Abstract
BACKGROUND: Addiction to smartphones is an increasingly recognized behavioral issue among university students. It has potentially adverse effects on mental and psychosocial well-being. OBJECTIVES: To assess the prevalence of smartphone addiction and examine its associations with six psychosocial and behavioral health measures among university students. METHODS: A cross-sectional, web-based survey was conducted among university students in Saudi Arabia. Using convenience sampling, we collected demographic data along with validated instruments: the 10-item Smartphone Addiction Scale-Short Version (SAS-SV) for addiction risk, and five additional validated scales for assessing depression, anxiety, sleep quality, physical activity, and social connectedness. Data were analyzed using Stata 17 (StatCorp LLC, College Station, TX) with descriptive statistics, between-group tests (t‑tests, Mann-Whitney U, χ²), Spearman correlations, and crude logistic regression analyses. RESULTS: A total of 383 students completed the survey, with a mean daily smartphone use of 7.6 ± 3.5 hrs. Overall, 268 (70.0%) individuals screened at risk for smartphone addiction, with no significant differences by gender, age, or academic grades. However, a higher risk was observed in computer engineering and business students (p = 0.043) and among those who used phones for longer periods daily (p < 0.001). Probable depression and anxiety were present in 176 (45.9%) and 162 (42.3%) participants, respectively, and were associated with increased odds of smartphone addiction (odds ratio (OR) = 3.83, 95 % CI 2.35-6.25; OR = 3.11, 95 % CI 1.91-5.06). Physical activity and better sleep quality were inversely associated with addiction risk (OR = 0.54, 95 % CI 0.34-0.86; OR = 0.78, 95 % CI 0.63-0.96), while loneliness (34.0% vs. 15.7%, p < 0.001) and negative perceptions of smartphone impact (OR = 3.50, p = 0.001) correlated with higher addiction risk. Smartphone‑addiction scores correlated positively with depression (r = 0.43) and anxiety (r = 0.35) and negatively with sleep quality (r = -0.13) and physical activity (r = -0.20) scores (all p < 0.05). Frequent engagement in creative activities (OR = 0.47, p = 0.018) was associated with reduced odds of smartphone addiction. CONCLUSION: Smartphone addiction risk was exceptionally high and strongly linked to depression, anxiety, and loneliness, whereas better sleep, regular physical activity, and creative engagement were protective. These findings reiterate the need for integrated interventions targeting students, combining digital literacy education, mental‑health screening, and lifestyle promotion.