Evidence map›Paper›PMID 40604635›Full record

ArticleBMC public health2025

Development and validation of a questionnaire to assess women's hookah smoking: insights from a multi-stage study.

Nahid Shahabi, Azin Alavi, Shirin Shahbazi Sighaldeh, Sara Dadipoor, Shokrollah Mohseni, Hadi Eshaghi Sani Kakhaki, Ziyad Ben Talebh, Ebbie Kalan

Abstract readValidation Study
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. From Menthol Cigarettes to Flavored Hookah: The Urgent Need for Stronger Policies.Iranian journal of psychiatry and behavioral sciences · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nahid ShahabiSocial Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Azin AlaviTobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Shirin Shahbazi SighaldehMidwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran Universities of Medical Sciences, Tehran, Iran.
Sara DadipoorTobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. mdadipoor@yahoo.com.
Shokrollah MohseniSocial Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Hadi Eshaghi Sani KakhakiTobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. dresani@yahoo.com.
Ziyad Ben TalebhDepartment of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA.
Ebbie KalanDepartment of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland (MD), USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background of studyHookah smoking is a major concern worldwide, especially in Eastern Mediterranean countries. In this study, we aimed to develop and psychometrically test the factors underlying hookah smoking among women.

methodsWe conducted both qualitative and quantitative phases between 2019 and 2022. The study sample comprised women who smoked hookah and were visiting health centers in Bandar Abbas. The primary questionnaire items were developed based on the findings from the qualitative phase of the study. The validity of the questionnaire was tested using the item impact, content validity ratio (CVR), content validity index (CVI), and face validity. A total of 485 subjects completed the questionnaire for an exploratory factor analysis (EFA) and 485 subjects did so for a confirmatory factor analysis (CFA).

resultsIn the qualitative phase, 97 items were generated to enter the psychometric phase. Twelve items were removed based on the content validity results and six were removed in the face validity phase. In the EFA, 16 items were removed with factor loadings less than 0.3, and 81 items were loaded on 16 factors. CFA results of the 16-factor structure of the questionnaire included socio-economic deficiencies, role of advertisement and education, availability, fun and entertainment, hookah smoking in family and relatives, search for peace, others’ attention and approval, physical/mental dependence, color, flavor and sound of hookah, happy environment of coffee shops, pleasant experience of the first puff of hookah smoking, more acceptability of hookah smoking in society (vs. cigarettes), false beliefs, low self-efficacy, peer pressure, and family tendencies.

conclusionThis study provides a robust, reliable, and valid tool to identify the complex social, psychological, and environmental factors driving hookah smoking among women in Iran. The findings underscore the urgent need for tailored, multi-pronged public health interventions to curb this emerging global health threat.

Indexed as

Water Pipe SmokingAdultFactor Analysis, StatisticalFemaleHumansIranMiddle AgedPsychometricsReproducibility of ResultsSurveys and QuestionnairesYoung AdultFactor analysisHookahPsychometricsTobacco

Identifiers

PMID40604635
PMCPMC12220748

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.