Abstract
Background: The widespread use of smartphones has been linked to various psychological and physical health issues, particularly among university students. Nursing students, in particular, may face heightened risks due to academic stress and clinical responsibilities. This study aimed to examine the relationship between smart phone addiction, social anxiety, and self-esteem among nursing students at Taif University, Saudi Arabia.
Methods: A cross-sectional analytical study was conducted among 287 nursing students selected through probability random sampling from a total population of 1,123 students. Data were collected using an online self-administered questionnaire comprising four sections: demographic information, the Smartphone Addiction Scale–Short Version, the Interaction Anxiousness Scale, and the Rosenberg Self-Esteem Scale. Statistical analysis was performed using SPSS Version 23.
Results: A total of 54.7% of participants exhibited high levels of smartphone addiction. Significant associa tions were found between smartphone addiction and gender (p < 0.001) as well as year of study (p = 0.045). Correlation analysis revealed moderate, statistically significant positive correlations between smartphone addiction and both self-esteem (r = 0.315, p < 0.001) and social anxiety (r = 0.351, p < 0.001). Multivariate logistic regression identified self-esteem as the strongest predictor of smartphone addiction [adjusted odds ratio (AOR) = 1.07; 95% CI = 1.008-1.130; p = 0.025], followed by social anxiety (AOR = 1.04; 95% CI = 1.013 1.063; p = 0.002). Female gender was associated with a lower likelihood of high smartphone addiction (AOR = 0.425; 95% CI = 0.245-0.737; p = 0.002).
Conclusion: More than half of the nursing students demonstrated high levels of smartphone addiction. Both elevated self-esteem and social anxiety were significant predictors of addiction, while female students were less likely to exhibit high addiction levels. These results highlight the need for interventions addressing psychological well-being and smartphone use among nursing students.

Key words: Keywords. Smartphone addiction, social anxiety, self-esteem, Nursing students, Taif University.