Waterpipe smoking is becoming fashionable in Lebanon, but no studies have studied nicotine dependence related to waterpipe smoking. A score was constructed from 21 items and subsequently submitted to two factor analyses, which led to the extraction of four factors. Reliability and test-retest reproducibility were measured. Convergent construct validity and discriminant validity also were assessed for different smokers' samples. The Lebanon Waterpipe Dependence Scale-11 (LWDS-11) was composed of four subscales, the first representing nicotine dependence, the second negative reinforcement, the third psychological craving, and the fourth positive reinforcement. Internal consistency and test-retest reproducibility were adequate, and the subscales correlated adequately with measurements of nicotine metabolites, exhaled carbon monoxide levels, and the frequency of waterpipe smoking. The LWDS-11 discriminated between mild, moderate, and heavy waterpipe smokers, based on a threshold score of 10. Results were biologically and psychologically sound. This is the first scale to characterize waterpipe dependence. With further improvement and confirmation, it could become a useful clinical and epidemiological tool.

Fumeurs de narguilé (pipe à eau) au Liban : une étude pilote RÉSUMÉ Nous avons réalisé une étude comparative afin d'évaluer les caractéristiques démographiques et sociales des fumeurs de narguilé, le lien avec la consommation de cigarettes et les maladies respiratoires chroniques, et le type de dépendance de quatre groupes : des sujets fumant uniquement le narguilé, des sujets fumant uniquement des cigarettes, des sujets fumant les deux et des sujets ne fumant pas du tout. La consommation de cigarettes était significativement plus élevée du point de vue statistique chez les sujets qui fumaient le narguilé que chez les autres ; 36,5 % des sujets fumant uniquement le narguilé en fumaient au moins sept par semaine. On signalait davantage de maladies respiratoires chroniques et de bronchite chronique chez les sujets fumant uniquement le narguilé que chez les non-fumeurs. La consommation de narguilé semble être un facteur de risque de maladie respiratoire chronique aussi important que la consommation de cigarettes.ABSTRACT We carried out a comparative study to assess the demographic and social characteristics of water pipe (WP) smokers, the association with cigarette smoking and chronic respiratory diseases and the dependence profile on 4 groups: exclusive WP smokers, exclusive cigarette smokers, mixed smokers and absolute non-smokers. Cigarette smoking was statistically significantly higher in WP smokers than non-WP smokers; 36.5% of exclusive WP smokers smoked ≥ 7 WPs/week. Chronic respiratory disease and chronic bronchitis were reported more frequently in exclusive WP smokers than absolute non-smokers. WP smoking seems to be as great a risk factor as cigarette smoking for chronic respiratory disease. ‫ارتيادية‬ ‫دراسة‬ ‫لبنان:‬ ‫يف‬ ‫(النارجيلة)‬ ‫الشيشة‬ ‫مدخنو‬‫عون‬ ‫زينة‬ ‫سالمة،‬ ‫باسكال‬ ‫واكد،‬ ‫مرينا‬ ‫(النرجيلة)،‬ ‫الشيشة‬ ‫ملدخني‬ ‫واالجتامعية‬ ‫الديمغرافية‬ ‫اخلصائص‬ ‫لتقيـيم‬ ‫مقارنة‬ ‫دراسة‬ ‫الباحثات‬ ‫أجرت‬ ‫اخلالصـة:‬ ‫جمموعات‬ ‫ألربع‬ ‫االعتامد‬ ‫مرتسم‬ ‫نَ‬ ْ

Introduction: No standardized sedation protocol is available for flexible bronchoscopy (FB).

Benign substernal goitres usually extend into the upper anterior mediastinum and are easily extractable through a cervical approach. Very infrequently these tumours extend into the thoracic cavity causing compression of mediastinal structures. The authors report a case of pulmonary hypertension and severe cardiac failure secondary to a long-standing substernal goitre, and support the surgical management of this disease.