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Construction and validation of the water pipe harm perception scale (WHPS-6) among the Lebanese population

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Abstract

Compared to cigarettes, water pipe is misconceived as being less addictive and containing less nicotine. This study aimed at constructing and validating a water pipe harm perception scale among a sample of the Lebanese population. A cross-sectional study was carried out between February and December 2017 using a proportionate cluster sample of Lebanese adults (492 participants). The water pipe harm scale items converged over a solution of one factor that had an eigenvalue over 1, explaining a total of 66.75% of the variance. The model used was adequate (Kaiser-Meyer-Olkin measure = 0.862 and Bartlett’s test of sphericity p < 0.001). The reliability of all scale’s items was high (Cronbach’s alpha = 0.896). Higher cigarette dependence (LCD score) was significantly associated with higher water pipe harm perception scores, whereas exclusive water pipe smokers (Beta = − 2.142) and dual water pipe and cigarette smokers (Beta = −2.142) compared to nonsmokers, as well as those with high monthly income compared to a low one (Beta = −0.614), were significantly associated with lower water pipe harm perception scores. We constructed the first scale for measuring water pipe harm perception: the WHPS-6. The results of the present study demonstrate that the WHPS-6 can be used in clinical practice and research to assess the harm perception induced by water pipe smoking.

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References

  • Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J (2010) The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol 39:834–857

    Article  Google Scholar 

  • Akl EA, Jawad M, Lam WY, Co CN, Obeid R, Irani J (2013) Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J 10:12

    Article  Google Scholar 

  • Akl EA, Ward KD, Bteddini D, Khaliel R, Alexander AC, Lotfi T, Alaouie H, Afifi RA (2015) The allure of the waterpipe: a narrative review of factors affecting the epidemic rise in waterpipe smoking among young persons globally. Tob Control 24(Suppl 1):i13–i21

    Article  Google Scholar 

  • Aljarrah K, Ababneh ZQ, Al-Delaimy WK (2009) Perceptions of hookah smoking harmfulness: predictors and characteristics among current hookah users. Tob Induc Dis 5:16

    Article  Google Scholar 

  • Anjum Q, Ahmed F, Ashfaq T (2008) Knowledge, attitude and perception of water pipe smoking (Shisha) among adolescents aged 14-19 years. JPMA 58:312

    Google Scholar 

  • Barnett TE, Shensa A, Kim KH, Cook RL, Nuzzo E, Primack BA (2013) The predictive utility of attitudes toward hookah tobacco smoking. Am J Health Behav 37:433–439

    Article  Google Scholar 

  • Benowitz NL (2018) Cardiovascular effects of hookah smoking: potential implications for cardiovascular risk. Nicotine Tob Res 1:11

    Google Scholar 

  • Comrey A, Lee H (1992) A first course in factor analysis. Lawrence Eribaum Associates. Inc., Publishers, Hillsdale

    Google Scholar 

  • Control CfD, Prevention (1994) Cigarette smoking among adults--United States, 1992, and changes in the definition of current cigarette smoking. MMWR Morb Mortal Wkly Rep 43:342

    Google Scholar 

  • Eissenberg T, Ward KD, Smith-Simone S, Maziak W (2008) Waterpipe tobacco smoking on a U.S. college campus: prevalence and correlates. J Adolesc Health 42:526–529

    Article  Google Scholar 

  • El-Zaatari ZM, Chami HA, Zaatari GS (2015a) Health effects associated with waterpipe smoking. Tob Control 24(Suppl 1):i31–i43

    Article  Google Scholar 

  • El-Zaatari ZM, Chami HA, Zaatari GS (2015b) Health effects associated with waterpipe smoking. Tob Control 24:i31–i43

    Article  Google Scholar 

  • Ghafouri N, Hirsch JD, Heydari G, Morello CM, Kuo GM, Singh RF (2011) Waterpipe smoking among health sciences university students in Iran: perceptions, practices and patterns of use. BMC Res Notes 4:496

    Article  Google Scholar 

  • Grant A, Morrison R, Dockrell MJ (2014) Prevalence of waterpipe (Shisha, Narghille, Hookah) use among adults in Great Britain and factors associated with waterpipe use: data from cross-sectional online surveys in 2012 and 2013. Nicotine Tob Res 16:931–938

    Article  Google Scholar 

  • Grekin ER, Ayna D (2008) Argileh use among college students in the United States: an emerging trend. J Stud Alcohol Drugs 69:472–475

