Lifestyle and exercise

Extreme levels of texting 'unhealthy'

“Feverish texting by your teenager may be a dangerous sign – they are more likely to have sex and binge drink,” reported The Daily Telegraph . The newspaper said research suggests that teenagers who ‘hyper-text’, sending more than 120 texts a day, are more likely to have sex, drink and smoke.

This news report is based on a study presented at US conference. More than 4,000 US teenagers were surveyed, and asked about their texting, social networking and other behaviours. Hyper-texting and hyper-networking (three or more hours a day of social networking) were found to be associated with various risky behaviours.

The study has not yet been published, making it difficult to appraise the reliability of its results. Despite the lack of detail, however, the cross-sectional nature of the survey means it cannot demonstrate cause and effect between different behaviours. The findings should not be applied to all teenagers in general. Hyper-texting is extreme behaviour, and it is not known how common it is in the UK.

This study shows that hyper-texting and networking, as with most excessive behaviours, may indicate that other unhealthy behaviours co-exist.

Where did the story come from?

The news reports are based on research publicised in a press release from the Case Western Reserve School of Medicine, Cleveland, Ohio in the US. The research has also been presented at the American Public Health Association’s 138th Annual Meeting and Exposition. Full details of the study are not yet publicly available and this appraisal is reliant on the information in the press release and abstract.

The BBC, Daily Telegraph and Daily Mail covered this story, all of which based their articles mainly on the press release.

What kind of research was this?

The researchers wanted to investigate whether the use of ‘communication technology’, such as mobile phones and social networking, was associated with poor health behaviours among teens, including smoking, drinking and sexual activity. They were particularly interested in hyper-texting (120 or more texts a day) and hyper-networking (three or more hours a day on social networking sites).

The study design used was a cross-sectional survey, which investigates what is happening in a given population at a defined point in time. This type of study can only give an idea of how common behaviours or conditions are in that population, but cannot demonstrate cause and effect. As such, the study does not show that the level of texting has any causative association with the lifestyle behaviours examined, or any direct effect upon health.

There are likely to be many interacting personal, social and environmental factors that influence many of these behaviours and the findings of this localised cross-sectional survey should be generalised to the wider teenage population with caution.

What were the basic findings?

The conference abstract and press release are brief and do not give details on how the study was carried out. The researchers are reported to have surveyed 4,257 high school students from an urban Midwestern county using the Youth Risk Behaviour Survey.

Hyper-texting was reported by 19.8% of students and hyper-networking by 11.5%. Almost a quarter of students reported no texting (22.5%) or online social networking (22.2%). Hyper-texting and networking were reported to occur more often among females, minority ethnic groups, and those of lower socioeconomic status.

Students who were classifed as hyper-texters were three and half times more likely to have had sex. They had also had more sexual partners and 90% of those who hyper-texted reported having had four or more partners. Other health behaviours examined included smoking, with hyper-texters being 40% more likely to have tried cigarettes, alcohol use (two times more likely to have tried alcohol), binge drinking (43% more likely), and illegal drug use (41% more likely). Similar associations were observed with hyper-networking.

Hyper-texting and networking students were also more likely to be obese or have an eating disorder, and miss school due to illness. They rated their own health as poorer and reported stress or suicidal thoughts. No better health outcomes were associated with texting and networking.

How did the researchers interpret the results?

The conclusion of the conference abstract is that “excessive use of communications technology among teens is related to higher levels of health risk behaviours and poorer health outcomes”. In the press release, the lead researcher says:

“The startling results of this study suggest that when left unchecked, texting and other widely popular methods of staying connected can have dangerous health effects on teenagers.

“This should be a wake-up call for parents to not only help their children stay safe by not texting and driving, but by discouraging excessive use of the cellphone or social websites in general.”


These findings need to be interpreted with some caution. As yet, details of the study are not publicly available, making it difficult to appraise the methods used and how reliable the findings are.

As it stands, the survey results can only tell us of the prevalence of hyper-texting, hyper-networking and other health-related behaviours in this population of high school students in the US. One cannot apply cause and effect to these results, and this type of study cannot tell us whether or how these factors are related to each other. Also, this study was in the US, and behaviour in the UK may be different.

As such, the study provides no evidence that excessive texting causes other risky behaviours among teenagers. There is likely to be a complex interaction of many personal, social and environmental factors that influence many of these behaviours. Without further detail, it is not possible to determine how well the researchers took this into account, nor how well they explored the possible benefits of networking.

Hyper-texting is extreme behaviour, characterised by teenagers sending more than 120 texts a day. What this study highlights is that hyper-texting and networking, as with most excessive behaviours, may indicate that other unhealthy behaviours co-exist.

NHS Attribution