information for young adult children. Delivering information and educational messages to both students and their parents may be a worthy approach when developing campaigns to deter hookah smoking. There is a need to deter hookah smoking, as it remains a public health concern.