Journal of Health Policy and Sustainable Health

Vol. 1, No. 3, Summer 2014

Pages: 101-105

Cell Phone and Internet Addiction among Students in

Isfahan University of Medical Sciences (Iran)

Maryam Amidi Mazaheri1, Fatemeh Rahmati Najarkolaei*,2

1 Health Services Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Health Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran

Received: 2014/5/29 Accepted: 2014/8/5

Abstract
Objective: In recent years, there has been a rapid expansion in use of Internet and cell phone. The purpose of this survey was to iden-
tify the extent of cell phone and Internet addiction and relationship between these two forms of behavioral addiction in students at
Isfahan University of Medical Sciences in Iran.
Methods: This descriptive cross-sectional study was performed in Isfahan University of Medical Sciences in 2012. Sampling method
was convenience and sample size of 1180 persons was considered. Participants completed demographic questionnaire, Internet Ad-
diction Test, Mobile Phone Addiction Index. Data were analyzed by SPSS version 18.0, T-test and one way ANOVA were used to
identify the possible relations between demographic variables and cell phone and Internet addiction.
Results: Overall prevalence of internet addiction was 20% and moderate and severe internet addictions were19.1% and .9%, respec-
tively. The prevalence of cell phone use addiction was 56.2%% for female students and 64.5%% for male students.
Conclusion: Internet and cell phone addiction were related to male gender, age less than 25 year, higher educated father, and high
socioeconomic status of family.
Educational institutions such as schools and universities should try to develop new teaching concepts to educate the students to use
internet and cell phone meaningfully and correctly.

Key Words: Behavior Addictive, Internet, Mobile Applications

Introduction phone addiction is a new field and the number of publica-

Throughout past decades, there has been a rapid expan- tions in this area is growing, but it is difficult to conduct
sion in use of the Internet and Cell phone. Numerous stud- precise searches due to a lack of clear terminology (9).
ies have demonstrated young people are more likely than Furthermore, in case of cell phone addiction there are con-
any other demographic group to use cell phone (1).Also, ceptual controversies for instance how this behavior could
there has been a rapid growth of investigation focusing on be defined was not concluded? Some studies measured
use of technology (2) especially cell phone and internet problematic cell phone usage (10), else research preferred
(3).Beside the discussion about possible physical risks of to use the term maladaptive cell phone usage (11) another
communication technology, more recent research has fo- research categorizes the over-usage of cell phones as a
cused on problematic behaviors or behavioral addiction pathological behavior (12), other research focused to ex-
such as addiction to cell phones that may threaten health cessive cell phone use (13).
or well-being (4).Defining behavioral addictions is not Although there is fragmentary evidence that extensive cell
easy because of the variety of symptoms associated with phone use can have adverse effects on well-being and life
it (5) although there is an increasing movement to recog- quality especially in youth (4). Little research has been
nize and categories it (6).Conceptual and methodical dis- done in developing countries (9). According to the IT
agreements about Internet addiction are less than cell News in 2011; the number of cell phone users in Iran was
phone addiction (1). 73 million people (www.mobna.net).Studies have demon-
The concept of Internet addiction was introduced by strated cell phone have become highly prevalent with
Young in 1996 as an “impulse disorder” not involving the youth, in Iran. Also has been reported that by 2009, some
ingestion of an intoxicant, making it a ‘behavioral addic- 98% of Iranian adults between the age of 20 and 30 years
tion’ similar to gambling addiction and unlike alcoholism had used the Internet (14) and the incidence of Internet
(7) and several diagnostic criteria have been developed for addiction has been estimated to vary from 3.8% to 30%
Internet addiction (8). among the Iranian youth. For Instance, Kheirkhah (2010)
Carbonell study (2009) mentions Internet addiction is investigated the prevalence of Internet addiction among
studied more frequently than addiction to cell phones, cell north Iranian Internet users. The results revealed that
*
Corresponding Author: Fatemeh Rahmati Najarkolaei, Email: fatemeh_rahmaty@yahoo.com
Amidi Mazaheri M.et al Cell Phone and Internet Addiction

