Urban-rural differences in factors associated with smartphone addiction among preschoolers in Dhaka district, Bangladesh: a cross-sectional investigation

Abstract Background: Children are increasingly becoming addicted to smartphones and screens, which is raising concerns about their physical and mental wellbeing. This study aimed to assess urban-rural differences in the prevalence and correlates of smartphone addiction among preschoolers in Dhaka district, Bangladesh. Methods: A cross-sectional study was conducted among the mothers of 840 preschoolers living in Dhaka city and two sub-districts. We assessed preschoolers’ smartphone addiction using the child version of the Smartphone Addiction Proneness Scale. Logistic regression was performed to identify the correlates of smartphone addiction among preschoolers, adjusting for potential confounders. Results: The overall prevalence of smartphone addiction was 59.9%, and it was higher among urban preschoolers (urban: 70.5% vs. rural: 49.3%). Playing games on smartphones was a risk factor for smartphone addiction, and the likelihood of addiction was higher among rural children (aOR: 3.76, 2.18 to 6.5) compared to urban children (aOR: 2.30, 95% CI: 1.25 to 4.26). Mother’s daily smartphone use at home for more than two hours in both urban (aOR: 2.65, 95% CI: 1.31 to 5.35) and rural areas (aOR: 1.91, 95% CI: 1.11 to 3.28) were associated with smartphone addiction. Both urban and rural children were respectively 1.64 (95% CI: 1.08 to 2.47) and 1.53 (95% CI: 1.14 to 2.07) times more likely to develop smartphone addiction if the number of smartphones they accessed increased by one. In urban areas, the children of working mothers were at 2.91 (95% CI: 1.09 to 7.73) times higher risk of smartphone addiction compared to those of stay-at-home mothers. Rural children who used the Wi-Fi internet had the higher odds of showing addictive behaviours (aOR: 3.03, 95% CI: 1.88 to 4.88). Conclusions: The prevalence of smartphone addiction was higher among urban children compared to rural ones. We found sociodemographic and smartphone use pattern-related risk factors for smartphone addiction among children in both urban and rural areas. Therefore, it is very important to adopt appropriate counselling and health education to prevent and control smartphone addiction in preschoolers.