Medical
  • Research and White Papers
  • February 2025

Understanding Smartphone ‘Addiction’

By
  • Dr. Peter Farvolden
A man and woman sitting at a table on their smartphones
In Brief

Emerging evidence suggests smartphone use can have a negative effect on mental health. In this article from RGA's ReFlections newsletter, Dr. Peter Farvolden explores how phone use is being considered a behavioral addiction and what the implications are for life and health insurers.

Abstract

  • In a relatively short time span, smartphones have become ubiquitous, and their many uses are ever expanding – from accessing information and communicating with others to transacting business and monitoring health.
  • However, along with the many enhancements and conveniences they bring, mounting evidence suggests smartphones also can negatively impact mental health.
  • While studies have established links between smartphone use and various mental health issues, such as anxiety, depression, stress, and sleep problems, the relationship is complex and influenced by multiple factors.
  • Many researchers and psychologists now consider excessive phone use a behavioral addiction, given its similarities to gambling disorder, another recognized non-drug addiction.

 

Smartphones and mental health

Global smartphone market penetration is very high, with the number of mobile phone subscriptions set to surpass the world population in 2027. North America, Western Europe, and East Asia have penetration rates near or above 100% for both mobile phones and smartphones. In 2023, approximately 66% of the global population had access to the internet via mobile devices, with growth driven by increasing access in developing markets.1,2,3

Globally, people use their phone three to five hours per day on average, although this can vary by country, with youth and younger adults tending to have higher usage rates.4,5,6

Smartphones have many positive uses and will continue to expand people’s capabilities, boundaries, and opportunities. However, it is important to consider their potential harm to mental health and happiness. Numerous studies have established links between smartphone use and various mental health issues, including:

  • Anxiety and depression – Studies have shown a link between high smartphone use (especially social media) and increased symptoms of anxiety, depression, and stress in teens and adults, largely due to factors such as social comparison, cyberbullying, and fear of missing out (FoMO).7,8,9
  • Sleep problems – Blue light emitted by phone screens interferes with melatonin production, and the mental stimulation from content can prevent restful sleep. Excessive phone use, particularly before bed, is linked to poorer sleep quality, insomnia, disrupted circadian rhythms, and exacerbation of mental health issues.10,11,12
  • Loneliness/social isolation – Excessive use can contribute to feelings of loneliness and social isolation, as people substitute virtual interactions for in-person relationships, leading to a sense of disconnection in the real world. Heavy social media users (three or more hours per day) are twice as likely to feel lonely or socially isolated.13,14,15
Numerous studies have established links between smartphone use and various mental health issues.

Although studies have consistently shown that excessive phone use can contribute to poor mental health outcomes, several factors complicate the understanding of smartphone use and mental health.16,17,18 These factors include:

  • Complex relationship – The relationship between smartphone use and mental health is curvilinear (vs. linear). Moderate smartphone use (two to three hours per day) may have neutral or even positive effects on wellbeing, while both very low use (less than two hours per day) and very high use (more than five hours per day) are linked to negative outcomes. Individual differences (e.g., age, personality, purpose of use) further complicate this relationship – what may be harmful for one individual might not be for another.
  • Content and context – Studies indicate that the type of use (e.g., passive consumption vs. active interaction) is more predictive of mental health risks than total time spent on phones. Passive use – such as scrolling through social media – is more strongly linked to negative emotions, FoMO, and social comparison. Active use – such as communicating with friends or family, or participating in online communities – may be less harmful and, in some cases, even beneficial for emotional wellbeing.
  • Role of individual and social context – Demographic factors such as age, gender, socioeconomic status, and pre-existing mental health conditions affect how individuals respond to smartphone use. Adolescents and young adults tend to be more vulnerable to the negative effects of smartphones, especially in the context of social media use. Cultural factors also play a role, as different societies have varying norms around smartphone use and its social significance.
  • Inconsistent and mixed research findings – Some studies show significant negative impacts of excessive smartphone use, while others find weak or no clear association. This inconsistency arises partly because studies use different methodologies that make comparisons difficult, and the definitions of “excessive use” vary, as do the specific measures of mental health outcomes. In addition, the rapid evolution of digital platforms means research can quickly become outdated.
  • Bias in self-reported data – Much of the research relies on self-reported data, which can be unreliable. People may underreport or overestimate their phone use, and mental health symptoms such as anxiety and depression are subjective, making accurate measurement difficult.
  • Association vs. causation – It is often unclear whether excessive smartphone use causes mental health issues or whether people with pre-existing conditions (e.g., depression, anxiety) are more likely to engage in excessive phone use. Other variables, such as sleep deprivation, social isolation, or lack of physical activity – which can accompany high phone use – are also likely contributing factors.
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Smartphones and addictive behaviors

Should excessive phone use be considered an addiction?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), addiction falls under the category of substance use disorder (SUD) and is characterized by a compulsive pattern of substance use despite harmful consequences. The DSM-5-TR does not use the term “addiction” explicitly but outlines the criteria for SUD based on behavioral, cognitive, and physiological aspects. These include impaired control, social impairment, risky use, and pharmacological criteria (tolerance and withdrawal).19

Although gambling disorder is the only officially recognized non–substance-related addictive disorder in the DSM-5-TR, researchers have suggested that other behaviors done in excess, such as internet gaming, shopping, pornography, sex, exercise, and phone use, may also be formally classified as addictive behaviors in future editions, pending further research evidence.20