    Article  Google Scholar 

  • Grekin ER, Ayna D (2012) Waterpipe smoking among college students in the United States: a review of the literature. J Am Coll Heal 60:244–249

    Article  Google Scholar 

  • Griffiths MA, Ford EW (2014) Hookah smoking: behaviors and beliefs among young consumers in the United States. Soc Work Public Health 29:17–26

    Article  Google Scholar 

  • Hallit S, Raherison C, Waked M, Salameh P (2017) Association between caregiver exposure to toxics during pregnancy and childhood-onset asthma: a case-control study. Iran J Allergy Asthma Immunol 16:488–500

    Google Scholar 

  • Hallit S, Salameh P (2017) Exposure to toxics during pregnancy and childhood and asthma in children: a pilot study. J Epidemiol Glob Health 7:147–154

    Article  Google Scholar 

  • Heinz AJ, Giedgowd GE, Crane NA, Veilleux JC, Conrad M, Braun AR, Olejarska NA, Kassel JD (2013a) A comprehensive examination of hookah smoking in college students: use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use. Addict Behav 38:2751–2760

    Article  Google Scholar 

  • Heinz AJ, Giedgowd GE, Crane NA, Veilleux JC, Conrad M, Braun AR, Olejarska NA, Kassel JD (2013b) A comprehensive examination of hookah smoking in college students: use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use. Addict Behav 38:2751–2760

    Article  Google Scholar 

  • Holtzman AL, Babinski D, Merlo LJ (2013) Knowledge and attitudes toward hookah usage among university students. J Am Coll Heal 61:362–370

    Article  Google Scholar 

  • Husain H, Al-Fadhli F, Al-Olaimi F, Al-Duraie A, Qureshi A, Al-Kandari W, Mitra AK (2016) Is smoking shisha safer than cigarettes: comparison of health effects of shisha and cigarette smoking among young adults in Kuwait. Med Princ Pract 25:117–122

    Article  Google Scholar 

  • Jawad M, Jawad S, Mehdi A, Sardar A, Jawad AM, Hamilton FL (2013) A qualitative analysis among regular waterpipe tobacco smokers in London universities. Int J Tuberc Lung Dis 17:1364–1369

    Article  CAS  Google Scholar 

  • Jawad M, El Kadi L, Mugharbil S, Nakkash R (2015) Waterpipe tobacco smoking legislation and policy enactment: a global analysis. Tob Control 24(Suppl 1):i60–i65

    Article  Google Scholar 

  • Jawad M, Power G (2016) Prevalence, correlates and patterns of waterpipe smoking among secondary school students in Southeast London: a cross-sectional study. BMC Public Health 16:108

    Article  Google Scholar 

  • Jradi H, Wewers ME, Pirie PR, Binkley PF, Ferketich K (2013) Cigarette and waterpipe smoking associated knowledge and behaviour among medical students in Lebanon. East Mediterr Health J 19:861–868

    Article  CAS  Google Scholar 

  • Layoun N, Hallit S, Waked M, Aoun Bacha Z, Leveque A, Dramaix M, Salameh P (2018) Predictors of past quit attempts and length of abstinence among Waterpipe smokers in Lebanon. J Clin Diagn Res 12(10):4–8

  • Marsh HW, Hau K-T, Wen Z (2004) In search of golden rules: comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler's (1999) findings. Struct Equ Model 11:320–341

    Article  Google Scholar 

  • Maziak W, Rastam S, Eissenberg T, Asfar T, Hammal F, Bachir ME, Fouad MF, Ward KD (2004) Gender and smoking status-based analysis of views regarding waterpipe and cigarette smoking in Aleppo, Syria. Prev Med 38:479–484

    Article  CAS  Google Scholar 

  • Maziak W (2008) The waterpipe: time for action. Addiction 103:1763–1767

    Article  Google Scholar 

  • Maziak W (2011) The global epidemic of waterpipe smoking. Addict Behav 36:1–5

    Article  Google Scholar 

  • Maziak W (2013) The waterpipe: an emerging global risk for cancer. Cancer Epidemiol 37:1–4

    Article  Google Scholar 

  • Mostafa A, Mohammed HT (2017) Graphic health warnings and their best position on waterpipes: a cross-sectional survey of expert and public opinion. Tob Prev Cessat 3:116

