Department of Health Promotion and Health Education, National Taiwan Normal University,Taipei,TaiwanTaiwan
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Purpose Internet addiction is a major health concern among undergraduate students; however, few studies have addressed modifiable behavioral factors associated with internet addiction in the context of Taiwan. This study aimed to investigate associations between physical activity and the risk of internet addiction among undergraduate students in Taiwan. Methods In 2017, we recruited 320 undergraduate students from Northern Taiwan to participate in a cross-sectional questionnaire-based survey. Physical activity was measured by the Taiwanese short-form version of the International Physical Activity Questionnaire, which evaluates an individual’s weekly levels of vigorous-intensity aerobic physical activity (VPA) and moderate-intensity aerobic physical activity (MPA). Internet addiction was measured by the Chen Internet Addiction Scale (CIAS). Results For the 320 surveyed students, the average CIAS score was 53.3, and 18.13% of participants were at risk for internet addiction (defined as CIAS score >64). The results of the multiple regression analysis indicated that a routine of at least 150 min of MPA per week was negatively associated with risk for internet addiction (β=−4.39, 95% CI=[-8.10, -0.66]). No significant associations were observed between internet addiction and 75 min of VPA or 150 min of total physical activity per week. Among the 5 dimensions of the CIAS scale, MPA was negatively associated with tolerance symptoms, time-management problems, and interpersonal and health-related problems when a routine of 150 min per week was adopted. Conclusion A routine of 150 min of MPA per week was associated with a lower risk for internet addiction. Intervention efforts aimed at reducing undergraduate students’ problematic internet use should promote recommended levels of MPA. We also recommend longitudinal research on the effects of engaging in physical activity on the risk of internet addition.
Keywords: Physical activity; Internet addiction; Undergraduate students
In 2017, we recruited 320 undergraduate students from Northern Taiwan to participate in a cross-sectional questionnaire-based sur-
vey. Physical activity was measured by the Taiwanese short-form version of the International Physical Activity Questionnaire, which
evaluates an individual’s weekly levels of vigorous-intensity aerobic physical activity (VPA) and moderate-intensity aerobic physical
activity (MPA). Internet addiction was measured by the Chen Internet Addiction Scale (CIAS).
For the 320 surveyed students, the average CIAS score was 53.3, and 18.13% of participants were at risk for internet addiction
(defined as CIAS score >64). The results of the multiple regression analysis indicated that a routine of at least 150 min of MPA per
week was negatively associated with risk for internet addiction (β=−4.39, 95% CI=[-8.10, -0.66]). No significant associations were
observed between internet addiction and 75 min of VPA or 150 min of total physical activity per week. Among the 5 dimensions
of the CIAS scale, MPA was negatively associated with tolerance symptoms, time-management problems, and interpersonal and
health-related problems when a routine of 150 min per week was
A routine of 150 min of MPA per week was associated with a lower risk for internet addiction. Intervention efforts aimed at reduc-
ing undergraduate students’ problematic internet use should promote recommended levels of MPA. We also recommend longitudi-
nal research on the effects of engaging in physical activity on the risk of internet addition.
Physical activity; Internet addiction; Undergraduate students.
he internet usage rate has increased rapidly worldwide, and in-
ternet use has become an integral component of leisure time.
T
In 2005, the number of internet users was one billion around the
world, and in 2019, the number of internet users reached four bil-
lion.1 Because of technological advancements, people use the in-
cc Copyright 2025 by Chang Y-J. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which
allows to copy, redistribute, remix, transform, and reproduce in any medium or adopted.
ternet to enjoy leisure time, strengthen interpersonal relationships,
and learn new information efficiently. However, excessive and out-
of-control internet use may lead to undesirable outcomes, such as
2-5 educational or health problems.2-5
The conceptualization and operationalization of internet
addiction have been debatable in past decades.6 Internet addiction
format, even commercially, provided the original work is properly cited.
disorder, defined as the inability to control internet use, can lead
to physical, psychological, and social difficulties.7 Internet addic-
tion, a type of behavioral addiction, also defined by the Diagnos-
tic and Statistical Manual of Mental Disorders with respect to the
following factors: tolerance, withdrawal, larger amounts, impaired
control, time spent, neglect of activities, and continued use despite
8,9 problems.8,9 Considering the popularity of the internet, the risk of
internet addiction may become a major public health concern, but
the literature on the efforts on prevention of internet addiction is
limited.10 To develop interventions targeting on internet addiction
prevention, the exploration of modifiable behavioral factors as-
sociated with internet addiction is necessary.
