Most addictive and harmful substances are either highly regulated and taxed, or straight out illegal. But something intentionally designed to be just as addictive as cigarettes and cocaine is used by teenagers and adults every day. Julie M. Albright argues why smart phone use is just as harmful as the drugs we ban.

I am a digital sociologist. I’ve spent my career tracking the growth and proliferation of digital devices and communications. At the beginning, I kind of poo-pooed talk of addiction, thinking: We stare at television screens, what’s the difference between that and a computer screen? With the invention of the iPhone though, where the Internet goes with you in your pocket (or hand) — my views on the addictive nature of digital technologies have changed. App developers have become savvy, learning how to manipulate your behavior and get you hooked. Our attention is being grabbed and held against our will, often without us even realize it.

While the severe health risks of smoking and cocaine use are well-documented, phone addiction — particularly among teens — is an emerging crisis with wide-ranging consequences that may prove to be even more detrimental — yet it’s often unseen. The constant connectivity facilitated by smartphones has ushered in a new era of compulsive behavior that mirrors the psychological patterns observed in substance addiction. Teens, whose brains are still developing, are especially vulnerable to this form of addiction. According to Pew Research, teenagers are now online "almost constantly," a trend that correlates with rising rates of depression, anxiety, and sleep disorders among this age group. Unlike the more overt physical damage caused by smoking and cocaine, the harms of phone addiction are insidious, infiltrating mental health, disrupting sleep, encouraging sedentary lifestyles, and eroding the quality of face-to-face human interactions. As this generation of digitally-immersed adolescents matures, we must grapple with the prospect that the societal toll of phone addiction could surpass the grim legacies of smoking and cocaine use.

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According to Pew Research, teenagers are now online "almost constantly," a trend that correlates with rising rates of depression, anxiety, and sleep disorders among this age group.

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Comparing past and current rates of smoking and cocaine use with the increasing prevalence of phone addiction paints a startling picture. According to the Centers for Disease Control and Prevention (CDC), cigarette smoking among U.S. adults has significantly declined from 20.9% in 2005 to 14.0% in 2019. Similarly, the National Institute on Drug Abuse reported a decline in cocaine use among young adults in the U.S., with the percentage of people aged 18-25 who had used cocaine in the past year dropping from 6.2% in 2007 to 5.1% in 2019. In stark contrast, screen time has been on a dramatic rise. A report from Common Sense Media revealed that, in 2019, American teens spent an average of more than seven hours per day on screen media for entertainment, not including time spent on schoolwork — a figure that was up nearly 45 minutes from 2015. For younger children, aged 8 to 12, the screen time average was nearly five hours per day, representing a substantial increase as well. As such, while public health initiatives have made progress in reducing the prevalence of smoking and cocaine use, screen time — a proxy for phone addiction — has been increasing alarmingly across different age groups.

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The Design of Addictiveness

Social media apps, such as Instagram and TikTok, are meticulously engineered to be addictive, employing techniques akin to those used in slot machines and other forms of gambling. At the heart of this design is something psychologists call random reinforcement — a variable reward system that leverages unpredictability to keep users engaged — sometimes you win, sometimes you don’t. Just as slot machines offer the allure of a potential reward with each pull of the lever, apps now employ features like "pull-to-refresh" and randomized notifications to create a sense of anticipation and excitement. For example, each time users refresh their Instagram feed or receive a notification from TikTok, they are presented with new and engaging content, akin to a gambler feeling a rush when a slot machine lights up with a win. This constant stream of new content, likes, and social validation triggers the release of dopamine, the brain's reward chemical, reinforcing the user's behavior and encouraging continuous engagement with the platform. Such features are not incidental; they are baked into the software with the express purpose of encouraging constant use and maximizing the time users spend within the app. The design of these applications, as Tristan Harris, a former design ethicist at Google, has pointed out, exploits human psychology to make these platforms hard to resist, highlighting the deliberate tactics employed to capture and sustain user attention.

The Psychological Effects of Phone Addiction

Social media platforms and constant notifications are specifically designed to activate the brain's dopamine-driven reward system, creating a loop of habitual and addictive behavior. Similar to the pleasure experienced from eating, sex, or receiving a compliment, successful social interactions — including receiving a 'like' or 'share' on social media — trigger the release of dopamine, a neurotransmitter that signals pleasure and reward to the brain. This dopamine release reinforces behavior, encouraging individuals to continue seeking out those rewarding social interactions, just as the 'high' of cocaine or the instant gratification from smoking prompts repeated use. A study by Volkow et al. (2017) elucidates this parallel, showing similar neurobiological changes — specifically in dopamine release — between drug addiction and behavioral addictions like excessive smartphone use. Importantly, the constant striving for social rewards via smartphones has been linked to significant mental health consequences. For example, research by Twenge and Campbell (2018) revealed a strong correlation between heavy screen time and increased rates of depression and anxiety, especially among young people, highlighting the tangible mental health toll associated with phone addiction. College administrators are now struggling with the fallout: amongst college students, anxiety and depression have hit a 30 year high.

