Background: Waterpipe tobacco smoking (WTS) emerges as a new component of the global tobacco epidemic. Adolescents smoking waterpipe are susceptible to cigarette smoking, but limited research has characterized dual (cigarette plus waterpipe) users. The study objective is to determine the prevalence estimates of dual users to understand how “collision” of the two epidemics is evolving in the Arab countries.Methods: Data (n = 31,359; N = 6,109,572) were obtained from nationally representative Global Youth Tobacco Surveys (GYTSs) from 17 Arab countries. Current tobacco use was categorized into four groups—cigarette smoking only, WTS only, dual use, and never use. Weighted age-, sex-, and country-specific prevalence estimates along with 95% confidence intervals were reported.Results: Overall 3.0%, 6.1%, and 3.8% of youth were cigarette smokers only, WTS only, and dual users. Boys reported high prevalence estimates of cigarette smoking only (5.1% vs 1.1%), WTS only (7.4% vs 4.6%), and dual use (3.7% vs...