The World Health Organization (WHO) has recom-
mended a specific level of physical activity for adults between the
ages of 18 and 64-years. Activities were measured in metabolic
equivalents (METs). For adults, one MET is defined as 1 kcal/kg/
hour and is roughly equivalent to the energy expenditure of sitting
quietly. Moderate-intensity activities burn 3-6 METs, vigorous-in-
tensity activities burn >6 METs; walking, for example, consumes
3.5 METS.11 Factors that may affect physical activity levels have
been well-studied, and the link between screen time and physical
activity has been proposed. People with excessive screen time may
participate in insufficient physical activity. However, notwith-
standing studies on excess screen time, little is known regarding
whether problematic internet use, particularly internet addiction, is
associated with physical activity. The purpose of this study was to
investigate the cross-sectional association between physical activity
and risk of internet addiction among undergraduate students.
We conducted a cross-sectional survey in Northern Taiwan in 2017
and recruited 320 undergraduate students. Sample size was deter-
mined by 95% confidence level and a confidence interval of 5. No
incentive was provided for participants. The Institutional Review
Board of National Taiwan Normal University approved the proce-
dure and materials used in this study.
The data used in this study were collected using a self-adminis-
trated questionnaire developed. Two valid and reliable scales were
applied: the International Physical Activity Questionnaire (IPAQ)14
and the Chen Internet Addiction Scale (CIAS).15 Sociodemograph-
ic information, including sex, age, school type (university versus vo-
cational college), and employment status, was also collected.
Physical activity was measured using the Taiwanese short-
form version of the IPAQ, which evaluates an individual’s weekly
vigorous-intensity aerobic physical activity (VPA) level, moderate-
intensity aerobic physical activity (MPA) level, and walking hab-
its. According to the recommended levels of physical activity for
adults, surveyed participants’ VPA level was classified by whether
the individual achieved at least 75 min of VPA throughout the
week; MPA level was classified by whether the individual achieved at least 150 min of MPA and walking throughout the week; and
total physical activity was classified by whether the individual
achieved at least a 150-min equivalent combination of VPA, MPA,
and walking.
The CIAS was used to measure the risk of internet ad-
diction. The CIAS consists of 26 items, and it evaluates five di-
mensions concerning internet addiction: compulsive use of the in-
ternet, internet addiction withdrawal symptoms, internet addiction
tolerance symptoms, interpersonal and health-related problems,
and time-management problems. Compulsive use of the internet,
internet addiction withdrawal symptoms, and internet addiction
tolerance symptoms were defined as the core symptoms of inter-
net addiction, and interpersonal and health-related problems and
time-management problems were defined as problems associated
with internet addiction. Each response was scored on a 4-point
Likert scale. A higher score indicated a higher risk of internet ad-
diction. Those with total scores higher than 64 were classified as
being at risk for internet addition.
Data were analyzed using descriptive statistics and multiple re-
12,13 gression analysis in SAS version 9.4 (SAS Institute Inc., Cary, NC,
USA). Significance was set at a p value of 0.05 or less. The regres-
sion model was adjusted for sociodemographic variables, including
sex, age, school type, and employment status.
For the 320 surveyed undergraduate students, the average CIAS
score was 53.3, and 18.13% of participants were at risk for inter-
net addiction (Table 1). In terms of IPAQ, 45.63% of participants
reported at least 75 min of VPA per week, 79.69% reported at least
150 min of MPA per week, and 59.06% reported at least 150 min
of total physical activity per week.
Multiple regression analysis results indicated that a rou-
tine of at least 150 min of MPA per week was negatively associ-
ated with the risk of internet addiction (β=−4.39, 95% CI=[-8.10,
-0.66]). No significant association was observed between the risk
of internet addiction and 75 min of VPA or 150 min of total phys-
ical activity per week (Table 2).
With respect to the five dimensions of internet addic-
tion, a routine of at least 150 min of MPA per week was negatively
associated with tolerance symptoms, time-management, and inter-
personal and health-related problems. No significant association
was observed between physical activity and withdrawal symptoms
or compulsive use symptoms (Table 3).
The findings of this study indicated that a routine of at least 150
min of MPA per week was negatively associated with the risk of
internet addiction in the context of Taiwan. In this study, we fur-
ther analyzed the five dimensions of the CIAS and found that a
routine of 150 min of MPA was negatively associated with tol-
Table 1. Demographic Characteristics, Internet Addiction Risk, and Physical Activity Level of 320 Surveyed Undergraduate Students
Male 131 40.94
Female 189 59.06
Age 22.4 1.5
University 298 93.13
Vocational College 22 6.88
Not employed 142 44.38
Full-time/ part-time job 178 55.62
CIAS Score 53.3 13.7
No risk 262 81.88
At risk 58 18.12
<75 min/week 174 54.38
>=75 min/week 146 45.62
<150 min/week 65 20.31
>=150 min/week 255 79.69
<150 min/week 131 40.94
>=150 min/week 189 59.06
SD: Standard deviation; CIAS: the Chen Internet Addiction Scale;VPA:Vigorous
physical activity; MPA: Moderate physical activity; PA: Physical activity.
