Background:
The prevalence of waterpipe tobacco smoking has been steadily increasing worldwide. Whereas cigarette smoking dependence and withdrawal scales have been developed and used extensively, this is not the case for waterpipe smoking. Our objective was to explore correlates of the Mood and Physical Symptoms Scale (MPSS), a withdrawal scale, and smoking dependency using the Lebanon Waterpipe Dependency Scale (LWDS-11) among waterpipe smokers in South-East Asia.

Methods:
MPSS and LWDS-11 were translated for use in a sample of Pakistani adults taking part in a double-blind, placebo-controlled randomised trial evaluating the efficacy of varenicline for abstinence among waterpipe smokers. Participants included adults using waterpipe on a daily basis who were willing to quit.
A total of 510 participants were randomised. The scales were administered at baseline and at week 25, the last follow-up that was just completed on May 23, 2017.

Results:
Among the 510 trial participants, 249 (49%) participants used only waterpipe for tobacco smoking whereas the other 261 (51%) used cigarettes as well. At baseline and week 25, respectively, the MPSS was completed by 501 (98.2%) and 475 (93%), whereas the LWDS-11 was completed by 505 (99%) and 475 (93%).

Conclusions:
Complete findings will be reported at 'The 17th World conference on Tobacco or Health' in Cape Town for the first application of LWDS-11 and MPSS Scale among waterpipe tobacco smokers in Pakistan. The application of these scales in Pakistan will inform whether they can be used in practice to assess the extent of dependency and withdrawal symptoms in South-East Asia.