MOBILE PHONE DEPENDENCE AND HEALTH-RELATED LIFESTYLE OF UNIVERSITY STUDENTS

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1 SOCIAL BEHAVIOR AND PERSONALITY, 2006, 34(10), Society for Personality Research (Inc.) MOBILE PHONE DEPENDENCE AND HEALTH-RELATED LIFESTYLE OF UNIVERSITY STUDENTS MASAHIRO TODA, KAZUYUKI MONDEN, KAZUKI KUBO, AND KANEHISA MORIMOTO Osaka University Graduate School of Medicine, Osaka, Japan This study investigated the associations between the intensity of mobile phone use and healthrelated lifestyle. For 275 university students, we evaluated health-related lifestyle using the Health Practice Index (HPI; Hagihara & Morimoto, 1991; Kusaka, Kondou, & Morimoto, 1992) and analyzed responses to a questionnaire (MPDQ; Toda, Monden, Kubo, & Morimoto, 2004) designed, with a self-rating scale, to gauge mobile phone dependence. For males, there was a significant relationship between smoking habits and mobile phone dependence. We also found that male respondents with low HPI scores were significantly higher for mobile phone dependence. These findings suggest that, particularly for males, the intensity of mobile phone use may be related to healthy lifestyle. Keywords: mobile phone, dependence, health-related lifestyle, Health Price Index, health, males. In Japan, from the mid-1990s, mobile phones rapidly came into widespread use. Excluding subscribers to Personal Handy-phone System (PHS), in March 2004 there were million mobile phones in use, which translates to a penetration rate of about 64% (Ministry of Internal Affairs and Communications, 2004). In addition, the diffusion of Internet access via mobile phone, which began in February 1999 has also been remarkable. Of the million mobile phones, million were also able to access the Internet (MIC, 2004). Masahiro Toda, Kazuyuki Monden, Kazuki Kubo and Professor Kanehisa Morimoto, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. Appreciation is due to reviewers including: Professor Leif Edvard Aaro, PhD, Research Centre for Health Promotion (HEMIL), University of Bergen, Christiesgt. 13, N-5015 Bergen, Norway, leif.aaro@psych.uib.no; Leena Koivusilta, PhD, Department of Social Policy, University of Turku, Turku, Finland, FIN , leena.koivusilta@utu.fi Please address correspondence and reprint requests to: Professor Kanehisa Morimoto, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada- Oka, Suita, Osaka, Japan Phone: 81 (6) ; Fax: 81 (6) ; morimoto@envi.med.osaka-u.ac.jp 1277

2 1278 MOBILE PHONE DEPENDENCE AND HEALTHY LIFESTYLE Thus, the mobile phone has established a general presence in daily life. At the same time, such a new information and communication technology may cause various issues. Some previous studies of Internet use suggest that excessive Internet use may be associated with subjective distress, loneliness and social disinhibition (Kraut et al., 1998; Moody, 2001; Niemz, Griffiths, & Banyard, 2005; Shapira, Goldsmith, Keck, Khosla, & McElroy, 2000). Meanwhile, although there are only a few studies of mobile phone use, it has been suggested that excessive mobile phone use may be associated with health-compromising behaviors, such as smoking or alcohol drinking (Koivusilta, Lintonen, & Rimpelä, 2003, 2005). To further elucidate the health-effect implications of excessive mobile phone use, we thought that a more comprehensive investigation of lifestyle was required. In the present study, by analyzing responses from a sample of university students, we investigated the associations between the intensity of mobile phone use and health-related lifestyle, and also the gender difference in these associations. Viewing mobile phone dependence as a type of technostress (Brod, 1984), in a previous study we defined dependence in terms of two factors: excessive use and use of mobile phones in public places even when such use is considered to be a nuisance. We suggested that measures to prevent the mental and physical health effects of such dependence are required (Toda, Monden, Kubo, & Morimoto, 2004). In this previous study, to identify high-risk groups, we designed, administered, and confirmed the reliability and pertinence of a questionnaire to gauge mobile phone dependence (MPDQ; Toda et al.). METHOD SUBJECTS In a survey called Investigation into lifestyle and the use of mobile phones, we distributed questionnaires to 275 university students in the Department of Technology, Medicine and Literature after a lecture. The students filled them in then and there on their own. Afterwards, we collected the completed forms. Statistical analysis could be performed for 271 respondents (117 males, 154 females) who properly completed all the questionnaire items. Mean (±SD) age for males was 21.5 ± 1.8 years and for females 21.3 ± 1.4 years. All subjects also had mobile phone access to the Internet and all mobile phone use was personal: there were no responses indicating use for business. MOBILE PHONE DEPENDENCE We evaluated mobile phone dependence from responses given to 20 selfrated items related to mobile phone use in the MPDQ (Toda et al., 2004; see Appendix). Each response was scored both on a Likert scale (0, 1, 2, 3) and a dichotomized scale (0, 0, 1, 1). The dichotomized scale was used only for