Table 3. Multiple Regression Models of Physical Activity and the Five Dimensions of Internet Addiction Measured Using the CIAS
VPA (reference: <75min/ 1.21 -0.32 (-0.92,0.27) 0.28 week)
MPA (reference: 150min/ 1.81 -0.91 (-1.63,-0.20) 0.01 week)
Total PA (reference: 1.12 -0.17 (-0.77,0.42) 0.56 <150min/week)
VPA (reference: <75min/
1.26 -0.40 (-1.11,0.30) 0.26 week)
MPA (reference: 150min/ 1.18 -0.27 (-1.37,0.33) 0.23 week)
Total PA (reference:
1.28 -0.52 (-0.97,0.43) 0.43 <150min/week)
VPA (reference: <75 min/ 1.75 -0.47 (-1.20,0.27) 0.21 week)
MPA (reference: 150 min/ 1.75 -0.56 (-1.45,0.33) 0.22 week)
Total PA (reference: 1.71 -0.41 (-1.15,0.32) 0.27 <150min/week)
VPA (reference: <75 min/ 2.26 -0.35 (-1.08,0.37) 0.34 week)
MPA (reference: 150 min/ 3.06 -1.23 (-2.10,-0.36) 0.01 week)
Total PA (reference: <150 2.25 -0.34 (-1.07,0.38) 0.35 min/week)
VPA (reference: <75 min/
3.06 -0.59 (-1.50,0.31) 0.20 week)
MPA (reference: 150 min/ 3.39 -1.16 (-2.25,-0.07) 0.04 week)
Total PA (reference: <150 3.27 -0.85 (-1.75,0.06) 0.07 min/week)
Adjusted: sex, age, type of school, and employment status
CIAS: the Chen Internet Addiction Scale,VPA:Vigorous physical activity, MPA:
Moderate physical activity, PA: Physical activity.
Table 2. Multiple Regression Models of Physical Activity and CIAS Scores
VPA (reference: <75 2.13 -2.14 (-5.22,0.95) 0.17 min/week)
MPA(reference: 150 2.54 -4.39 (-8.10,-0.66) 0.02 min/week)
Total PA (reference: 2.11 -2.05 (-5.13,1.05) 0.19 <150 min/week)
Adjusted: sex, age, type of school, and employment status
CIAS: the Chen Internet Addiction Scale,VPA:Vigorous physical activity,
MPA: Moderate physical activity, PA: Physical activity.
erance symptoms, time-management problems, and interpersonal
and health-related problems. In previous literature, physical activity
is also reportedly associated with a low risk of problematic inter-
net use among Korean adolescents.16 Students spend a great deal
of time using the internet, which might limit the amount of time
that they can devote to physical activity. Data from Pakistan also
indicated that the prevalence of internet addiction is higher among
students who do not participate in any physical activity compared
with those who do.17
A possible explanation for this negative association is
self-control. It was previously observed that higher levels of self-
control and self-management skills can reduce the risk for internet
addiction. If individuals enhance their self-control and self-man-
agement skills, their risk for internet addiction may consequently
be reduced.18 A study of Korean adolescents suggested the effect
of sports participation on internet addiction mediated by self-con-
trol.19 Future study may investigate the mediation effects of life
skills, such as self-control, time management, goal setting, or deci-
sion making, on the associations between physical activity levels
and internet addiction.
Using two valid and reliable scales to measure the level of
physical activity and internet addiction, this study indicated that a
routine of 150 min of MPA per week was associated with a lower
risk of internet addiction, particularly tolerance symptoms, time-
management problems, and interpersonal and health-related prob-
lems. In the existing literature, little is known about the association
between physical activity and internet addiction risk in the context
of Taiwan. Among youths in Taiwan, the prevalence of internet
addiction was noteworthy,20 and it related to lower health-related
quality of life.21 Intervention efforts aimed at reducing under-
graduate students’ problematic internet use should promote stu-
dent participation to ensure recommended levels of MPA. MPA is
usually recommended as an appropriate form of regular exercise
because it does not require specific skills or equipment and is con-
venient to engage in. Regular MPA can be an alternative behavior
of internet use, which is an intervention strategy to reduce the risk
of internet addiction.
This study employed a self-administrated questionnaire-based
survey; thus, recall bias is a possible limitation. Information on
the details of internet use habits, such as the activities types that
participants have done online, was not collected. The purposive
sampling method also limits the representativeness of the study
sample. Moreover, causality between physical activity and internet
addiction could not be conclusively determined in this cross-sec-
tional study. Future research on the longitudinal effects of physical
activity on the risk of internet addiction is recommended.
A routine of 150 min of MPA per week was negatively associated
with the risk of internet addiction among surveyed undergraduate
students in Taiwan. Intervention efforts aimed at reducing prob-
lematic internet use should promote recommended levels of MPA
in this population.
The authors declare that they have no conflicts of interest.