22.8% of Internet users were dependent users and there normal, score 50 to 79 as light addicts, and score higher
was a significant difference between gender and Internet than 79 as severe addicts to Internet.
addiction (15).Studies also indicate that prevalence of In- Young’s classic definition of Internet addiction was
ternet addiction among Iranian college students has in- adopted; in which a total of 8 items from 17 that are most
creased markedly (16-17). conceptually equivalent to Young’s (1996) screening in-
To our knowledge, Iranian previous Studies In the case of strument on internet addiction were employed (long). A
cell phone are very few. Baqhyany Moghadam (2011) ex- chance probability level of less than .05 was set to reject
plored the pattern of cell phone usage among Yazd Uni- the null hypotheses.
versity of Medical Sciences(Iran), 97% of students have
cell phone and 14 % of girls and 24 % of boys experienced Result
sleep disorders after buying cell phone most of them Among the 1180 university students, 65.5% were female,
stated that their daily use of cell phone is moderate (18). 88% were single, 56.7% lived in dormitory and 80.1%
Naderi (2009) investigated relationship between impul- were unemployment, mean and standard deviation of age
sivity and loneliness with usage of the cell phone among were 20.96± 2.32years, ages ranged from 18 to 39
university students (19). years.The mean age in the beginning of the use of cell
The purpose of this survey was to identify the extent of phone in female and male students were 16.2 and 17.5 re-
cell phone and Internet addiction and relationship be- spectively.
tween these two forms of behavioral addiction in univer- Nearly ten percent of female and 15.6% of male had more
sity students. than one SIM card. Twenty-five point seven percent of fe-
male and 41.4% of the male had changed their phone more
Methods than twice (P ≤ .001).
2.1 Participants According to the IAT, the prevalence of ‘‘light Internet
This descriptive cross-sectional study was performed in addiction’’ was 13.5% for female students and 29.6% for
Isfahan University of Medical Sciences in 2012. By con- male students, and the prevalence of ‘‘severe Internet ad-
venience sampling method1180 persons was considered. diction’’ was 0.8% for female students and 1.1% for male
In lunch time, on all days of two weeks, interviewers were students (P<0.05),
stationed in central restaurants, and the questionnaires According to the MPAI, The prevalence of cell phone ad-
were distributed among students. Inclusion criteria were diction was 56.2%% for female students and 64.5%% for
having a cell phone and internet access and a willingness male students (p=.005).
to participate in the study.Exclusion criteria were lack of There were significantly positive correlations between the
opportunity to participate in the study. Central restaurant score of MPAI and score of IAT, r=0.453, p<0.001.
was chosen because in this location, confounding varia- The relations between mean of cell phone addiction and
bles of samples such as sex, marital status, etc randomly demographic variables were shown in Table 1 and rela-
selected. A total of 1500 questionnaires were distributed, tions between mean of Internet addiction and demo-
1295 were responded. There were 1180 useable question- graphic variables were shown in Table 2.
naires.
2.2 Measurements Discussion
Internet Addiction test: Persian version of Young Inter- Despite the growing number of Iranian cell phone users,
net Addiction test (IAT) was applied which had a good few studies have been done about it. This study can be
reliability with a Cronbach’s alpha of 0.89 and test–retest considered as primary step to better understand and esti-
of 0.68 after 2 weeks (17). mate cell phone addiction among university students in
Cell phone addiction index (MPAI): The 17- items Mo- Iran.
bile phone Addiction Index (MPAI) developed by Leung, Age of first use of cell phone is one of the variables af-
(2008) was applied (20). In Leung study; the reliability of fecting the amount and how to use the cell phone. Similar
the scale as indicated by Cronbach’s alpha was remarka- to Inyang et al in Australian adolescents (21) males were
bly high at .90. significantly younger at age of first use of cell phone. Also
This tool translated into Persian in Iran in 2009 by Naderi 19% of females and 33% of males had purchased cell
and Hagh Shenas and acceptable reliability and validity phone under the age of 15 years. Cell phone addiction
have been reported (19). A five-point likert scale was used scores in students who had purchased cell phone under the
on the 17-item MPAI scale with 1 = not at all, 2 = rarely, age of 15 years were significantly higher than the others
3 = occasionally, 4 = often, and 5 = always. similar to Zokaee (22). Nearly 10% of female and 15.6%
2.3 Statistical analyses of male had more than one SIM card. The first and most
Data were analyzed by SPSS 18.0. T-test were used to obvious reasons that come to mind about having more
check for possible gender differences and one way than one SIM card are improper use of cell phone and hide
ANOVA were used to identify the possible relations be- contact and information or data of others. Cell phone ad-
tween demographic variables and cell phone and internet diction scores in students who had more than one SIM
addiction. Pearson correlations were additionally used to card were significantly higher than the others.
determine the extent of associations between the cell Male significantly more than female change their phone.
phone and internet addiction. This finding was consistent with Baqhyany moghadam
According to the manual; participants were divided into (18). Cell phone addiction scores in students who had
three levels based on their score, i.e., score less than 50 as changed their cell phone more than 2 times were signifi-
cantly higher than the others.

