Excessive reliance on smartphones may indicate increased risk of alcohol and smoking in teens

A large Korean teen study links problematic smartphone dependence to higher odds of lifetime drinking and smoking, raising new questions about how digital behavior, reward seeking, and substance use risk may increase during adolescent development.

Study: Association between excessive smartphone dependence and alcohol and tobacco use behaviors among adolescents in Korea.. Image Credit: Zweibachesser/Shutterstock

a fresh scientific report The study assessed the relationship between excessive smartphone dependence and self-reported alcohol and tobacco use among Korean adolescents.

Prevalence and behavioral implications of excessive smartphone dependence among adolescents.

Rapid technological advancements have led to a rapid increase in smartphone adoption across the world. Between 2016 and 2021, global smartphone ownership increased by 73.9%, with more than 7.2 billion devices representing nearly 90% of the global population. This widespread adoption and user engagement has raised concerns about overdependence.

Teenagers exhibit particularly high levels of smartphone dependence. In 2022, 40.1% of Korean adolescents showed the highest level of dependence among all age groups, representing a substantial increase from the previous two-year average of 23.6%. They often use smartphones to navigate peer relationships and deal with emotional challenges, which can further increase dependency.

Neurodevelopmental factors make them more vulnerable to addiction than adults. While excessive reliance on smartphones has been associated with negative mental health outcomes and behavioral addictions, few studies have examined its association with alcohol and tobacco use in this population.

Adolescence is characterized by the maturation of the prefrontal cortex and hypersensitive reward system, leading to increased impulsivity and reward seeking. Excessive reliance on smartphones may share neural mechanisms with substance use and may also be associated with behavioral changes such as less sleep and greater exposure to peer norms, both of which are linked to alcohol and tobacco use.

Despite evidence linking excessive smartphone dependence to adverse outcomes, research on its association with alcohol and tobacco use among adolescents is scarce. Small, non-representative samples, cross-sectional designs, and inadequate assessment of substance use patterns limit most existing studies. Few have examined possible dose-response relationships or the stability of these associations over time.

Assessing the association between excessive dependence on smartphones and alcohol and tobacco use in adolescents.

Data were obtained from the 2020 and 2023 Korea Youth Risk Behavior Web-based Survey (KRBS), an annual anonymous online survey of Korean middle and high school students selected through stratified cluster sampling. Using standardized measures, the study analyzed associations and assessed whether findings were consistent across the two survey years, including onset, frequency, intensity, and dose-response relationships.

Dependence on smartphones was measured using a validated 10-item scale that classified adolescents as usual users, potential-risk users, or high-risk users. Alcohol and smoking experiences were determined through standard lifetime use questions as well as additional details on age of onset, frequency, and quantity.

Chances of alcohol and smoking increased among high-risk smartphone users

A total of 107,606 adolescents, including 54,985 males and 52,621 females, participated in the current study. Of those, 34% reported consuming alcohol, with these individuals being more likely to be male, aged 16–18, from low-income backgrounds, and rate their health as very unhealthy. They also reported higher stress, improper sleep duration, and lower academic grades.

Alcohol consumption is most prevalent among high-risk smartphone users, 45.3%, compared to 36.42% among those with potential risk and 30.98% among normal users. Similarly, smoking experience was reported by 10.59% of possible-risk and 8.44% of normal users compared to 19.18% of high-risk users, reinforcing a pattern of risk clustering.

Logistic regression indicated that, relative to normal users, low-risk users were 22% more likely to use alcohol and 26% more likely to smoke, while high-risk users were 65% more likely to use alcohol and 132% more likely to smoke.

These associations remained significant after adjusting for selected demographic, socioeconomic, and health-related covariates, highlighting a significant association between excessive dependence on smartphones and self-reported substance use.

Sensitivity analyzes supported the stability of these findings across survey years. Critically, a clear dose-response relationship was observed: earlier onset, higher frequency, and greater amounts of alcohol or smoking were each associated with an increased likelihood of high-risk smartphone dependence.

These results suggest that earlier onset and heavy alcohol or tobacco use were associated with a higher adjusted probability of high-risk smartphone dependence.

conclusion

The present study revealed a strong association between excessive smartphone dependence and self-reported high prevalence of lifetime alcohol and tobacco use among adolescents. Higher smartphone dependence was associated with earlier onset, more frequent and heavier substance use. Although causality could not be established, these findings highlight the need to consider smartphone overdependence in adolescent public health initiatives.

Incorporating digital well-being and healthy smartphone use into substance abuse prevention programs may prove valuable. Screening for problematic smartphone use may also improve identification of at-risk teens.

Overall, these results provide meaningful guidance for future research and targeted interventions.

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