European Journal of Cardiovascular Medicine

In today’s contemporary digital and virtual society, Anxiety is the affliction of life. A new addition to the stress list is Nomophobia. The term “Nomophobia” is an abbreviation for NO- Mobile phone – PHOBIA is a term coined during a study conducted in 2008 by the UK Post Office to investigate anxieties mobile phone users suffer. Nomophobia is defined as the fear of being out of mobile phone contact and is considered a modern-age phobia introduced to our lives as a byproduct of the interaction between people and mobile information and communication technologies, especially smartphones. The availability of Wi-Fi, the increasing capacity of smartphones concerning speed and operating systems, and decreased prices have resulted in the widespread use of smartphones.²

A mobile phone (also known as a cellular phone, cell phone, and a hand phone) has made our life easier by making and receiving telephone calls over a radio link to the farthest places of the world irrespective of our presence at any place. In olden times, individuals depended on the phone for communication, but now they have a thirst for it due to the countless benefits it provides. Nowadays, cell phones have become a principal part of our lifestyle, a means of communication and a basic requirement as the mobile phone provides innumerable benefits like internet, social networking, personal diary, e-mail dispatcher, calculator, calendar, video game player, camera and music player.³

Over the last decade, mobile phones have become the most pervasive mobile devices, which have morphed into smartphones with advanced features. For many the smartphone has become an extension of their ear, from the moment they wake up until the second they fall asleep. This love affair with the mobile phone is both enabling and crippling at the same time. The use of mobile phones is now so extensive that in some countries the number of phone subscriptions outnumbers the population. The Indian market is one of the largest in the world for mobile phones.⁴

Smartphones have become today an important part of our techno-culture, especially among the younger population, whose primary need is to socialize, join in, and be liked. Research shows that Nomophobia is on the rise across the globe and more and more people fear being without or losing their mobile devices.³

 The increasing utilization of new technological devices and virtual communication involving personal computers, tablets, and mobile phones (smartphones) are causing changes in individuals’ behavior and daily habits. Besides providing various advantages these new technologies, can lead to many types of social problems like social isolation, and economic/financial problems like larger debts incurred to buy or use smartphones. It can also cause both physical and psychological pathologies like damages related to electromagnetic field radiation, car accidents, and distress linked to the fear of not being able to use new technological devices. The constant checking and use of smartphones has created sleep disturbances, stress, anxiety, and deterioration of health along with a decrease in academic and physical performance.⁴ Thus our study was intended to study the pattern of Nomophobia among smartphone users.

Study Area:
The study was conducted at the Urban Health Training Centre, Vidyagiri, Dharwad.

Study Period:
The study was carried out over two months, from May to June 2018.

Study Design:
A cross-sectional study design was employed.

Study population:
The study included individuals aged 15–55 years who had been using smartphones for more than one year.

Sample Size:
A total of 188 participants were included in the study.

Inclusion Criteria:

1. Individuals aged 15–55 years who have been using smartphones for more than one year.
2. Individuals who provided informed consent to participate in the study.

Exclusion Criteria:
Individuals using iPhones were excluded from the study.

Data Collection:
Data was collected using a semi-structured questionnaire administered by interns posted at the Urban Health Centre after obtaining informed consent from the participants. The questionnaire comprised the following sections:

1. Sociodemographic Data: Information on age, gender, education level, occupation, and socioeconomic status.
2. Smartphone Usage Data: Details on duration, frequency, and purpose of smartphone use.
3. Nomophobia Questionnaire (NMP-Q): A validated questionnaire consisting of 20 items, measured on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). The total scores were categorized as follows:
   1. No Nomophobia: 20
   2. Mild Nomophobia: 21–59
   3. Moderate Nomophobia: 60–99
   4. Severe Nomophobia: 100–140

Statistical Analysis:

Data entry was performed using Microsoft Excel, and statistical analysis was conducted using SPSS version 22.0. Categorical variables were analyzed using frequencies and percentages. The Chi-square test was used to assess the association between Nomophobia and other variables, with a significance level set at p<0.05.

Sociodemographic Characteristics of Study Participants

Table 1 presents the distribution of study participants according to sociodemographic characteristics. The majority of the participants (54.26%) were in the 20-35 years age group. Males constituted 53.19% of the study population. Most participants (97.87%) were literate. Among them, 30.32% were engaged in employment, whereas 69.68% were not working. Nuclear families were the most common family structure (68.62%).

Table 1: Distribution of Study Participants According to Sociodemographic Characteristics

Table 2: Levels of Nomophobia in Study Participants

Table 2 presents the levels of Nomophobia among study participants. The majority (47.87%) exhibited mild Nomophobia, whereas 46.28% had moderate Nomophobia. Severe Nomophobia was observed in 2.66% of participants.