102 Journal of Health Policy and Sustainable Health

Cell phone and Internet addiction Amidi Mazaheri M.et al

Table 1. Relations between demographic variables and mobile phone addition in the students
Variables N Mean SD F
Age
≤20 505 32.19 9.91 3.08*
20 thru 25 477 32.80 9.96
≤25 57 29.38 10.01
Gender
Female 686 31.41 9.90 14.19**
male 361 33.82 9.90
Marital Status
Single 917 32.24 9.88 .008
married 125 32.16 10.68
Accommodation
Home 452 31.44 9.74 5.79*
Dormitory 589 32.94 10.19
Father Education
Less than high school 189 30.60 8.79
Diploma 306 31.67 9.62 5.37**
Bachelor 353 33.19 10.31
Higher education 141 34.45 10.80
Socioeconomic Status
Wealthy 93 34.39 10.75
Relatively wealthy 313 33.68 10.56 5.96**
Middle income 588 31.17 9.47
Low-income 49 32.56 9.10
Educational levels
Bachelor 618 32.10 9.68
General Medicine 355 32.47 10.47 .464
Higher Education 54 32.38 10.51
Times of phone change
0 149 28.91 8.94
1 252 31.26 9.12 11.20**
2 267 32.92 8.87
≥3 328 34.22 10.85

Table 2. Relations between demographic variables and Internet addiction in the students
Variables N Mean SD F
Age
≤20 538 35.75 15.50 1.24
20 thru 25 480 36.29 14.89
≤25 60 33.05 14.39
Gender
Female 709 33.21 14.00 61.43**
male 372 4.062 16.09
Marital Status
Single 947 36.48 15.31 17.93**
married 129 30.49 13.02
Accommodation
Home 458 36.08 15.03 .335
Dormitory 616 35.54 15.27
Father Education
Less than high school 200 30.21 12.54
Diploma 316 34.57 13.83 26.7**
Bachelor 359 36.77 15.60
Higher education 144 44.22 16.74
Socioeconomic Status
Wealthy 99 41.71 18.11
Relatively wealthy 320 37.81 15.48 10.77**
Middle income 608 33.79 14.07
Low-income 46 35.15 15.19
Educational levels
Bachelor 650 34.16 14.63
General Medicine 358 37.11 15.54 11.58**
Higher Education 53 38.91 15.77
Times of phone change
0 149 32.75 13.60
1 252 32.81 13.37 13.26**
2 267 36.22 15.23
≥3 328 39.68 16.41

than the older students. This finding was consist with pre-
Also the mean of cell phone addiction and Internet addic- vious studies (10, 4, 23). It can be said that the younger
tion scores in younger students were significantly higher age is a related factor for internet and cell phone addiction.
Journal of Health Policy and Sustainable Health 103
Amidi Mazaheri M.et al Cell Phone and Internet Addiction