3 MOBILE PHONE DEPENDENCE AND HEALTHY LIFESTYLE 1279 case identification. Likert scores for each item were then summed to provide an overall mobile phone dependence score ranging from 0 to 60. Higher scores indicate greater dependence. Subjects exceeding the mean + 1 SD were put in the high-dependence category. HEALTH-RELATED LIFESTYLE Health-related lifestyle was evaluated using a Health Practice Index (HPI). Based upon the lifestyle study by Belloc and Breslow (1972) and taking into consideration cultural differences, the questionnaire and scoring were designed for Japanese subjects. Modifications particularly addressed nutritional balance and mental stress. For instance, it has been shown that many Japanese are aware that a diet containing a large quantity of vegetables and little meat may lower mortality from some cancers (Hirayama, 1979, 1982). Furthermore, Japanese society differs from U.S. society in that there is much less of a separation between work and social activities. With higher points being awarded for responses that are better for health, each respondent s overall rating was derived from eight lifestyle items smoking habits, drinking habits, daily consumption of breakfast, appropriate daily duration of sleep and work, regular physical activity, appropriate levels of subjective stress, and nutritionally balanced diet. Based on their HPI scores, respondents were then allocated to one of three groups: good 7-8 points; moderate 5-6 points; and poor 0-4 points. This method of classification has been found to be useful in evaluating personal lifestyles among Japanese (Ezoe & Morimoto, 1994; Hagihara & Morimoto, 1991; Kusaka, Kondou, & Morimoto, 1992; Maruyama, Sato, & Morimoto, 1991; Morimoto et al., 1993; Shirakawa & Morimoto, 1991). STATISTICAL ANALYSIS All results are displayed as mean values ± standard deviation. Before statistical analysis, normal distribution was tested by Kolmogorov-Smirnov testing. Each parameter (mobile phone dependence, health-related lifestyle) fulfilled this test. Chi-square testing was performed to compare the responses of males and females to each MPDQ item and for overall mobile phone dependence. Moreover, for each respondent, the relationship between mobile phone dependence and health-related lifestyle was investigated using chi-square testing. Values were considered to be significantly different at p < RESULTS ITEM-BY-ITEM PHONE DEPENDENCE COMPARISON OF MALES AND FEMALES Chi-square results revealed significant gender differences for the following

4 1280 MOBILE PHONE DEPENDENCE AND HEALTHY LIFESTYLE items. More males than females answered: I give my mobile phone more priority than clothes and food (χ 2 = 5.56, df = 1, p < 0.05); When I am riding on a train or in similar situations, I tend to handle my mobile phone (χ 2 = 4.17, df = 1, p < 0.05); Even while riding on trains, I make and receive calls (χ 2 = 5.02, df = 1, p < 0.05); and I make mobile phone calls even late at night (χ 2 = 13.80, df = 1, p < 0.001). Meanwhile, more females than males answered: I send ten or more s a day (χ 2 = 4.17, df = 1, p < 0.05); I am pleased when I receive (χ 2 = 4.76, df = 1, p < 0.05); and I use a lot of pictographs in my (χ 2 = 20.14, df = 1, p < ) (Table 1). TABLE 1 PERCENTAGE OF RESPONDENTS WITH HIGH SCORE FOR EACH MPDQ ITEM Question No. Males (n=117) Females (n=154) Chi-square * * * *** * * **** *p < 0.05, *** p < 0.001, **** p < RELATIONSHIP BETWEEN MOBILE PHONE DEPENDENCE AND HPI SCORES Mean score for mobile phone dependence was 32.4±9.5 (males, 32.0±10.6; females, 32.8±8.7). Subjects exceeding the mean + 1 SD, scoring 42 points or more, were put in the high-dependence category. There was no significant difference between males and females in the percentage of respondents who scored 42 points or more (18.8% vs. 17.5%). For males, we found a significant relationship between mobile phone dependence and health-related lifestyle: that is, more respondents with poor HPI scores were in the high-dependence group (χ 2 = 4.29, df = 1, p < 0.05). No such

