Do we need to take smartphone use more seriously?

“A handful of tech companies control billions of minds every day.” So claims Tristan Harris,   former Design Ethicist at Google, and founder of the Centre for Humane Tech. Meanwhile, an article in The Independent claimed that giving someone a smartphone is comparable to “giving them a gram of cocaine”. In the Atlantic, apparently resigned to the idea that the battle against smartphone addiction had already been lost, psychology professor Jean M Twenge asks: “Have smartphones ruined a generation?”

Most of us see our phone use as just a bad habit, but what if it were more than that? Could it really be that we are all pathologically addicted to our phones? Should we look at smartphone use – and smartphone abuse – as a medical problem?

Why this might be one of the most important questions of our time

The problem affects almost everyone

Almost everyone in the UK has a smartphone. If it’s damaging our health significantly, then what we have isn’t just a social annoyance. It’s a public health problem – on the scale of smoking or drinking.

The problem could put huge demands on our health system

Quitting a bad habit is one thing. Curing an addiction is quite another.

The worry among researchers is that curbing phone use isn’t something you can achieve with a phone-limiting app like Moment or a digital detox retreat in the countryside. It may actually be very difficult – even impossible without professional help. The worry is that the apps we use are designed to keep us coming back – and we’re simply not evolved to resist the constant gratification that these apps offer. In short, we’re addicted.

If we really did suffer from smartphone addiction, this would have huge consequences for our health system. Dealing with addictive substances in the UK is a multi-billion pound effort, involving:

• Massive investment in education, quitting services, and rehabilitation
• Huge NHS spending on treating related health problems
• Taxes levied on certain products such as cigarettes
• Advertising restrictions
• Age restrictions

So the big question is: should we be taking smartphone misuse more seriously and tackling it on a national level – or is it all one big scare story?

That’s why we need to know whether smartphones are addictive.

What is addiction?

According to the World Health Organisation (WHO), there are six key features to an addiction:

1. Compulsive use – you have a strong sense of compulsion to use the thing you are addicted to.
2. Lack of control – you find it difficult to stop yourself or limit your usage, and previous efforts to limit your usage have failed.
3. Withdrawal – if you do limit your usage or stop entirely, you enter a state of withdrawal where the symptoms depend on what you’re addicted to.
4. Tolerance – over time you need to increase your usage to achieve the same benefit
5. Preoccupation – the thing you’re addicted to is at the forefront of your mind, and you start to neglect doing other things.
6. Continued use –even when you know it’s harming you.

For a long time, the only types of addiction recognised by the WHO were substance disorders – including alcohol, nicotine, cannabis, opioids, and hallucinogens. However, more recently the WHO added so-called “behavioural addictions” to the list, including gambling disorder and gaming disorder. Could smartphone addiction be the next one? Let’s look at the evidence and see if it meets the criteria.

The evidence

Does it damage our health?

There is increasing evidence that smartphone usage could be damaging our health. Here are the main problems:

We’re losing our mental downtime

Mental downtime – time when our mind isn’t occupied by anything in particular and can rest – is important for creativity, the formation of memories, and replenishing our attention and motivation. We know that our attention span is harmed by constant interruptions. Yet the average Brit checks their phone every 12 minutes – and we tend to fill up any moment of waiting or boredom when our mind might otherwise wander.

There’s increasing evidence of a link with mental health problems

Heavy use of a smartphone is closely correlated with symptoms of anxiety and depression. Although these studies so far don’t establish causation (is it the smartphones causing mental health problems or mental health problems causing smartphone usage?) new research is looking into this.

We’re losing sleep

79% of Brits check their phones within an hour of going to sleep. A recent study showed that people who checked their phone within half an hour of sleeping experienced sleep disturbance. We’re probably well aware of the effect of poor sleep on our mood, but few of us know that poor sleep can also increase your risk of obesity, heart disease, high blood pressure, and diabetes.

It’s also an enormous drain of time

The average amount of time spent online on a smartphone is 2 hours and 28 minutes a day. If this was time spent productively, maybe this wouldn’t be an issue. But 40% of us feel that we’re using our phones too much. So how do we imagine this gaping hole of lost time?

Here’s one strategy – let’s say you could reasonably cut your phone usage by 20%, or about half an hour a day. Within a year, working on minimum wage, you could earn almost £1500. Between all of us in the UK, we’d contribute another £98 billion to the economy over a year. Or £1.8 billion a week.

That’s a big number. Maybe we should put it on a bus:

Of course, this is all very early days. Let’s remember that it took decades to discover the link between smoking and lung cancer, centuries to link alcohol misuse with liver disease. When it comes to smartphones, the iPhone was released just 12 years ago. Research into the effects of smartphone usage is still thin on the ground – there could be other effects we don’t yet know about.