Beranuy expressed that the use of cell phone and Internet may be because of cultural, social and, economical differ-
is more problematic during adolescence and normalizes ences in different societies.
with age toward a more professional and less playful use, Also significantly positive correlations between cell
and with fewer negative consequences (11).Although phone addiction and internet addiction, which was consist
both males and females have squeezed cell phone technol- with previous studies (32, 33).
ogy equally; comparing the use of it in both sexes seems There are several limitations involved in this study ini-
interesting. Different rate of cell phone and Internet ad- tially, the more concern is about the validity and accuracy
diction was seen in two genders.This finding has con- of self reported data regarding cell phone and Internet ad-
firmed previous result (10, 16). diction; however, Tokola et al. (2008) obtained a correla-
Cell phone and internet addiction scores in students who tion coefficient of 0.71 between self reported cell phone
had wealthy family were significantly higher than the use and network operators’ information (34).
other students that were consistent whit previous findings Further limitation is about generalization of the results,
(24, 25). although a relatively suitable sample size of 1180 was
wealthy families may not only have the economic re- studied, it was confined to a limited region. Therefore,
sources for cell and Internet expenditures, but also create generalization of the results must be interpreted with cau-
a particular cultural environment for their use.Also cell tion and continued research should include larger sample
phone and Internet addiction scores in students who had sizes to draw more accurate conclusions.However the
higher educated fathers were significantly higher than the enormous existence of cell phones in our daily lives fur-
other students.These fathers are more likely to socialize ther underlines the importance of research in this area.
their children into the world of modern information tech- Limitation
nology. Due to the high prevalence of cell phone and Internet ad-
Cell phone addiction scores in students who lived in dor- diction in students, future longitudinal studies should fo-
mitory were significantly higher than other students. This cus on the long-term effects of cell phone and Internet ad-
could be due to be away from family and homesickness diction and discover the causal relationship between ad-
and loneliness. Prior study among university students re- diction and depression or other psychological symptoms.
vealed that there is a significant relationship between
loneliness and cell phone addiction (19). Conclusion
The overall prevalence of internet addiction was 20% and Internet and cell phone addiction were related to male
moderate and severe internet addictions were19.1% and gender, age less than 25, higher educated father, and high
.9%, respectively. socioeconomic status of family.
In Alavi (2010) study 15% of the students were suffering Educational institutions such as schools and universities
from internet addiction (17). should try to develop new teaching concepts to educate
It can be said Internet addiction in students has been in- the students to use internet and cell phone meaningfully