5 MOBILE PHONE DEPENDENCE AND HEALTHY LIFESTYLE 1281 relationship was apparent for female respondents. In addition, with the exception of smoking habits (χ 2 = 4.58, df = 1, p < 0.05), no significant relationships between particular lifestyle items and mobile phone dependence were apparent for either males or females (Table 2). TABLE 2 PERCENTAGE OF RESPONDENTS WITH POOR HEALTH-RELATED LIFESTYLE BY MOBILE PHONE DEPENDENCE Males Females Normal- High- Chi- Normal- High- Chidependence dependence square dependence dependence square (n=95) (n=22) (n=127) (n=27) Smoking habits * Drinking habits Daily consumption of breakfast Appropriate daily duration of sleep Appropriate daily duration of work Regular physical activity Appropriate levels of subjective stress Nutritionally balanced diet * p < 0.05 DISCUSSION We found significant gender differences for several of the responses to mobile phone dependence items in the questionnaire. Higher male scores tended to be related to voice phone services, while higher female scores tended to be related to Internet services. Furthermore, more females than males answered: I use Internet services more than mobile voice phone services (χ 2 = 5.10, df = 1, p<0.05). These findings might suggest that females tend, more than males, to prefer indirect communication. Previous studies of Internet use found that females are more satisfied with communication via , and are more likely to utilize it to build intimate relationships (Boneva, Kraut, & Frohlich, 2001; McKenna, Green, & Gleason, 2002). However, the present findings could be related to cost. Since Internet services are less expensive than mobile voice phone services, this may account for the females giving lower scores to I give my mobile phone more priority than clothes and food. For males, there was a significant relationship between smoking habits and mobile phone dependence. These findings support previous studies which

6 1282 MOBILE PHONE DEPENDENCE AND HEALTHY LIFESTYLE suggested that excessive mobile phone use may be associated with healthcompromising behaviors, such as smoking or alcohol drinking (Koivusilta et al., 2003, 2005). We found no significant relationships between drinking habits and mobile phone dependence for either males or females. This may have been due to the lower prevalence of daily alcohol consumption (3.0%) compared to the previous results with adolescents in Finland (42.3%) (Koivusilta et al., 2005). It has been suggested that excessive Internet use may be associated with subjective distress (Kraut et al., 1998; Shapira et al., 2000). For either gender, however, a lifestyle item levels of subjective stress was not associated with mobile phone dependence. Furthermore, compared with the normal-dependence group, more male (χ 2 = 8.52, df = 1, p < 0.01) and female (χ 2 = 5.19, df = 1, p < 0.05) respondents in the high-dependence group scored higher for I feel myself related to other people by having a mobile phone. Such responses suggest that, particularly for young adults at university, rather than mobile phone technology being a stressor, mobile phone use aids in coping with stress by providing a channel of human support. Previous studies have also suggested that, among young people, mobile phones increase the frequency of communication, and allow opportunities for expanding interpersonal relationships (Igarashi, Takai, & Yoshida, 2005; Matsuda, 2000). When scores from the eight lifestyle items were totaled, for males, respondents with poor HPI scores were significantly higher for mobile phone dependence than were those with good or moderate HPI scores. No such relationship was apparent for female respondents. These findings suggest that, particularly for males, the intensity of mobile phone use may have a more comprehensive relationship to healthy lifestyle and that males may require more comprehensive guidance about mobile phone use. To establish these assumptions conclusively, further studies are required. In this study, we found associations between the intensity of mobile phone use and health-related lifestyle, and also a gender difference in these associations. This research, however, has several limitations. The sample size was too small to be representative of the young Japanese population. The present findings, therefore, should not be assumed to hold true for all young people. Furthermore, in order to establish the health implications of mobile phone dependence, studies with other designs, such as prospective panel studies or field experiments, are also required. REFERENCES Belloc, N. B., & Breslow, L. (1972). Relationship of physical health status and health practices. Preventive Medicine, 1, Boneva, B., Kraut, R., & Frohlich, D. (2001). Using for personal relationships: The difference gender makes. American Behavioral Scientist, 45,

