Causes and impacts of phubbing on students in a public university

Background: With the rapid development of smartphones in the market, phubbing has become popular, which is a behavior of ignoring someone in the environment because it focuses more on gadgets than on building conversations. Objective: The purpose of this study was to explore causes of phubbing, and its impact on the health of adolescents, especially students. Methods: This study employed a qualitative research design conducted in June 2021 at Halu Oleo University, Indonesia, among students in the fourth semester. Focus Group Discussion and In-Depth interviews were used for data collection. Data analysis was thematic. Result: The results showed that the students realized that an individual with phubbing behavior tends to forget the interaction activities in the surrounding environment. The duration of smartphone usage was from two hours to ten hours per day. Phubbing is becoming a phenomenon among students due to the need to get the latest information or news during their studies. Conclusion: There are many reasons for phubbing, including obtaining updated knowledge and information that leads to social media use more often, eliminating boredom, seeking entertainment, and staying in touch with friends and parents. However, phubbing impacts physical health, such as headaches, soreness in the eyes, the strain on the neck, and mental/social health, such as anxiety, fear, discomfort, and disruption of social interactions. It is therefore recommended to remind the students not to use smartphones excessively.


Background
A smartphone is a tool used by the general public, especially teenagers, which provides a lot of ease in communicating. However, as with the internet, some people only use it to obtain necessary information.
Along with the times and information technology, two people who are far away can also come face to face without having to come face to face using video call services and many others, such as entertainment media, refreshing, and games. However, with all the conveniences provided, some people forget the negative impact of smartphone use, called phubbing (Mariati & Sema, 2019).
Phubbing is an action term that ignores someone in the environment because it focuses more on gadgets than building conversations. With the rapid development of smartphones in the market, this term began to sound and popular. However, in the modern era that provides various conveniences today, people often forget the negative impact of phubbing behavior. A person who pretends to be communicated with will act to pay attention not to hurt others, but his eyes will stare at the smartphone in his hand from time to time (Fitri et al., 2020).
At first, the phubbing is just to escape because there will be a feeling of discomfort in crowded environmental conditions; for example, when bored at a party or when taking a bus, the situation has changed. Millennials are currently phubbing in all conditions and locations (Primasari, 2018). One of the signs that someone is talking is pretending to follow others, but their eyes are often on (Goleman, 2000). Alone people who have offensive behavior also have obstacles in interpersonal communication patterns. Interpersonal communication is face-toface communication between individuals that can provide verbal and non-verbal effects and feedback (Sariani, 2014;Oktarina, 2021). Research has shown that smartphone use can significantly affect interpersonal communication. This is because smartphones have become a new part of human life, so even when communicating with others, people now need to open and view smartphones (Syifa, 2020).
To our knowledge, research on the impact of excessive use of smartphones and phubbing in Indonesia is limited. Therefore, this article aimed to the causes of phubbing and its effect on the health of adolescents, especially students.

Study Design
A qualitative descriptive research design was used in this study.

Study Participants and Sampling
The samples in this study were students of the Faculty of Public Health (FKM), Halu Oleo University (UHO), Indonesia, who were actively studying in the fourth semester and all using smartphones. In selecting the participants, the researchers did two principles: appropriateness (conformity) chosen by purposive sampling and adequacy obtained from the adequacy of information based on the purpose of research.

Data Collection
Data were collected in June 2021 at Halu Oleo University, Indonesia. Researchers used Focus Group Discussion (FGD) and In-Depth Interviews to collect data. For the Focus Group Discussion (FGD) method, 12 students were selected into two groups. In contrast, for the In-Depth Interview method, two students from the class of 2019 FKM UHO and all informants were interviewed regarding their views, attitudes, and opinions regarding phubbing.

Data Analysis
Data analysis was thematic.

Ethical Consideration
The ethical consideration for this study has been secured by Halu Oleo University, Indonesia. Informed consents have also been done to all participants.