creasing after two years. and correctly.
In June et al.'s study among Korean students, prevalence
of internet addiction was 20%, which was similar to our
results (26). In Ghamari et al.'s study in medical students References
1. Yen CF, Tang TC, Yen JY, Lin HC, Huang CF, Liu SC, et al.
of Arak University (Iran)(2009) the prevalence of light In- Symptoms of problematic cellular phone use, functional impair-
ternet addiction was 8.1% (23)and in Lam et al.'s study ment and its association with depression among adolescents in
(2009), was10.2% (27) and in Johansson et al.'s study Southern Taiwan. J adolesc. 2009;32(4):863-73.
among Norwegian young people, was 10.66% which were 2.Buckner JE, Castille CM, Sheets TL. The Five Factor Model
less than that of our study (28). In Lu et al.'s study the of personality and employees’ excessive use of technology.
prevalence of ‘‘light Internet addiction’’ among Japanese Computers Human Behav .2012;28(5):1947-1953.
adults was 33.7% for men and 24.6% for women, and the 3 .Lu X, Watanabe J, Liu Q, Uji M, Shono M, Kitamura T. In-
prevalence of ‘‘severe Internet addiction’’ was 6.1% for ternet and mobile phone text-messaging dependency: Factor
structure and correlation with dysphoric mood among Japanese
men and 1.8% for women (3) which was more than that
adults.Computers Human Behav. 2011;27(5);1702-1709.
of our study. 4 .Augner C, Hacker GW. Are people living next to mobile
The prevalence of cell addiction was 56.2%% for female phone base stations more strained? Relationship of health con-
students and 64.5%% for male students.Interpretation of cerns, self-estimated distance to base station, and psychological
this finding and comparison with other studies is difficult parameters. Indian J Occup Environ Med .2009;13(3):141.
since in comparison with Internet addiction, only few 5 -Walsh SP, White KM, Young RM. Over-connected? A qual-
studies have dealt with cell phone addiction so far. Ac- itative exploration of the relationship between Australian youth
cording to Carbonell et al. (2009) searched phones only and their mobile phones. J Adolesce. 2008;31(1):77-92.
2.1% of the published studies dealt with cell phones (9). 6 .Block J. Issues for DSM-V: Internet addiction. Am J Psychi-
atry. 2008;165(3):306-7.
In addition previous studies have used various tools which
7 .Young KS. Internet Addiction: A New Clinical Phenomenon
make it difficult to compare results. and Its Consequences. Am Behav sci. 2004;48(4):402-415.
In Leung study the prevalence of cell phone addiction was 8 . Ko CH, Yen JY, Chen SH, Yang MJ, Lin HC, Yen CF. Pro-
27.4% (20).A Spanish survey with 13–20-year-old ado- posed diagnostic criteria and the screening and diagnosing tool
lescents identified prevalence for cell phone dependence of Internet addiction in college students. Comprehensive psychi-
of 20% (29). Ahmed et al study indicated that university atry. 2009;50(4):378-84.
students in Pakistan used their cell phone under reasona- 9. Carbonell X, Guardiola E, Beranuy M, Bellés A. A biblio-
ble limits (30). metric analysis of the scientific literature on Internet, video
In Billieux et al(2006) study the general level of perceived games, and cell phone addiction. J Med Library Assoc: JMLA.
2009;97(2):102.
dependence to cell phone was high (31).This dissimilitude

