title: Waterpipe tobacco dependence in U.K. male adult residents: a cross-sectional study.
abstract: BACKGROUND
  The prevalence of waterpipe tobacco smoking (WPTS) is increasing worldwide. The aims of this study were (a) to evaluate the psychometric properties of the Lebanon Waterpipe Dependence Scale (LWDS-11), and (b) to assess, estimate, and identify factors associated with waterpipe tobacco dependence symptoms among U.K. male adult resident waterpipe tobacco smokers.
  
  
  METHODS
  A total of 180 waterpipe tobacco smokers were recruited during random visits to 7 outlets serving waterpipe tobacco. Data were collected via face-to-face interviews using the WPTS module of the Global Adult Tobacco Survey and the LWDS-11. Descriptive statistics, exploratory psychometric, univariate, and Poisson regression analysis were employed.
  
  
  RESULTS
  Participants' M/SD age was 29.46/±9.41 years, Arabic ethnicity accounted for 58.3%, and 53.9% had completed more than secondary education. Psychometric analyses for the LWDS-10, after removing 1 item from the generic scale, revealed Cronbach's alpha coefficient = 0.74. About 47% of the sample demonstrated waterpipe tobacco dependence. Being Arab (p = .040, OR = 2.63, 95% CI = 1.05-6.62), smoking waterpipe daily in the past (p = .003, OR = 2.13, 95% CI = 1.30-3.49), and an increase in length in the last session of WPTS (p = .044, OR = 1.15, 95% CI = 1.00-1.32) were identified as risk factors for waterpipe tobacco dependence.
  
  
  CONCLUSIONS
  This study demonstrated the potential of LWDS-11 and revealed 2 domains: positive and negative reinforcement and physiological dependence. Results indicated that waterpipe tobacco smokers in the United Kingdom demonstrated tobacco dependence symptoms, which were associated with socio-behavioral factors. Generalizability of these findings and their implications in public health are yet to be investigated.
authors.affiliation: Dental Public Health, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Institute of Dentistry, London, UK;
authors.forename: Saba
authors.initials: S
authors.lastname: Kassim
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Bakri
authors.forename: Mustafa
authors.initials: M
authors.lastname: Al'Absi
authors.forename: Ray
authors.initials: R
authors.lastname: Croucher
mesh_terms: D000328:Adult; D018912:Arabs; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D011594:Psychometrics; D012907:Smoking / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology*; D006113:United Kingdom / Q000208:ethnology