Internet addiction and its associated factors among secondary level students of Urlabari municipality, Nepal

Abstract

SUMMARY:Introduction: The internet is currently a part of daily life, especially among teenagers who are at particular risk for problem internet use due to the undergoing development. Internet addiction has been linked with a number of adverse health effects including absence of physical exercise, sleep disturbances, musculoskeletal pain, eye strain and psychological disturbances like depression, anxiety, and stress. Generating local evidence is therefore crucial to inform interventions, awareness, and policy for safe internet use among young people. Thus, the study aims to assess the prevalence of internet addiction among school level students and also identify factors associated with it. Methodology: A cross-sectional study was conducted among 564 students from grades 11 and 12 selected through two-stage cluster sampling from six randomly chosen schools from 2025/12/21 to 2026/01/01. Data was collected using validated self-administered questionnaires, including Young’s Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scale (DASS-21) for measuring internet addiction, sleep quality and depression, anxiety and stress respectively. Descriptive and Multivariable Logistic Regression analysis was used to assess prevalence and associations between internet addiction and key variables. P-value <0.05 was considered statistically significant. Results: The mean age of respondents was 17.15 (SD 0.92) years. Around 57.2% of respondents were female. About 42.7% of respondents were addicted to internet. Also, 45.2% reported expressing depressive symptoms, 50.4% had anxiety and 30.3% reported stress symptoms at different severity. Around 30.5% of respondents had poor sleep quality. Multivariable logistic regression showed that being in private school (AOR 1.765 CI: 1.040-2.994), using internet for entertainment (AOR 1.941, CI: 1.201-3.135) and online gaming (AOR 2.547, CI: 1.181-5.493), poor sleep quality (AOR 2.692, CI: 1.727-4.197), anxiety (AOR 1.987, CI: 1.240-3.184) and stress (AOR 1.895, CI: 1.117-3.216) were significantly associated with internet addiction. Conclusions: The study identified several factors that were significantly associated with internet addiction, including school type, main purpose of internet use, poor sleep quality, anxiety and stress. The findings suggest that targeted education and digital awareness programs for parents, school authorities, and students, along with interventions addressing sleep quality, anxiety, stress, and excessive recreational internet use, are essential for address internet addiction.