الفهرس 
Acknowledgments
Scales/tests for assessment of smartphones addictionOnly 14 pages are availabe for public view
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Abstract
Smartphones have become a part of our daily life. Smartphones are used for many purposes as communication and entertainment with the main advantage of easy access to internet. Unfortunately, the excessive use of smartphones makes people ’addicted’ to that type of technology. The problem of smartphones addiction is most likely to affect young people who are fascinated with new technologies.
The widespread use of mobile phones in recent years, especially among young people, has given rise to concerns about the potential effects of its use on human health. There are also many psychological factors related to smartphones addiction such as anxiety, stress, poor social and family relationship, depression, loneliness, shyness and degree of self-esteem.
Aim of the study:
The objectives of the study are to estimate the prevalence of smartphones addiction among Assiut University students, to identify some associated factors that may lead to smartphones addiction and to investigate consequences of smartphone addiction on different psychological and physical health aspects.
Methodology:
The current study was a cross-sectional study and conducted on Assiut University among students from five faculties representing theoretical, practical and medical undergraduate students from third year with total calculated sample size of 700 students. A multi-stage stratified cluster sampling technique was used to select the sample.
Data were collected at the beginning of second semester of the academic year 2017-2018 away from exam times after approval of the Ethical Review Committee at Assiut Faculty of Medicine and obtaining administrative permission from the University authority.
Data were collected by self-administered questionnaire by the help of two assistants, the consent was obtained from the students before data collection. The questionnaire consisted of five parts to investigate; socio-demographic characteristics of the students, pattern of smartphones use, criteria of smartphones addiction, level of smartphones addiction by use of Arabic version of smartphones addiction scale (SAS-A) and level of depression symptoms and loneliness by patient health questionnaire-9 (PHQ-9) and short loneliness scale respectively.
Results:
Characteristics of the sample and socio-demographics:
Age of the studied participants ranged from19-25 years with mean of 21.27 ± 0.88 years. Males and females constituted 40.1% and 59.9% of the students respectively. As regard smoking, 8% of the studied students were current smokers either daily or not daily, 2.1% of students were ex-smokers and the majority of students (89.8%) never smoke.
More than half of the students resided urban (53.4%) and belonged to medium to high socioeconomic status families (59.25%). While only 6.2% of students’ fathers and 19.2% of mothers were illiterate, higher percentages of students’ parents educated to university and post graduate level (46.3% of fathers and 31.9% of mothers).
Pattern and main purposes of smartphones use:
Owing smartphones for more than three years was reported by 69.7% of sampled students, 52.7% of students reported using smartphones more than four hours daily. The most common purposes for smartphone use were scrolling of social networks as Facebook and Twitter (65.4%) followed by using smartphones for urgent calls (64.9%) and texting (58.7%).
Checking smartphones always immediately after waking up was reported by 28.9% of students, while 47.9% of them always check their smartphones before sleep, 11% of students always use their smartphones during lectures or sections and 5% of them always use smartphones during driving or passing the street. As regard self-reporting as smartphones addict, 20.2% of students consider themselves smartphones addict.
Prevalence of smartphones addiction, its associated risk factors and adverse effects:
The studied students were classified by smartphones addiction scale (SAS) into 2 categories: 44.7% of them were smartphones addict and 55.3% were non addict, the percentage of smartphones addiction was higher in males than in females (50.2% versus 41.1%) with statistical significant difference (P- value = 0.017).
There were no statistical significant differences as regards residence, family size and socioeconomic status, parents’ education and occupation or smoking status between smartphone-addicts and non-addicts.
There was statistical highly significant association between adverse effects of smartphones use and smartphones addiction, percentage of students reported different adverse effects due to use of smartphones was higher in smartphones addict group compared to non-addicts.
Depression symptoms and loneliness:
There was highly significant association between smartphones addiction and depression symptoms. The percent of smartphones addiction increased gradually from 25.2% in students with no depression symptoms to 72.9% in students with severe depression symptoms (P-value >0.001).
There was also a statistical significant difference in mean ± SD of loneliness score between smartphones addict students and smartphones non-addict students with higher mean in the smartphones addiction group (P-value >0.001).
Predictors of smartphones addiction:
Multivariate logistic regression found these factors to be significant predictors of smartphone addiction: self-reporting as smartphones addict, different degrees of depression symptoms; severe, moderately severe and moderate depression symptoms, using smartphone more than four hours per day and male gender.
Therefore, the current study concluded that:
Smartphones addiction is highly prevalent among Assiut University students and predictors of smartphones addiction were self-reporting as smartphone addict, moderate to severe depression symptoms, using smartphones more than 4 hours daily and male gender.
In highlight of these results the study suggests following recommendations:
• As for students: Awareness program should be planned to increase the knowledge of students about the risk factors and hazardous consequences of smartphones addiction.
• Students with depression symptoms should be screened as Smartphones addiction may be a symptom of depression. In such instances, there would be a need to address the underlying problem, as well as inappropriate smartphone use.
• As for legislations: Some restrictions must be made on the usage of smartphone during lectures, practical classes and also during driving.
• Finally, more researches are required to observe the effects of mobile phones on different systems of the human body along with clinical examination.