Evaluation of the Psychometric Properties of the Lebanon Waterpipe Dependence Scale in a Sample of Iranian Waterpipe Smokers

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-11 (LWDS-11).

A cross-sectional study was conducted in the year 2017 whereby 367 waterpipe smokers wererecruited from Golestan Province of Iran. LWDS-11 scale is composed of 4 subscales: 1) nicotine dependence,2) negative reinforcement, 3) psychological craving, and 4) positive reinforcement. The validity of thequestionnaire was examined using construct validity. Reliability of this scale was examined using test-retestreliability and internal consistency.

The four-factor model for LWDS [comparative fit index (CFI) = 0.985, Tucker-Lewis index(TLI) = 0.979, standardised root mean residual (SRMR) = 0.059, root mean square error of approximation(RMSEA) = 0.049 (0.031, 0.061)] demonstrated good fit to this data. Cronbach’s α was 0.825 for totalscale and it was 0.818, 0.746, 0.624, and 0.670 for each individual subscale. The test-retest reliability of thescale was 0.925.

All goodness of fit indices (GFIs) represented a good fit of model. The LWDS-11 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.