Study participants were adolescent and young adult women who had the experience of WTS and lived in Isfahan and Hamadan, Iran. Inclusion criteria were being aged 13–30 years and agreement to participate in the study and to share WTS-related experiences. However, to identify the diverse aspects of the WTS among adolescents and young adult women and increase the strength and consistency of the data, people who were somehow connected with this the issue are also eligible to participate in the interviews. Other participants included family members, friends, WTS providers, teachers, and smoking control staffs. Participants were selected with maximum variation from different educational levels, employment status, ethnic groups, and geographic areas in Iran. Sampling was done through both purposeful and snowball sampling and was continued up to data saturation. Less than 10% of eligible participants who had been invited to the study refused participation.

Data were collected via in-depth semi-structured interviews opened using questions on participants’ demographic characteristics such as age, educational level, marital status, occupation, age at first WTS, family history of tobacco use, and WTS pattern. Then, interviews were continued using general open-ended questions about WTS such as “May you please explain about your WTS?” “What factors made you to smoke tobacco using waterpipe?” “What factors would make you to continue smoking tobacco using waterpipe?” Based on participants’ responses to such questions, probing questions were asked to collect more in-depth data. Examples of probing questions were, “May you please explain more about this?” and “What do you mean by this?”. Moreover, based on the data extracted from the initial interviews, questions about sociocultural factors contributing to WTS were used in later interviews. Examples of these questions were as follows: “What social factors can affect your WTS?” “What is your opinion about the effects of advertisements for WTS?” Questions used for other participants were different from those used for main participants. For instance, a question for WTS providers and sellers was as follows: “What measures do you take to attract more female customers and tempt them into WTS?” while two questions for smoking control staff were as follows: “What are the guidelines for controlling WTS” and “How well are these guidelines being followed?”Interviews were conducted at participants’ preferred time and place, including recreational facilities, hookah bars, workplaces, and dormitories. The length of interviews ranged from thirty to 65 minutes. Although the social stigma associated with women’s WTS is less severe than the stigma associated with their cigarette smoking, some women may prefer not to openly talk about their WTS (‏ Baheiraei et al., 2015c). Moreover, some participants refused talking about their WTS in focus group discussions due to personal preferences or their husbands’ or parents’ disagreement. Consequently, all interviews were held in-person by a female interviewer (i.e. the first authors) in order to gain the participants’ trust. Forty participants provided consent for recording their interviews singed a digital voice recorder, while two participants refused such consent and hence only their interviews were only documented.

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