Bagher Pahlavanzadeh - Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyed Abolhassan Naghibi - Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
Rahman Berdi-Ozounidavaji - Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
Fatemeh Zarghami - Department of Health Education and Health Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
Shirin Shahbazi-Sighaldeh - Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Ali Mohammadinia - Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
Mahdieh Sadat Hosseini - Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
Kamal Mirkarimi - Health Management and Social Development Research Center AND Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
Amangholi Rahimi - Gonbad-e-Qabus Health Center, Golestan University of Medical Sciences, Gorgan, Iran
Mohammad Shoaib-Hamrah - Center for Rural Health, School of Health Sciences, University of Tasmania, Tasmania, Australia
Edwin Paul - Center for Rural Health, School of Health Sciences, University of Tasmania, Tasmania, Australia
Abdurrahman Charkazi - Environmental Health Research Center AND Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran

Background: Waterpipe tobacco smoking (WTS) has recently increased in Iran. There is no valid instrumentto measure the level of nicotine dependence among its consumers. This study was aimed to investigate thevalidity and reliability of the Lebanon Waterpipe Dependence Scale-۱۱ (LWDS-۱۱).Methods: A cross-sectional study was conducted in the year ۲۰۱۷ whereby ۳۶۷ waterpipe smokers wererecruited from Golestan Province of Iran. LWDS-۱۱ scale is composed of ۴ subscales: ۱) nicotine dependence,۲) negative reinforcement, ۳) psychological craving, and ۴) positive reinforcement. The validity of thequestionnaire was examined using construct validity. Reliability of this scale was examined using test-retestreliability and internal consistency.Findings: The four-factor model for LWDS [comparative fit index (CFI) = ۰.۹۸۵, Tucker-Lewis index(TLI) = ۰.۹۷۹, standardised root mean residual (SRMR) = ۰.۰۵۹, root mean square error of approximation(RMSEA) = ۰.۰۴۹ (۰.۰۳۱, ۰.۰۶۱)] demonstrated good fit to this data. Cronbach’s α was ۰.۸۲۵ for totalscale and it was ۰.۸۱۸, ۰.۷۴۶, ۰.۶۲۴, and ۰.۶۷۰ for each individual subscale. The test-retest reliability of thescale was ۰.۹۲۵.Conclusion: All goodness of fit indices (GFIs) represented a good fit of model. The LWDS-۱۱ scale had anappropriate remarkable validity and reliability for waterpipe consumers to measure the level of nicotinedependence and it appeared to be likely useful for utilizing in the clinical and epidemiological studies.

Waterpipe smoking, Nicotine, Tobacco, Iran