Authors
Sánchez-Martínez M, Otero A. Factors Associated with Cell Phone Use in Adolescents in the Community of Madrid (Spain). Cyberpsychol Behav.  Dec 10 2008 Ahead of print.

Background 
Cell phones are a fundamental part of everyday life for young people.  They contribute to a young person’s identity and are viewed as a sign of independence.  However, young users are also prone to intensive cell phone use and addiction, problems that have received little attention.  Furthermore, adverse health behaviours such as smoking, greater alcohol consumption, and depression have been associated with excessive cell phone use in young people.

Objective 
To measure cell phone use among secondary school adolescents and to explore the association between intensive cell phone use and socio-demographic and health variables.

Methods 
A total of 1,328 students aged 13-20 years from 9 high schools in Madrid, Spain were invited to participate in a survey conducted between January and April 2007. Two students declined to participate. The questionnaire collected information on age, sex, cell phone use, academic performance in the previous year, family income, relationships with friends and family, free-time and leisure activities, use of tobacco, alcohol, and other drugs, and depressive symptoms.

Results 
Almost all students (96.5%) had at least one cell phone and 15.9% had two or more cell phones. By age 13, nearly four out of five students had acquired a cell phone.  Over half of the participants (54.8%) said they took their cell phones to school, of which 83% kept them on during class, despite rules to the contrary in most schools. Of adolescents with cell phones, 76.3% sent text messages and 18.2% sent 4 or more messages per day. Cell phone dependence was measured by the questions: “Could you be without your cell phone for a day?” and “Do you think you are nothing without your cell phone?”  Over one quarter of females and one tenth of males were dependent on their cell phones.  According to the definition adopted, 41.7% of participants were intensive cell phones users. Female adolescents, those aged less than 16, those with a good compared to a problematic family income, and those living in rural compared to urban areas were more likely to be intensive cell phone users. Intensive cell phone use was also more common when depressive symptoms were present, among those who had failed in school, among adolescent smokers, and among those who drank alcohol to excess. Those who were dependent on their cell phones were three times as likely to be intensive cell phone users compared to those who were not dependent.

Interpretation and Limitations 
The students included in the current study were similar to those in the rest of Spain with respect to demographics and health. Therefore, these results are likely applicable to a wider population. Nonetheless, since the students were studied at one point in time, it is impossible to determine whether intensive cell phone use caused the adverse health effects or vice versa. Furthermore, the validity of some of the questions used in this study has not been tested and the students’ responses may not have been truthful or accurate.

Conclusions 
More education on safe and responsible cell phone use is needed for adolescents, especially for those with unhealthy behaviours and poor school performance, and parents and educators must fulfill this need.



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