Smartphone Addiction and Physical activity Among Students of a Medical College in Bengaluru - A Cross-Sectional Study

Introduction

Smartphones have become integral to modern living, enabling constant connectivity and serving as key tools for communication, social interaction and information access. It has also become an indispensable tool for nearly every medical professional, enabling them to share patient information, stay updated on recent advancements, participate in online meetings, and attend virtual classes. However, this accessibility has led to excessive usage patterns that are increasingly recognized as problematic.

The global total of smartphone mobile network subscriptions approached seven billion in 2023 and is expected to surpass 7.7 billion by 2028. The countries with the most significant number of smartphone mobile network subscriptions are China, India, and the United States. By 2040, the number of individuals using smartphones in India will reach 1.55 billion.¹

Smartphone addiction has emerged as a significant public health concern, characterized by the compulsive overuse of mobile devices that disrupt daily life and well-being. Behavioral addiction, as recognized within the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), refers to a compulsive engagement in non-substance-related behaviours that leads to significant impairment or distress.² Smartphone addiction is similar to traditional behavioural addictions, exhibiting symptoms such as tolerance, withdrawal, and preoccupation with device use. Smartphone addiction has concerning links to several mental health problems, such as anxiety, depression, and stress.³

Recent research indicates that around 45% of medical students are addicted to smartphones.^4,5 As students increasingly depend on their devices for academic purposes and social engagement, opportunities for physical activity may diminish. The overuse of smartphones is closely linked to sedentary behavior, which increases the risk of health issues like obesity and cardiovascular diseases. Additionally, the psychological effects of smartphone addiction can worsen these physical health risks, leading to a cycle of inactivity and mental distress.⁶

From this perspective, the study was carried out to assess smartphone addiction and its association with physical activity among medical students.

Materials and Methods

A cross-sectional study was conducted at a Government Medical College located in Bengaluru between June 2023 and September 2023 after getting approval from the Institutional Ethics Committee. Based on a previous study conducted in Maharashtra, which showed a 46.15% prevalence of smartphone addiction, 5% absolute precision sample size is calculated as 382 and was approximated to 400.⁷

A stratified random sampling technique was carried out to select the study participants. The name list of all the students of MBBS of 4 years, starting from 1st year to final year, was collected. From that list, an equal number of students were randomly selected from each of the years.

A structured questionnaire was administered Google Forms. Informed consent was taken electronically. The questionnaire consisted of three sections:

1. Semi-structured and pretested questionnaire for sociodemographic details.

2. Smartphone Addiction Scale Short Version (SAS-SV): A validated tool containing 10 questions with a 6-point Likert scale was used to assess smartphone addiction. The cut-offs used were 31 and 33 for male and female respondents, respectively.⁸

3. International Physical Activity Questionnaire (IPAQ): A standard tool to measure physical activity levels (low, moderate, and high).⁹

Permission to use these scales was obtained from the respective authors.

Data were analyzed using SPSS version 26. Descriptive statistics (means, percentages) summarized demographic data and prevalence rates. Chi-Square tests were done to find associations between categorical variables. A P value < 0.05 was regarded as statistically significant.

Results

A total of 400 students, aged 18 to 24 years (mean age: 20.44 ± 1.92 years), participated in the study. Among them, 269 (67%) were males and 131 (33%) were females. The majority of participants belonged to the upper-middle and lower-middle socioeconomic classes. Most families are nuclear, comprising 84.0% of the total families. Figure 1 shows the distribution of smartphone addiction. It was present in 170 (42.5%) of 400 students. Figure 2 shows the distribution of physical activity. Moderate physical activity is the most common category.

The odds ratio for smartphone dependency among the participants with moderate physical activity compared to high physical activity was 2.6 (95% CI: 1.5-4.4), showing that individuals with moderate physical activity were approximately 2.6 times more prone to developing a dependency on smartphones compared to those with high physical activity. The odds ratio for smartphone addiction in participants with low physical activity compared to those with high physical activity was 2.8 (95% CI: 1.434-5.7), indicating that individuals with low physical activity were nearly 3 times more likely to exhibit smartphone addiction compared to those with high physical activity.

Table 2 shows an association between participant characteristics and smartphone addiction. The study showed significant associations between smartphone addiction and various sociodemographic factors. Gender, type of family, religion, and duration of smartphone use showed significant association with addiction. Males (n=130) are more likely to depend on their smartphones than females (n=40). The prevalence was highest among second-year students (n = 52), whereas it was lowest among fourth-year students (n=32).

Although no substantial correlation was identified with BMI, further dietary pattern exploration may be necessary.

Discussion

In this research, the rate of smartphone addiction among medical students was discovered to be 42.5%, which is similar to additional research carried out by Awasthi S et al., in Uttarakhand, which showed 43.8% smartphone addiction and Ishan et al., in Assam, which showed the prevalence of 44.07%.^5,6 Males displayed a higher tendency towards smartphone addiction than females, which aligns with research conducted in Puducherry. A study conducted by Kumar S et al., found an inverse relationship between smartphone dependency and physical activity levels, which aligns with this study.¹⁰ Earlier research has also pointed out the detrimental effects of smartphone addiction on physical activity, with students exhibiting higher sedentary time due to excessive screen exposure.¹¹ A study conducted on Polish adolescents showed that low overall physical activity was associated with a higher level of smartphone addiction.¹²

In another study, it was revealed that those in the highest screen time category had higher BMI, whereas in the study we conducted, there was no meaningful link between smartphone addiction and BMI.¹³

Conclusion

In the current research, almost 50% of the students exhibited signs of smartphone addiction. This research emphasizes the important connection between smartphone addiction and levels of physical activity, in addition to various sociodemographic factors among medical students. Students with lower physical activity were more likely to exhibit smartphone addiction, with those engaging in moderate activity levels showing a higher prevalence compared to their highly active peers. Encouraging healthy lifestyle habits, such as more physical activity and less screen time, is essential for lessening the negative impacts of smartphone addiction on the mental and physical health of medical students. Further comprehensive studies on smartphone addiction, physical activity, and dietary patterns may help formulate new strategies.

Conflict of Interest

Nil