Prevalence of Smartphone Overuse and Its Association with BMI among University Students in Arar, Saudi Arabia

One of the many devices produced by technology's rapid advancement is the smartphone [1]. Smartphones have made our lives easier and are now necessary for daily living, yet unrestrained and excessive use dependence of them can result in "smartphone addiction" [SA]. SA is a growing public health concern, especially among young people worldwide. According to reports, the majority of people worldwide own smartphones. People are more likely to spend their time on social networking, business emails, academic searches, locating information, and playing games. [2-3].

Research indicates that excessive smartphone use is troublesome as a result of the population's increased smartphone usage rate The terms "problematic mobile or smartphone use” “smartphone addiction" "smartphone dependence”, and "smartphone overuse" have all been used mutually in the literature to describe essentially the same phenomenon, which is a person's incapacity to control their smartphone use, which has detrimental effects on daily life [3-4].

Addiction to mobile devices, when someone uses their phone excessively is unable to cut back, uses it to pass the time when they are bored, becomes anxious or depressed when their phone is out of reach and loses relationships [5-6].

Dependence on technology, negative attitudes, and excessive smartphone use can all contribute to anxiety, stressful behavior, and depression. An online poll survey regarding Elon University students' behavior concluded that students appeared to be addicted to their mobile phones excessive smartphone use had a detrimental psychological impact [5-6].

Individual who becomes addicted to their smartphones may experience a variety of problems. For instance, excessive smartphone use endangers physical health by reduced exercise time, obesity, disrupting sleep, impairing vision, creating shoulder, wrist, and cervical spine pain, and leading to additional issues from inactivity [7-8]. Depression, anxiety, increased hostility, and poor attention are some of the detrimental consequences on mental health that it has social issues like poorer academic performance, accidents, relationship troubles, and increased exposure to pornography as a result of excessive smartphone use is also becoming more prevalent. Due to reductions in physical activity and a significantly sedentary lifestyle, increased use of technology is linked to higher incidence of obesity [9-15].

Numerous studies have found that smartphone addiction is highly prevalent. For instance, the frequency was high among Egypt (58.0 %) and Malaysian students (50 %) [15-16]. On the other hand, a number of studies have discovered a low prevalence of smartphone addiction: Chinese college students had a prevalence of 29.8% Teenagers are particularly susceptible to smartphone addiction [16]. Social media sites online gaming, and chatting apps comprise the most common causes of smartphone overuse issues [17].

Many findings revealed that more than a quarter of youth suffered from smartphone addiction, which calls for additional investigation into its root causes and how it affects students' well-being. The study aims to assess the prevalence of smartphone excessive use and its association with obesity in youth.

Subject and Study Design

A population-based cross-sectional study will be conducted including participants aged 18-25 in Arar city.

Using the single proportion size formula, the sample size was calculated. The greatest sample size required was 403 participants. After accounting for the drop-out rate of 5%.

Inclusion Criteria

The study will include all persons aged 18-25 years who agree to participate in the study. Those who will refuse to participate will not include in the study.

Using a self-administered questionnaire, data will be gathered. The questionnaire has two sections:

The first section of includes the following information:

• sociodemographic data, including age, gender, place of residence, marital status, type of college, parents' educational attainment level, weight, height and socioeconomic status
• behavioral factors, or lifestyle factors, including smoking, participation in physical activity lasting at least 30 minutes each day, average typical sleep duration, average daily internet usage, and the devices used (smartphone, desktop computer, or laptop computer)

Levels of smartphone use will be evaluated using the Smartphone Addiction Scale-Short Version (SAS-SV). This scale has ten items, each of which has six alternative responses: strongly disagree, disagree, disagree, weakly disagree, disagree, and strongly agree. The total SASSV scores range from 0 to 60, with 0 being a "low" level of smartphone addiction and 60 a "high" level. A score between 33 and 60 in females and 31 to 60 in males will deemed to indicate a high level of addiction, according to Kwon et al's definition [18]

The BMI scores of the individuals will determined by using the formula to assess obesity: Based on self-reported information, BMI is calculated as Weight (kg)/Height (m ²).

