The least-used app on my phone is “phone.” The diverse functionality of the smartphone—texting, talking, video streaming, gaming, social networking—has changed the way we work, play, and communicate. I still wonder if Steve Jobs, when he introduced the iPhone at the Macworld San Francisco Keynote Address in 2007, anticipated the influence Apple’s revolutionary creation would have on human behavior. He probably did. Just fifteen years after its release, numerous copycat devices have made the smartphone nearly ubiquitous.
According to the Pew Research Center, 85 percent of Americans have one, and nearly 50 percent admit they may be addicted. We’re tethered to our devices. They sit on our desks when we work; we use them when studying and attending lectures, while watching movies and sporting events; and we use them at mealtimes. They even rest on our nightstands, being the last thing we see when we sleep and the first we see when we wake. One-in-six cellphones contains traces of fecal matter, bacteria, and E. coli, because we use smartphones in the bathroom. When it comes to microbial infection, your smartphone is “The Trojan horse of transmission.”
Notwithstanding the self-reported statistics, if we define addiction as “The use of substances or behaviors that become compulsive and often continue despite harmful consequences,” then smartphone addiction probably afflicts us all.
There are well-documented implications on mental health. Excessive smartphone use is consistently associated with depression, anxiety, obsessive compulsive disorder, attention-deficit hyperactive disorder, loneliness, chronic stress, low self-esteem, and other negative emotions. Heavy use of social media, specifically, is also associated with poor mental health including increased risk of anxiety and depression. When social media fraternizes with the pursuit of health and fitness, there are additional dangers. “Fitspiration”—the process by which fitness influencers use motivational images, videos, and messages to inspire their followers to exercise and “be healthy”—is most often accessed through social media. Yet because fitness influencers make content creation their full-time vocation—benefitting from professional photo shoots, professional lighting and makeup, photo-editing software, and/or performance-enhancing supplements and drugs—fitspiration proliferates unrealistic and unobtainable body ideals that increase the risk of psychopathologies: (i) exercise addiction and compulsive exercise; (ii) body dissatisfaction and objectification; (iii) appearance-related anxiety, depressive symptoms, and low self-esteem; (iv) excessive control of eating habits; (v) use of performance enhancing drugs; and (vi) low quality of life.
Notwithstanding the widespread effects of smartphone addiction on mental health, the literature suggests there may be a heavy toll on physical health, one that is often overlooked. Recent studies showed that young adults who reported greater cellphone use tended to have higher measures of body fat, probably because they did less physical activity and had a lower daily step count. Cellphone use is also associated with difficulties in emotion regulation that, in turn, triggers dysregulated eating and food addiction. Some caution is warranted because these data derive from correlational studies—those that test relationships among variables, rather than cause and effect.
Another analysis applied a hierarchical regression model and found that greater cellphone use was associated with lower cardiorespiratory fitness, measured, in this case, as peak oxygen uptake (V̇Opeak). This, too, was a correlational study, but the relationship between cellphone use and fitness is a plausible one. For example, the smartphone’s broad utility makes it generally incompatible with physical activity: it’s hard to exercise while you’re playing Wordle or Snake. Furthermore, talking or texting during exercise (e.g., while walking/running on a treadmill) significantly reduces treadmill speed and estimated calorie expenditure, with a large overall main effect, when compared to listening to music or exercising phoneless. Texting during exercise evokes the lowest overall heart rate, perhaps therefore limiting the physiological adaptation to training.
Lastly, it’s a tautology that smartphone use at the gym may have safety implications because your device can distract you from environmental ques that would normally alert you to an impending hazard. An analysis of a national database found that, between 1998 and 2017, a total of 2,501 patients (roughly split between male and female) were admitted to emergency departments with head and neck injuries directly related to distractions caused by cellphones. In the weights rooms, talking and/or texting has been shown to significantly compromise balance by creating competition for limited attentional resources and challenging the brain on appropriate prioritization. Yet these risks are frequently ignored based on the optimism bias—the mistaken belief that you’re less likely to experience negative events and more likely to experience positive events, when compared to your peers.
In many ways, the relationship between your smartphone and your health is a toxic one. But could it be reformed to facilitate better health outcomes? Consider that less than a quarter of American adults meet the extremely conservative physical activity guidelines (150 minutes of moderate-to vigorous exercise and two strength sessions per week), citing “lack of time” as the primary reason. But objective data suggest that the greatest barrier to exercise is not “lack of time,” but rather lack of enjoyment. So, could smartphones be used to increase the enjoyment of exercise and, therefore, increase adherence?
Young people enjoy their workouts more when they’re using their cellphones. Music, for instance, most often accessed through smartphones, has consistently been shown to promote more positive affective valence during exercise (the quality of being perceived as “good”), enhance physical performance, and reduce perceived exertion. Moreover, unlike texting or talking on the phone, music doesn’t appear to diminish postural control during exercise.
Smartphones can also optimize exercise training by tracking basic metrics such as step count, heart rate, heart rate variability, and calorie expenditure. And initiatives that exploit the smartphone’s connectivity to increase physical activity (e.g., through the delivery of automated physical activity programs and physical activity prompts) are on the rise. Accordingly, with some intensive couples therapy, your smartphone and your health might yet live in harmony. But the relationship likely depends on your ability to maximize the advantages and minimize the disadvantages: it’s the difference between using your smartphone as a tool or your smartphone using you.
Your smartphone provides the functionality of a laptop computer, a television, the internet, and a games console, integrated into a portable device that fits in your pocket and follows you everywhere. The disadvantages of excessive screentime are many, with numerous psychological and physical manifestations. Still, we’ve described several ways that smartphones can enhance and even facilitate physical activity. As with all paradigm-shifting creations, the net effect—positive or negative—will be determined by whether we can put in the dedicated time and introspection to attain a healthy coexistence. Perhaps critical thinking, with its emphasis on objectivity and cognitive debiasing, can help in this respect; yet another reason to embrace skepticism in your life.