Background: Tobacco use is a significant and controllable risk factor for the spread of diseases, as well as a rise in morbidity and mortality, which leads to early death. Because of its popularity, the use of this substance is on the rise among children and adolescents. Aim: The aim of this study is to understand stages of change for hookah smoking among high school male students. Methodology: Part of the study was an experimental randomized controlled trial used to guide this study. The study was carried out at Tuz High School for males in Tuz Khurmatu District, Salah-Aldeen Governorate. The study included a simple random sample of 144 high school students. The study instrument includes students’ sociodemographic data. It also includes the Stages of Change Scale for Hookah Smoking, The Processes of Change Scale for Hookah Smoking, The Self-Efficacy/ Temptation Scale for Hookah Smoking, and The Decisional Balance Scale for Hookah Smoking. Data were collected using a self-reported method for the period from November 1st, 2021 to March 31th, 2022. Data were analyzed using the statistical package for social science (SPSS) for Windows, version 26. Results: There are significant differences in the values of the Processes of Change of hookah smoking over time for participants both in the study and control groups (F = 90.973, df = 2, p < .01 vs. F = 32.346, df = 2, p < .01). Conclusion: The lower the Stage of Change, the poorer the Self-Efficacy for hookah smoking cessation. In posttest II, the lower the Stage of Change, the more the used Processes of Change for hookah smoking cessation. The higher the Stages of Change, the greater the Self-Efficacy and Decisional Balance for hookah smoking cessation. Keywords: Hookah Smoking, High School Male Students