7 MOBILE PHONE DEPENDENCE AND HEALTHY LIFESTYLE 1283 Brod, C. (1984). Technostress: The human cost of the computer revolution. Reading, Mass: Addison- Wesley Publishing Co. Ezoe, S., & Morimoto, K. (1994). Behavioral lifestyle and mental health status of Japanese factory workers. Preventive Medicine, 23, Hagihara, A., & Morimoto, K. (1991). Personal health practices and attitudes toward nonsmokers legal rights in Japan. Social Science & Medicine, 33, Hirayama, T. (1979). Cancer epidemiology in Japan. Environmental Health Perspectives, 32, Hirayama, T. (1982). Relationship of soybean paste soup intake to gastric cancer risk. Nutrition and Cancer, 3, Igarashi, T., Takai, J., & Yoshida, T. (2005). Gender differences in social network development via mobile phone text messages: A longitudinal study. Journal of Social and Personal Relationships, 22, Koivusilta, L., Lintonen, T., & Rimpelä, A. (2003). Mobile phone use has not replaced smoking in adolescence. British Medical Journal, 326, 161. Koivusilta, L., Lintonen, T., & Rimpelä, A. (2005). Intensity of mobile phone use and health compromising behaviours: How is information and communication technology connected to health-related lifestyle in adolescence? Journal of Adolescence, 28, Kraut, R., Patterson, M., Lundmark, V., Kiesler, S., Mukopadhyay, T., & Scherlis, W. (1998). Internet paradox: A social technology that reduces social involvement and psychological well-being? The American Psychologist, 53, Kusaka, Y., Kondou, H., & Morimoto, K. (1992). Healthy lifestyles are associated with higher natural killer cell activity. Preventive Medicine, 21, Maruyama, S., Sato, H., & Morimoto, K. (1991). Relationship between work-life satisfaction, health practices and primary symptoms/problems. Japanese Journal of Hygiene, 45, Matsuda, M. (2000). Interpersonal relationships among young people and mobile phone usage: From attenuant to selective relationships. Japanese Journal of Social Informatics, 4, McKenna, K. Y. A., Green, A. S., & Gleason, M. E. (2002). Relationship formation on the Internet: What s the big attraction? Journal of Social Issues, 58, Ministry of Internal Affairs and Communications (MIC). (2004). White Paper: Information and communications in Japan, Year Moody, E. J. (2001). Internet use and its relationship to loneliness. Cyberpsychology and Behavior, 4, Morimoto, K., Takeshita, T., Takeuchi, T., Maruyama, S., Ezoe, S., Mure, K., & Inoue, C. (1993). Chromosome alterations in peripheral lymphocytes as indices of lifestyle and genotoxicity. International Archives of Occupational and Environmental Health, 65, Niemz, K., Griffiths, M., & Banyard, P. (2005). Prevalence of pathological Internet use among university students and correlations with self-esteem, the General Health Questionnaire (GHQ), and disinhibition. Cyberpsychology and Behavior, 8, Shapira, N. A., Goldsmith, T. D., Keck, P. E. Jr., Khosla, U. M., & McElroy, S. L. (2000). Psychiatric features of individuals with problematic Internet use. Journal of Affective Disorders, 57, Shirakawa, T., & Morimoto, K. (1991). Lifestyle effect on total IgE. Allergy, 46, Toda, M., Monden, K., Kubo, K., & Morimoto, K. (2004). Cellular phone dependence tendency of female university students. Japanese Journal of Hygiene, 59,

8 1284 MOBILE PHONE DEPENDENCE AND HEALTHY LIFESTYLE APPENDIX MOBILE PHONE DEPENDENCE QUESTIONNAIRE (MPDQ) 1. I give my mobile phone more priority than clothes and food. 2. I feel unsettled when I forget to take my mobile phone with me. 3. I would rather lose my wallet or purse than my mobile phone. 4. I recharge my mobile phone battery every day. 5. I don t really want to go to places where mobile phone signals are weak. 6. When I am riding on a train or in similar situations, I tend to handle my mobile phone. 7. Even while riding on trains, I make and receive calls. 8. I use my phone when I am in the company of one or two other people. 9. I make mobile phone calls even late at night. 10. I talk on my mobile phone for more than one hour a day. 11. I find it hard to keep company with people who don t have mobile phones. 12. Without thinking, I check my phone for or voice mail even when it hasn t rung. 13. I send mail even when I am at work or in class. 14. I send ten or more s a day. 15. I am pleased when I receive I send mail with little content that has no practical purpose. 17. I use a lot of pictographs in my 18. I always reply to phone I send lots of long messages. 20. I express my true feelings better via than by voice mail. Respondents were asked to score each item as follows: Always, 3 points; Often, 2 points; Sometimes, 1 points; or Hardly ever, 0 points. The total score indicates the level of mobile phone dependence.

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