Smartphone overdependence may signal higher alcohol and smoking risk in teens

By Dr. Priyom Bose, Ph.D.Reviewed by Lauren HardakerMay 21 2026

A large Korean adolescent study links problematic smartphone dependence with higher odds of lifetime drinking and smoking, raising new questions about how digital behaviors, reward-seeking, and substance-use risks may cluster during teenage development.

Study: Association between smartphone overdependence and alcohol and tobacco use behaviors among adolescents in Korea. Image Credit: Zwiebackesser / Shutterstock

A recent Scientific Reports study assessed the relationship between smartphone overdependence and self-reported alcohol and tobacco use among Korean adolescents.

Prevalence and Behavioral Implications of Smartphone Overdependence in Adolescents

Rapid technological advancement has sharply increased smartphone adoption worldwide. Between 2016 and 2021, global smartphone ownership rose by 73.9%, with more than 7.2 billion devices representing about 90% of the global population. This widespread adoption and user attachment have raised concerns about overdependence.

Adolescents demonstrate especially high levels of smartphone dependence. In 2022, 40.1% of Korean adolescents showed the highest level of dependence among all age groups, marking a substantial increase from the previous two-year average of 23.6%. They often use smartphones to navigate peer relationships and cope with emotional challenges, which can further heighten dependence.

Neurodevelopmental factors make them more susceptible to addictive behaviors than adults. While smartphone overdependence is linked to negative mental health outcomes and behavioral addictions, few studies have examined its relationship with alcohol and tobacco use in this population.

Adolescence is characterized by the maturation of the prefrontal cortex and hypersensitive reward systems, leading to increased impulsivity and reward-seeking. Smartphone overdependence may share neural mechanisms with substance use and may also be associated with behavioral changes like reduced sleep and greater exposure to peer norms, both of which are linked to alcohol and tobacco use.

Despite evidence connecting smartphone overdependence to adverse outcomes, research on its association with alcohol and tobacco use among adolescents remains scarce. Small, non-representative samples, cross-sectional designs, and inadequate assessment of substance use patterns limit most existing studies. Few have investigated potential dose-response relationships or the consistency of these associations over time.

Assessing the Link Between Smartphone Overdependence and Adolescent Alcohol and Tobacco Use

Data were sourced from the 2020 and 2023 Korea Youth Risk Behavior Web-based Survey (KYRBS), an annual anonymous online survey of Korean middle and high school students selected via stratified cluster sampling. Using standardized measures, the study analyzed associations and assessed whether findings were consistent across the two survey years, including initiation, frequency, intensity, and dose-response relationships.

Smartphone overdependence was measured using a validated 10-item scale that categorized adolescents as general users, potential-risk users, or high-risk users. Alcohol and smoking experiences were determined through standard lifetime use questions, along with additional details on age at initiation, frequency, and quantity.

Increased Odds of Alcohol and Smoking in High-Risk Smartphone Users

A total of 107,606 adolescents, including 54,985 males and 52,621 females, participated in the current study. Among them, 34% reported having consumed alcohol, with these individuals more likely to be male, aged 16-18 years, from low-income backgrounds, and perceiving their health as very unhealthy. They also reported higher stress, inappropriate sleep durations, and lower academic grades.

Alcohol consumption was most prevalent among high-risk smartphone users, 45.3%, compared to 36.42% of potential-risk and 30.98% of general users. Similarly, smoking experience was reported by 19.18% of high-risk users versus 10.59% of potential-risk and 8.44% of general users, reinforcing a pattern of risk clustering.

Logistic regression indicated that, relative to general users, potential-risk users had 22% higher odds of alcohol use and 26% higher odds of smoking, while high-risk users exhibited 65% higher odds for alcohol use and 132% higher odds for smoking.

These associations remained significant after adjusting for selected demographic, socioeconomic, and health-related covariates, highlighting a significant association between smartphone overdependence and self-reported substance use.

Sensitivity analyses supported the consistency of these findings across survey years. Critically, a clear dose-response relationship was observed: earlier initiation, higher frequency, and greater quantity of alcohol or smoking were each associated with an increased likelihood of high-risk smartphone overdependence.

These results suggest that earlier initiation and heavier alcohol or tobacco use were associated with a higher adjusted probability of high-risk smartphone overdependence.

Conclusions

The current study revealed a strong association between smartphone overdependence and a higher prevalence of self-reported lifetime alcohol and tobacco use among adolescents. Higher smartphone dependence was associated with earlier onset, more frequent, and heavier substance use. Although causality could not be established, these findings underscored the need to consider smartphone overdependence in adolescent public health initiatives.

Incorporating digital well-being and healthy smartphone usage into substance use prevention programs could prove valuable. Screening for problematic smartphone use could also improve the identification of at-risk adolescents. 

Overall, these results provide meaningful guidance for future research and targeted interventions.

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