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The design of these applications, as Tristan Harris, a former design ethicist at Google, has pointed out, exploits human psychology to make these platforms hard to resist, highlighting the deliberate tactics employed to capture and sustain user attention.

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Physical Health Consequences

Constant phone use inherently promotes a sedentary lifestyle, as individuals often spend hours seated or in a fixed position while engaging with their devices. This sedentary behavior is associated with a range of health risks, including obesity, cardiovascular diseases, and diabetes, reminiscent of the well-documented health risks of smoking, such as lung cancer and heart disease, and the systemic harm induced by cocaine use. Moreover, phone addiction has been linked to its own unique set of physical health consequences. Emerging studies indicate that excessive phone use, particularly before bedtime, can lead to significant sleep disruption, partly due to the blue light emitted by screens, which suppresses the production of melatonin, a hormone that regulates sleep. In addition to sleep issues, constant phone use is associated with digital eye strain, a condition characterized by symptoms such as dry eyes, headache, and blurred vision, as documented by the American Optometric Association. As phone use continues to increase, these physical health issues are becoming more pervasive, highlighting the necessity for public health interventions similar to those employed to combat the health risks of smoking and cocaine or other drug use.

Social and Societal Consequences

Phone addiction, marked by excessive and compulsive use of smartphones, can significantly diminish face-to-face social interaction. Engaging with screens for prolonged periods naturally reduces the time and energy individuals allocate to direct interpersonal relationships, leading to a preference for digital communication over personal contact. As a societal concern, growing up in an environment dominated by screens poses risks for a generation’s capacity for deep, focused work and the cultivation of meaningful relationships. Constant phone notifications, for instance, have been linked with reduced attention span and an increased likelihood of distraction in professional and academic settings. This contrasts sharply with the more "individual" nature of harm caused by smoking and cocaine use, which, although having significant societal costs, primarily manifests as direct physical harm to the user. Phone addiction, conversely, is reshaping fundamental aspects of human interaction and cognition on a societal level, altering how a generation communicates, forms relationships, and engages with the world — a process I’ve called “coming untethered” — which is further driving the mental health crisis amongst the young.

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Phone addiction, particularly among teens, represents a burgeoning crisis that, based on current evidence, may pose a threat potentially more severe than that of smoking and cocaine use.

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The Response to Phone Addiction

The response to phone addiction has been notably subdued when compared to the extensive public health campaigns launched against smoking and cocaine use. For decades, governments and health organizations have employed aggressive tactics, including graphic warnings, educational programs, and substantial policy changes to combat smoking and drug abuse. In contrast, phone addiction, despite emerging evidence highlighting its serious mental and physical health consequences, has not elicited a comparable level of public health response. Given the demonstrated association between excessive phone use and issues such as anxiety, depression, sleep disruption, and impaired social interaction, there is a compelling case for a more aggressive public health approach. This could encompass educational initiatives that raise awareness about the risks of phone addiction, policy interventions that encourage responsible design by tech companies, and the development of resources to help individuals manage their screen time more effectively. As our society becomes increasingly digital, the urgency of addressing phone addiction as a legitimate and significant public health issue is clear, warranting action that is commensurate with the scale and depth of the problem.

Conclusion

In conclusion, phone addiction, particularly among teens, represents a burgeoning crisis that, based on current evidence, may pose a threat potentially more severe than that of smoking and cocaine use. Its insidious nature — manifesting in mental health issues, sleep disruption, physical strain, diminished social interaction, and altered cognitive abilities — signals the urgency of this problem. Yet, despite the mounting evidence, societal response remains significantly muted compared to the extensive public health campaigns waged against smoking and cocaine use. It is imperative that comprehensive studies are undertaken to further understand the full spectrum of phone addiction's impact, and that these findings catalyze robust public health initiatives aimed at tackling this modern epidemic. From my perspective, this is not merely an issue for parents, educators, or health professionals — it is a societal issue that demands acknowledgment and urgent, substantive action. Filmmaker David Donnely has made a film inspired by my book which will debut soon, called The Cost of Convenience; it is my hope that we will be able to screen the film on college campuses — to spark discussions on striking a healthier balance between our offline lives and devices and digital connectivity. As our world becomes ever more digitized, the time to address and prioritize the mental and physical health of our digital natives is now.