en Biostatistics and Epidemiology Biostatistics and Epidemiology Original Research Original Research <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">People with waterpipe tobacco smoking (WTS) seem to be more at risk for the serious complications of coronavirus disease 2019 (COVID-19). This study aimed at assessing the behavioral intention (BI) of WTS by women in the COVID-19 pandemic and its contributing factors.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> This cross-sectional descriptive-correlational study was conducted in 2020 (ie, during the COVID-19 pandemic). Participants were 300 women randomly selected through multistage sampling from comprehensive healthcare centers in Khorramabad, Iran. Data collection instrument was a 42-item questionnaire with 4 main subscales, namely knowledge, attitude, differential association, and BI. Data were collected through both online and phone-based methods and were analyzed using non-parametirc path analysis.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> The prevalence of WTS among women was 13% (95% CI, 11.06-14.94) and the mean scores of attitude, differential association, and behavioral intention among participants with WTS were significantly higher than participants without WTS (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> < 0.001). Moreover, 46.12% (95% CI, 38.12-54.08) of participants with WTS reported intention to quit WTS due to the COVID-19 pandemic and 43.6% (95% CI, 35.66-51.54) of women with WTS and 16.5% (95% CI, 14.20-18.80) of women without WTS believed in the protective effects of WTS against COVID-19. The path analysis model showed that the BI of WTS had a significant inverse relationship with knowledge and a significant direct relationship with attitude and differential association.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> This study suggests the need for quality educational and counseling interventions for the general public to correct popular misconceptions about the protective effects of WTS against COVID-19. </span></span></span></span></span></span></span></span> Tobacco, Smoking, Waterpipe, COVID-19, Nonparametric Path Analysis 221 228 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-5516-2&slc_lang=en&sid=1 Soodabeh Zare s_zare@modares.ac.ir 200319475328460076637 200319475328460076637 No Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Anoshirvan Kazemnejad kazem_an@modares.ac.ir 200319475328460076638 200319475328460076638 Yes Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Amir Hamta hamta.amir@gmail.com 200319475328460076639 200319475328460076639 No Department of Biostatistics, Faculty of Medical Sciences, Arak University of Medical Sciences, Arak, Iran Satemeh Raeesi Dehkordi sabadehkordi@gmail.com 200319475328460076640 200319475328460076640 No Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran