Asian Journal of Medical Principles and Clinical Practice

Background: Excessive screen-time has emerged as a significant public health concern among adolescents due to its association with adverse physical, mental, and social health outcomes. Despite increasing access to digital devices among Nigerian youths, evidence on awareness of screen-time-related health consequences and its influence on usage behaviour remains limited, particularly in secondary school settings.

Objective: This study assessed the level of awareness of the health consequences of excessive screen-time, patterns of screen use, and factors influencing screen-time among secondary school students in Osisioma-Ngwa Local Government Area, Abia State, Nigeria.

Methods: A cross-sectional descriptive survey was conducted among 276 students selected through stratified proportional random sampling from one public and one private secondary school. Data were collected using a structured self-administered questionnaire covering socio-demographic characteristics, screen-time patterns, awareness of health consequences, information sources, and barriers to screen-time reduction. Data were analysed using descriptive statistics, chi-square tests, and binary logistic regression at a significance level of p < 0.05.

Results: Smartphone ownership was high (87.2%), and 54.4% of respondents reported high screen-time, with 25.8% spending more than five hours daily on non-academic activities. Social media was the predominant purpose of screen use (41.1%). Most students were aware of the physical (71.7%) and mental/social (67.8%) health consequences of excessive screen-time, while 42.4% demonstrated good overall awareness. Commonly recognised consequences included eye strain (76.8%), poor concentration (75.4%), reduced face-to-face interaction (70.6%), and anxiety or stress (68.4%). Internet/social media (63.1%) and teachers (50.9%) were the primary sources of information. Entertainment (55.2%), social connectivity (48.5%), and peer influence (43.7%) were the major barriers to reducing screen-time. A significant association was observed between awareness level and screen-time duration (χ² = 7.622, p = 0.022); however, awareness was not an independent predictor of lower screen-time in logistic regression analysis (AOR = 0.90, 95% CI: 0.28–2.93, p = 0.867). Female students were significantly less likely to engage in high screen-time than males (AOR = 0.45, 95% CI: 0.26–0.78, p = 0.004).

Conclusion: Excessive screen-time is prevalent among secondary school students despite relatively high awareness of its health consequences. Awareness alone is insufficient to drive behavioural change. Comprehensive interventions emphasising digital wellness skills, parental involvement, self-regulation, and attractive offline recreational alternatives are required to promote healthier screen-use behaviours among adolescents.