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This study was the first to apply the LWDS-11 to non-Arabic-speaking sample, and it highlights the need for further refinement of measures of dependence in waterpipe tobacco smokers that are generalisable and usable across cultures.90 As noted elsewhere,91 there is a growing need for waterpipe-specific measures of dependence that are validated for use in other populations where WTS is common.92 One article explicitly discussed nicotine/tobacco dependence and WTS without reference to the LWDS-11.32 Here, two instruments commonly used to assess dependence in tobacco cigarette smokers, the Fagerstrm Test for Nicotine Dependence (FTND;93) and the negative affect, addiction and stimulation subscales of the Horn-Waingrow Reasons for Smoking (RFS;94) scale were modified by substituting the word shisha for cigarette as necessary.32 One hundred and fifty-four Egyptian men who were exclusive waterpipe smokers responded to the modified instruments that were administered via interview

The longer cigarette smoke lingers, the deeper it penetrates, making it harder to remove

Saliva testing provides a convenient, non-invasive way to detect both nicotine and cotinine, making it especially useful for employment screenings and smoking cessation programs

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Then, when it's my turn to talk, the lights go down and it's dark for five or six seconds