title: Waterpipe smoking: construction and validation of the Lebanon Waterpipe Dependence Scale (LWDS-11).
abstract: Waterpipe smoking is becoming fashionable in Lebanon, but no studies have studied nicotine dependence related to waterpipe smoking. A score was constructed from 21 items and subsequently submitted to two factor analyses, which led to the extraction of four factors. Reliability and test-retest reproducibility were measured. Convergent construct validity and discriminant validity also were assessed for different smokers' samples. The Lebanon Waterpipe Dependence Scale-11 (LWDS-11) was composed of four subscales, the first representing nicotine dependence, the second negative reinforcement, the third psychological craving, and the fourth positive reinforcement. Internal consistency and test-retest reproducibility were adequate, and the subscales correlated adequately with measurements of nicotine metabolites, exhaled carbon monoxide levels, and the frequency of waterpipe smoking. The LWDS-11 discriminated between mild, moderate, and heavy waterpipe smokers, based on a threshold score of 10. Results were biologically and psychologically sound. This is the first scale to characterize waterpipe dependence. With further improvement and confirmation, it could become a useful clinical and epidemiological tool.
authors.affiliation: Lebanese University, Faculty of Public Health II, Fanar, Lebanon. pascalesalameh@yahoo.com
authors.forename: Pascale
authors.initials: P
authors.lastname: Salameh
authors.forename: Mirna
authors.initials: M
authors.lastname: Waked
authors.forename: Zeina
authors.initials: Z
authors.lastname: Aoun
mesh_terms: D016739:Behavior, Addictive / Q000175:diagnosis* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007861:Lebanon; D008297:Male; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012907:Smoking; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000145:classification / Q000175:diagnosis*