    Article  Google Scholar 

  • Rachidi S, Awada S, Al-Hajje A, Bawab W, Zein S, Saleh N, Salameh P (2013) Risky substance exposure during pregnancy: a pilot study from Lebanese mothers. Drug Healthc Patient Saf 5:123–131

    Google Scholar 

  • Salameh P, Waked M, Aoun Z (2008a) Waterpipe smoking: construction and validation of the Lebanon Waterpipe dependence scale (LWDS-11). Nicotine Tob Res 10:149–158

    Article  Google Scholar 

  • Salameh P, Waked M, Aoun Z (2008b) Waterpipe smoking: construction and validation of the Lebanon Waterpipe dependence scale (LWDS-11). Nicotine Tob Res 10:149–158

    Article  Google Scholar 

  • Salameh P, Khayat G, Waked M (2014) The Lebanese cigarette dependence (LCD) score: a comprehensive tool for cigarette dependence assessment. Int J Behav Med 21:385–393

    Article  CAS  Google Scholar 

  • Shihadeh AL, Eissenberg TE (2011) Significance of smoking machine toxicant yields to blood-level exposure in water pipe tobacco smokers. Cancer Epidemiol Biomark Prev 20:2457–2460

    Article  CAS  Google Scholar 

  • Sidani JE, Shensa A, Barnett TE, Cook RL, Primack BA (2014) Knowledge, attitudes, and normative beliefs as predictors of hookah smoking initiation: a longitudinal study of university students. Nicotine Tob Res 16:647–654

    Article  Google Scholar 

  • TREND AED (2007) American Lung Association. Tobacco policy trend alert: An emerging deadly trend: Waterpipe tpbacco use. Available from:https://www.slati.lungusa.org/alerts/Trend%20Alert_Waterpipes.pdf

  • Waked M, Salameh P (2015) Maternal waterpipe smoke exposure and the risk of asthma and allergic diseases in childhood: a post hoc analysis. Int J Occup Med Environ Health 28:147–156

    Article  Google Scholar 

  • Ward KD, Eissenberg T, Rastam S, Asfar T, Mzayek F, Fouad MF, Hammal F, Mock J, Maziak W (2006) The tobacco epidemic in Syria. Tob Control 15(Suppl 1):i24–i29

    Article  Google Scholar 

  • Wilson D, Wakefield M, Owen N, Roberts L (1992) Characteristics of heavy smokers. Prev Med 21:311–319

    Article  CAS  Google Scholar 

  • World Health Organization (2017) WHO report on the global tobacco epidemic, 2017: monitoring tobacco use and prevention policies. World Health Organization. https://apps.who.int/iris/handle/10665/255874

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Author notes

  1. Souheil Hallit, Chadia Haddad and Sandrella Bou Malhab contributed equally to this work.

Authors and Affiliations

  1. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon

    Souheil Hallit

  2. INSPECT-LB:, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon

    Souheil Hallit

  3. Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon

    Chadia Haddad

  4. Ecole Doctorale des Sciences et Technologie, Lebanese University, Hadat, Lebanon

    Sandrella Bou Malhab

  5. Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de Qualité des Médicaments (LPCQM), Pôle Technologie- Santé (PTS) Faculté de Pharmacie, Beirut, Lebanon

    Sandrella Bou Malhab & Lydia Rabbaa Khabbaz

  6. Ecole Doctorale Sciences et Santé, Université Saint-Joseph, Rue de Damas – Beyrouth, Lebanon

    Sandrella Bou Malhab

  7. Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon

    Lydia Rabbaa Khabbaz

  8. Faculty of Pharmacy, Lebanese University, Hadat, Lebanon

    Pascale Salameh

  9. Faculty of Medicine, Lebanese University, Hadat, Lebanon

    Pascale Salameh

Authors
  1. Souheil Hallit
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  2. Chadia Haddad
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  3. Sandrella Bou Malhab
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  4. Lydia Rabbaa Khabbaz
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  5. Pascale Salameh
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Correspondence to Souheil Hallit.

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Hallit, S., Haddad, C., Bou Malhab, S. et al. Construction and validation of the water pipe harm perception scale (WHPS-6) among the Lebanese population. Environ Sci Pollut Res 27, 3440–3448 (2020). https://doi.org/10.1007/s11356-019-07247-8

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  • DOI: https://doi.org/10.1007/s11356-019-07247-8

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