Table 3: Association of Nomophobia with Study Variables

(*Statistically significant at p < 0.05)

Table 3 presents the statistical association of Nomophobia with sociodemographic variables and smartphone usage patterns. A significant association was found between Nomophobia and education (p < 0.01), occupation (p < 0.01), socioeconomic status (p < 0.01), type of family (p < 0.01), hours of smartphone use per day (p < 0.01), hours of smartphone use per day for social networking (p < 0.01), and frequency of smartphone usage in an hour (p = 0.035). However, no statistically significant association was found between gender (p = 0.612) and total expenditure on smartphone services per month (p = 0.06).

The present study aimed to assess the prevalence of nomophobia among smartphone users attending the Urban Health Training Centre, Dharwad, and its association with sociodemographic variables. Our findings revealed that a significant proportion of participants exhibited varying degrees of nomophobia, with the majority (47.87%) experiencing mild nomophobia, followed by 46.28% with moderate nomophobia, and 2.66% with severe nomophobia. These findings align with previous studies that have reported high levels of nomophobia among smartphone users, particularly in younger age groups [1,2].

The sociodemographic analysis indicated that the highest prevalence of nomophobia was observed in the 20-35 years age group (54.26%). This is consistent with research by Yildirim and Correia [3], which found that younger individuals are more prone to smartphone dependence due to increased digital connectivity and social networking usage. Further, our study showed no significant association between gender and nomophobia (p=0.612), which is in line with studies by Pavithra et al. [4] and Prasad et al. [5], suggesting that both males and females are equally susceptible to smartphone addiction.

A strong association was observed between education level and nomophobia (p<0.01). Similar findings were reported by Dixit et al. [6], who highlighted that individuals with higher education levels tend to use smartphones more frequently for academic, professional, and social purposes, leading to increased dependency. Additionally, occupation showed a significant correlation with nomophobia (p<0.01), indicating that working individuals may experience anxiety related to smartphone unavailability due to their professional commitments.

Socioeconomic status was also significantly associated with nomophobia (p<0.01), with participants from higher socioeconomic classes showing higher levels of smartphone dependence. This trend is supported by the study conducted by King et al. [7], which found that individuals with higher income levels tend to have greater access to advanced smartphones and internet services, increasing their dependency on these devices.

The study also found a significant relationship between nomophobia and family structure (p<0.01), with nuclear family members exhibiting higher levels of nomophobia. This finding aligns with research by Kuss and Griffiths [1], who suggested that individuals from nuclear families may rely more on smartphones for social interaction, given the reduced face-to-face communication in such family setups.

Smartphone usage patterns, such as total hours of smartphone use per day (p<0.01) and hours spent on social networking (p<0.01), were significantly associated with nomophobia. Similar observations were made in studies by Bhattacharya et al. [8] and Kaur et al. [9], which reported that prolonged smartphone use for social media, gaming, and entertainment increases the risk of developing nomophobia.

Another crucial finding was the significant association between nomophobia and the frequency of smartphone usage per hour (p=0.035). This is consistent with findings from Ahmed et al. [10], who reported that excessive checking of smartphones, even in the absence of notifications, is a hallmark behavior of nomophobia individuals.

While the study provided valuable insights into the prevalence and determinants of nomophobia, certain limitations must be acknowledged. The study was conducted in a single urban health training center, limiting its generalizability. Additionally, self-reported data may be subject to recall bias. Future studies should consider larger sample sizes and diverse populations to enhance the understanding of nomophobia across different demographic groups.

Our study highlights the widespread prevalence of nomophobia among smartphone users and its significant association with various sociodemographic factors and smartphone usage behaviors. Given the increasing reliance on smartphones, it is essential to raise awareness about the psychological impact of nomophobia and promote healthy smartphone usage habits. Further research is needed to explore effective interventions for reducing smartphone dependency and mitigating the adverse effects of nomophobia.

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2. Yildirim C, Correia AP. Exploring the dimensions of nomophobia: Development and validation of a self-reported questionnaire. Comput Human Behav. 2015;49:130-137.
3. Yildirim, Caglar. "Exploring the dimensions of nomophobia: Developing and validating a questionnaire using mixed methods research" (2014). Graduate Theses and Dissertations. 14005. https://lib.dr.iastate.edu/etd/14005.
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5. Prasad M, Patthi B, Singla A, Gupta R, Saha S, Kumar JK et al. Nomophobia: A cross-sectional study to assess mobile phone usage among dental students. Journal of Clinical and Diagnostic Research. 2017;11(2):ZC34-9.
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9. Kaur A, Bashar MA, Singh A, Grover A. Nomophobia: A rising concern among Indian medical students. Int J Res Med Sci. 2015;3(3):705-707.

10. Ahmed S, Pokhrel N, Roy S, Samuel AJ. Impact of nomophobia: A nondrug addiction among students of physiotherapy course using an online cross-sectional survey. Indian J Psychiatry. 2019;61(1):77-80.