Statistical Analysis

Data analyzed by the use of SPSS software, version 16.0 (SPSS Inc. Chicago, USA). A suitable test (chi square, correlation or t test) was be used to compare continuous and categorical variables. All p-values lower than 0.05 considered statistically significant with a 95% confidence interval.

Table (1) presents demographic and behavioral data across several variables, including sex, age, smartphone overuse, university faculty, academic year, smoking status, daily smartphone usage duration, and BMI categories. Males (57.1%) slightly outnumber females (42.9%), and a majority (58.3%) are aged 21 or older. Students from non-medical faculties (57.6%) outnumber those from medical faculties (42.4%). Most students are in their 3rd and 4th academic years (52.4%), followed by 1st and 2nd years (36.2%). Smoking prevalence is relatively high at 72%, and most students (68%) use their smartphones for five or more hours daily. Regarding BMI, nearly half (46.2%) fall within the normal range (18.5–24.9), while 28.5% are underweight, and 25.3% are overweight or obese.

Table 1: Socio-Demographic and Behavioral Characteristics

Table 2 shows a comparison of smartphone overuse and non-overuse among participants based on socio-demographic and health characteristics. The p-value (0.07) indicates no significant difference in smartphone overuse between males and females, though males slightly dominate the overuse group (76.9%). A significant difference exists (p = 0.001) between age groups, with older participants (≥21 years) showing a higher rate (77.9%) of smartphone overuse compared to younger participants (<20 years, 63.1%). There is a statistically significant difference (p = 0.031), with non-medical faculty students reporting higher overuse (75.9%) compared to medical faculty students (66.1%).

Table 2: Comparison Between Smart Phone Overuse and Non-Overuse Regarding Socio-Demographic and Health Characteristics of the Study Participants

Strongly significant (p = 0.007), with participants using smartphones ≥5 hours a day reporting higher overuse (78.5%) than those using them <5 hours (57.4%). A significant association (p = 0.001) is noted, with smokers showing higher smartphone overuse (67.9%) compared to non-smokers (81.4%).

No significant difference (p= 0.14) in smartphone overuse was observed among students in different academic years. Also, no significant difference (p = 0.122), though overuse seems to increase with BMI, particularly among participants with a BMI >30 (85.7%).

The most frequent purpose of mobile phone use was social communication, with 76.2% of participants reporting always using their phones for this purpose. This was followed by entertainment (60.5%), internet browsing (58.8%), and academic education (52.9%). Telephone calls were reported by 49.9% of participants as an always-used function. Gaming represented the least common activity, with 35.7% of participants reporting rare use. All usage patterns were statistically significant (p<0.05), Table 3.

Table 3 Reason Behind Their Regular Smartphone Use

These results are consistent with a study [19] to investigate smartphone use and related perceived health impacts among the teenagers enrolled in Medical College and stated that every teenager used a smartphone to access social media. Another study [20] conducted in 2021 found that, the typical daily smartphone usage length among teenagers and young adults was four hours.

According to the average overall scores and levels of smartphone addiction for each sex, it was discovered that over three-quarters of teenagers were addicted to smartphones and used them problematically, with over half of them being male. This result is consistent with that of Manna et al. [21], who found that over three-quarters of teenagers were addicted to smartphones and used them problematically, with over half of them being male This result contrasts with the research done by Patki [22]. According to his research on mobile phone use and its alleged negative health impacts, 50% of teenagers were smartphone addicts and used their phones problematically: An Indian cross-sectional study conducted in Chennai.

Regarding the relationship between the adolescents' BMI and the Smartphone Addiction Scale Short Version, was statistically non-significant (p<0.05). Our finding not consistent with many studies [23] findings, that a statistically significant difference was observed between the group of adolescents who were addicted to smartphones and the group of adolescents who were not.

Smartphone overuse is highly prevalent among youth in Arar city. Several demographic and behavioral factors were associated with excessive smartphone use, particularly age, faculty type, and daily duration of smartphone use. However, no significant association was observed between smartphone overuse and obesity.

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