Do we get withdrawal symptoms?

With many addictive substances, attempts to cut down on usage can result in severe physical symptoms and difficulties with staying off the drug.

With smartphones, we do get something called “nomophobia”. Nomophobia is one of the most horrible words to be added to the dictionary in recent years, so this is the last time you’ll read it in this article. It means “anxiety caused by being without one’s mobile phone”.

However, this is one area where it’s important not to pathologise behaviour that is actually reasonable. Your mobile phone is valuable. It costs a lot of money, it’s a store for your photos and messages, and it functions as your map, your contact with family and friends, and sometimes as your credit card. There’s also a lot of personal information on there that you wouldn’t want to fall into the wrong hands.

As for staying off your phone long-term, what comes up time and time again in personal stories is that life is simply much more inconvenient without a smartphone. Writing down directions, not being able to update people if you’re late – there’s a reason we’ve moved past this. The likelihood is that the difficulty of staying off your smartphone is largely a practical one.

What about tolerance?

Tolerance is a tricky thing to measure. We do have some studies where participants agreed with the statement that they needed to spend more time on their phone to achieve the same level of satisfaction. However, these studies don’t independently check whether the participants actually are spending more time on their phones, and they don’t properly measure their participants’ satisfaction over time.

The only other evidence we have are studies showing that we’re spending more and more time on our phones. But there’s no distinction between “useful” and “problematic” activity. We simply don’t know if our increased usage is just a reflection of the fact that we can do much more on our phones now – including banking, shopping, and watching TV.

What about preoccupation?

Studies have shown participants agreeing that they have their smartphone in their mind even when they’re not using it.

Once again, this information is only meaningful if we know why people are using their phone. If you’re keeping up with family members, or checking for job alerts, it’s normal to think about your phone. What’s needed is more studies on whether people think this way about things that, in a sense, shouldn’t matter – such as winning a game on Facebook or extending your Snapchat streak.

Do we lack control over our phone use?

Participants in a number of studies strongly agree with the statements that:

• they felt they could not control their impulse to use their smartphone
• they felt they were unable to cut down on their smartphone usage

Other studies have started to make the distinction between intentional phone usage and “checking”, which might be driven by compulsion and could represent a more addictive behaviour than usage, but there’s not much evidence on how much people do this yet.

The other main weakness of the evidence so far is that it isn’t clear how severe this compulsion is. A compulsion which can be cured by turning off your notifications, installing a phone-limiting app, and downloading a set of podcasts to listen to is unlikely to be classed as a mental health disorder. This kind of behaviour has yet to be tested in a controlled, clinical setting, so it will be interesting to see what future studies show.

Could there be other explanations for our behaviour?

Do our phones just facilitate problems that we already have?

Is this focus on the technology – the internet itself and social media platforms – a distraction?

For example, was Instagram just the first time some of us discovered that we’re narcissists? Do some of us simply have an insatiable desire to collect friends, and does Facebook just make that much easier?

Former Facebook executives and Google employees tend to brag – sometimes dressed up as a confession – about the influence they have had over our brains, and the extent to which they’ve “hooked” us on their apps through “gamification” and dopamine hits. But without properly comparing people’s behaviour before and after smartphone usage, we won’t know whether social media is the cause, or just a facilitator.

Are we all just under increasing pressure to keep up?

This would explain why we might feel anxious without our phone, or compelled to check it so often. If so, perhaps social media/internet addiction could be more analogous to an anxiety disorder, or obsessive compulsive disorder.

Even then, most of us try to conform to societal expectations in other areas of our life as well. We’ve been told from a young age we need to compete. The competition for the best life or best job is just something that social media has taken to a new level. To turn around and say we have a “disorder” for feeling the pressure to keep up would be disingenuous. Worse, it would deflect us from talking about whether society itself could (or should) be less competitive, and how to help people – especially young people – cope with external pressure.

The verdict

Unfortunately, it’s simply too early to say how strongly we feel the compulsion to use our phones. Given the lack of evidence, the jury is out on the addiction question – it’s unlikely to be listed by the World Health Organisation any time soon.

In the meantime, it may be worth trying out strategies to use your phone more intentionally – and getting those precious moments of mental rest back.

Don’t expect to give your phone up entirely. The truth is that there are lots of good reasons to use our phones in general, and lots of practical reasons why living without them would be difficult. What we need is a wider discussion about the trends that smartphone use could be driving – such as the constant expectation of availability, and the insidious creep of competition into every aspect of our lives.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814538/#CR9

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328289/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174603/