104 Journal of Health Policy and Sustainable Health

Cell phone and Internet addiction Amidi Mazaheri M.et al

10 . Bianchi A, Phillips JG. Psychological predictors of problem 22. Zokaee MS, Valizade V, Youth culture and mobile phones.
mobile phone use. CyberPsychology & Behav. 2005;8(1):39-51. Iran Cultural Res.2009; 2 (7) :119-152.
11. Beranuy M, Oberst U, Carbonell X, Chamarro A. Problem- 23.Ghamari F, Mohammadbeigi A, Mohammadsalehi N,
atic Internet and mobile phone use and clinical symptoms in col- Hashiani AA. Internet addiction and modeling its risk factors in
lege students: The role of emotional intelligence. Computers medical students, iran. Indian j psychol med. 2011;33(2):158-
Human Behav. 2009;25(5):1182-7. 62.
12.Jenaro C, Flores N, Gómez-Vela M, González-Gil F, Caballo 24.Zulkefly SN, Baharudin R. Mobile phone use amongst stu-
C. Problematic internet and cell-phone use: Psychological, be- dents in a university in Malaysia: its correlates and relationship
havioral, and health correlates. Addict Res theory. to psychological health. Eur J Sci Res. 2009;27(2):206-18.
2007;15(3):309-20. 25.Koivusilta LK, Lintonen TP, Rimpela¨ AH. Orientation in
13. Khan MM. Adverse effects of excessive mobile phone use. adolescent use of information and communication technology: a
Int j occup med environ health. 2008;21(4):289-93. digital divide by sociodemographic background, educational ca-
14.Alavi SS. The Psychometric Properties of GPIUS, CIUS in reer, and health. Scand J Public Health.2007; 35(1):95–103.
Students Internet Users of Isfahan Universities. The final report 26.June KJ, Sohn SY, So AY, Yi GM, Park SH. A study of fac-
of the research project. Vice Chancellery for research, Isfahan tors that influence Internet addiction, smoking, and drinking in
University of Medical Sciences; 2009 . high school students. Taehan Kanho Hakhoe Chi.
15.Kheirkhah F, Ghabeli Juibary A, Gouran A. Internet addic- 2007;37(6):872–82.
tion, prevalence and epidemiological features in Mazandaran 27 .Lam LT, Peng ZW, Mai JC, Jing J. Factors Associated with
Province, Northern Iran. Iran Red Crescent Med J. Internet Addiction among Adolescents. Cyberpsychol Behav.
2010;12(2):133-7. 2009;12(5):551–5.
16. Ghassemzadeh L, Shahraray M, Moradi A. Prevalence of in- 28.Johansson A, Götestam KG. Internet addiction: Characteris-
ternet addiction and comparision of internet addicts and non-ad- tics of a questionnaire and prevalence in Norwegian youth (12-
dicts in Iranian high Schools. Cyberpsychol Behav 18 years) Scand J Psychol. 2004;45(3):223–9.
.2008;11(6):731-3. 29- Sánchez-Martínez M, Otero A. Factors associated with cell
17.Alavi SS, Alaghemandan H, Maracy MR, Jannatifard F, Es- phone use in adolescents in the community of Madrid (Spain).
lami M, Ferdosi M. Impact of Addiction to Internet on a Number Cyberpsychol Behav. 2009;12(2):131-7.
of Psychiatric Symptoms in Students of Isfahan Universities, 30.Ahmed I, Qazi TF, Perji K. Mobile phone to youngsters: Ne-
Iran, 2010. Inte J Prev Med. 2012;3(2):122. cessity or addiction. Afr J Business Manag. 2011;5(32):12512-
18 .Baghiyani MoghadamMH, Shahbazi H, An Explanatory 9.
Analysis of Mobile Phone Usage Pattern among Medical Stu- 31.Billieux J, Van der Linden M, d'Acremont M, Ceschi G, Zer-
dents of Yazd Shahid Sadoghi University of Medical Sciences, matten A. Does impulsivity relate to perceived dependence on
2010, Global Media J, 2011;6(1): 1-13. and actual use of the mobile phone? Appl Cognitive Psychol.
19 . Naderi F,Haghshenas F. Relationships between impulsivity 2006;21(4):527-37.
and loneliness, with the use of mobile students, new findings 32 .Hong FY, Chiu SI, Huang DH. A model of the relationship
psychol, 2009; 4(12) :111-121. between psychological characteristics, mobile phone addiction
20. Leung L. Linking psychological attributes to addiction and and use of mobile phones by Taiwanese university female stu-
improper use of the cellular phone among adolescents in Hong dents. Comput Human Behav. 2012;28(6):2152-2159.
Kong. J Child Media. 2008;2(2):93-113. 33 .Pawlowska B, Potembska E. P-78-Involvement in the inter-
21 .Inyang I, Benke G, Dimitriadis C, Simpson P, McKenzie R, net and addiction to the mobile phone in polish adolescents. Eur
Abramson M. Predictors of mobile telephone use and exposure Psychiatry. 2012;27(1):1.
analysis in Australian adolescents. J Paediatr Child Health. 34.Tokola K, Kurttio P, Salminen T, Auvinen A. Reducing over-
2010;46(5):226-33. estimation in reported mobile phone use associated with epide-
miological studies. Bioelectromagnetics. 2008;29(7):559-63.

Journal of Health Policy and Sustainable Health 105