People can develop a non–substance-use behavioral addictive disorder (e.g., problem gambling) through their smartphone. Problematic smartphone use is sometimes classified as a form of behavioral addiction, where users exhibit symptoms such as craving, withdrawal, and tolerance.21

By The Numbers

A recent survey from Reviews.org22 indicates these phone use patterns:

  • Americans spend 4 hours, 25 minutes each day on their cell phones.
  • Americans check their phones 144 times per day.
  • 89% say they check their phones within the first 10 minutes of waking up.
  • 75% feel uneasy leaving their phones at home.
  • 75% check their phones within five minutes of receiving a notification.
  • 60% sleep with their phones at night.
  • 55% say that they have never gone longer than 24 hours without their cell phones.
  • 47% of people say they feel a sense of panic or anxiety when their cell phone battery goes below 20%.
  • 46% use or look at their phones while on a date.
  • 27% use or look at their phones while driving.

 

A study found 76% of 3,534 internet users aged 12-77 experienced more than five of 23 phone addictive behaviors. Overall, 46% of the study participants suffered from feelings of depression, 70% from levels of anxiety, and 14% from some form of sleep disturbance.5 A larger study reported that approximately one-third of people around the world may be at a high risk for smartphone addiction, with younger women and people in parts of Asia more likely to report problematic use.23

While not currently described as such, the DSM-5-TR criteria for diagnosing non-substance use addictive disorders provide a structure for further research into whether some patterns of excessive smartphone use may be best described as an “addiction.”21 For example:

  • Craving and compulsive use – Individuals with excessive phone use feel an uncontrollable urge to check their phones frequently, even when it interferes with daily activities or relationships. This behavior can resemble compulsions seen in SUDs.
  • Loss of control – An inability to reduce phone use is common. Users may plan to check their phones for a minute but find themselves scrolling for hours.
  • Tolerance and escalation – Over time, individuals may need to spend more time on their phones to achieve the same sense of satisfaction or relief. The constant use escalates, much like substance users developing tolerance and requiring more of a drug to achieve the same effects.
  • Withdrawal symptoms – When phone access is limited, individuals may experience anxiety, irritability, restlessness, or distress. This mirrors withdrawal symptoms seen in SUDs.
  • Interference with daily life – Excessive phone use can disrupt normal functioning in social interactions, work, and academic performance and can impact sleep and physical health (e.g., eye strain, headaches, and poor posture).
  • Mood modification – Like other addictive behaviors, phone use can serve as a coping mechanism to alter mood. Users may turn to their phones to escape stress, boredom, loneliness, or depression, leading to a cycle of reliance.
  • Salience – Excessive phone use can become a dominant activity in life, with users prioritizing phone engagement over other important activities, such as exercise, spending time with loved ones, or pursuing hobbies.
  • Psychological and social impact – Constant notifications and multitasking can affect cognitive functioning, reducing attention span and impairing memory. Overuse of phones often leads to neglect of real-life relationships, creating a sense of isolation even when surrounded by others. Research links excessive phone use, especially social media consumption, with heightened anxiety, depression, and feelings of inadequacy.
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Insurance considerations

From an insurance perspective, accurately accessing mortality and morbidity risk due to phone addiction will require building on current knowledge in a variety of ways, including:

  • Longitudinal studies – Most studies on smartphone use and mental health are cross-sectional, meaning they examine data at one point in time. Longitudinal research, which tracks individuals over time, is needed to better understand the long-term effects of smartphone use on mental health.
  • Impact of new technologies – The rapid evolution of technology, including artificial intelligence, virtual reality, and new social media platforms, means that the specific risks to mental health are continually shifting. The rise of platforms like TikTok and their immersive nature (e.g., short video formats, instant feedback) may introduce new challenges for mental health requiring up-to-date research.
  • Individual factors – Research should continue exploring factors that make certain individuals more vulnerable to the negative effects of smartphone use, such as underlying mental health conditions, personality traits (e.g., neuroticism), or social circumstances.

While smartphone addiction is not currently an underwritten condition, insurers will need to monitor research, weigh the various aspects of this evolving issue, and adapt risk stratification and claims assessment processes accordingly. They might also proactively seek opportunities to enhance client engagement on this issue through wellness initiatives, client education, and screening tools.

Conclusion

While increasingly researched, the mental health risks of smartphone use are not fully understood. Although numerous studies have established links between smartphone use and mental health issues, the relationship is complex and influenced by multiple factors. The rapid evolution of smartphone technology and social media platforms adds further complexity, making it difficult to draw conclusions about the full extent of risks.

Mobile phone use has been described as the biggest non-drug addiction of the 21st century. Studies highlight that excessive phone use activates the brain’s reward system, releasing dopamine, which reinforces habitual checking of notifications, social media, and apps. Researchers and psychologists often refer to mobile phone addiction as a behavioral addiction, given its similarities to gambling disorder. The constant accessibility and engagement of smartphones have amplified this issue globally.

Smartphones are now inextricably integrated into modern life. Understanding how to optimize this relationship with technology while mitigating risks presents an ongoing challenge not only for medical professionals and insurers but for every individual.

RGA experts are eager to engage with clients to better understand and tackle the industry’s most pressing challenges together. Contact us to learn more about RGA's capabilities, resources, and solutions.

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Meet the Authors & Experts

Dr. Peter Farvolden
Author
Dr. Peter Farvolden
Mental Health Consultant

References

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