Perceptions of the Internet
The results of this study show the importance of the internet in life, such as the assumption of informants who say that the current pandemic conditions are all done with the internet. "Intenet is very important to me; why would I say so? During the pandemic , it is now all done online. With this internet, we can access information that we don't know before", said one of the informants about the importance of the internet for him.
Almost all informants said the same thing that the internet is beneficial to them in all their daily needs, especially in getting all the essential information. Using the internet today is very helpful in getting information and helping with all activities. Some FGD participants said: "The Internet is very important today because it is very helpful in finding information, especially now is a digital era where the internet is needed. In my daily life, the internet plays a crucial role in helping the learning process." (WM Male Student 1).
Behavior and perception will always coincide in life because each individual's perception will always influence one's behavior. Since a few years ago, when the informant was still in junior high school, the internet has been needed to get information, communicate with friends, and explore the necessary learning materials. Many things can make students very connected to the internet, such as for lectures, organizations, looking for entertainment, getting essential news, and can use social media to be easier in communicating with others even if the distance is far.
During the COVID-19 pandemic, all activities were mostly online in finding learning materials, exploring lecture assignments, looking for reading materials to support lectures, and some online lecture exams.
Here are some of the words of students about how important the internet is to them: "I think the internet is essential because the internet can connect us with many people and make work easier and more practical...

Knowledge of Phubbing
The results of this study showed that most informants already know about phubbing. A large number of them say phubbing is a behavior that tends towards gadgets, so it is a concern to interact socially. There are many exciting things from the opinion of female FGD informants who say that frequent use of the internet can provide positive things because it can help in doing college assignments and get information from social media as one of the following informants said: "Very often, social media is most often opened WhatsApp because it becomes a medium of communication to friends and parents. Next is Twitter, easy to find the latest news updates and viral. I also often open YouTube and TikTok to see the latest videos and fun..." (FGD Female Student 8).
However, informants also say they use gadgets too often so as not to care about the surrounding environment and in times of boredom, just like the following: "It is needed for learning, contacting people and when feeling bored..." (FGD Female Student 2).
But in the current pandemic, some informants say that using the internet is very appropriate because there is still a directive from the government always to keep a distance and avoid crowds so that online communication will be very effective. As the words of the male student as follows: "For now, I think it is effective because seeing the pandemic situation now, well all online like through chat..." or "Yes because now COVID, then it is better to communicate via chat only..." (FGD Female Student 10).
Communicating through social media, some informants say it is very interactive because it can lead to misconceptions later, such as the following: "I think not, because sometimes we misunderstand the intentions that my friend wrote..." (FGD Female Student 2).
But in contrast, some informants say that communication via social media is more interactive and more accessible because many chats features support conversations to be more fun as follows: "Yes, because social chat is more flexible and communication through social media has available sticker feature..." (FGD Female Student 8).

Phubbing Behavior Overview
All informants say that using smartphones to get information and help in the lecture process. The duration of smartphone usage from interviews to informants from 2 hours per day to 10 hours per day, "I think the normal use of smartphones is approximately 6 hours" (FGD Female Student 2).
Most informants say the use of smartphones for 3 -5 hours is still a regular use or still relatively normal, but some informants argue that the use of such a long time will interfere with vision, "I think 4 hours per day because the longer we hold the cell phone then our vision will be impaired.." (FGD Female Student 3).
In this study, it is known that some informants admit not to be afraid when not using a smartphone will miss the news or not update the latest information from the internet, such as the following informant: "Not because I realize there is still another busyness that is more urgent than having to update about the latest news especially if the news is not very important..." (FGD Female Student 4) Some informants also said otherwise. They are afraid to miss information or news from the internet because it is needed in everyday life. "Quite afraid because the update information about the current situation is very much in need...." (WM Male Student) As to whether their parents gave freedom in using the internet, most informants stated that their parents gave freedom in using the internet because it greatly affects daily activities such as the following: "Yes, giving freedom because smartphones are very influential especially now and in the future...." (FGD Female Student 10). So indeed parents should give confidence to their children to be able to use the internet well but should also keep an eye on them in using the internet well so as not to get the negative impact of smartphones.

Causes of Phubbing Behavior
In today's digital era, the fulfillment of news or information will be needed because it will support the lecture process of these students. Similarly, when we are late to get important information, then we will miss information that may be important for lectures. The informants expressed concern about missing out on getting the news because it would cause fear or distrust. As one of the following informants said:

"Quite afraid because the update information about the current situation is very much in need...Yes, because it is very important in daily life....". (FGD Female Student 10)
The influence of the surrounding environment or the influence of peers in obtaining information is very important in supporting them in getting updated news. The environment is very influential on the behavior, attitudes, or actions of students in carrying out their daily activities. Playing mobile phones in the crowd is one of the questions we give to informants, and some of them say it's unnatural because it assumes we do not care about our surroundings when someone invites us to talk, but we are busy playing mobile phones. Like one of the following informants: "I think it's unnatural because he will not be indifferent and disrespectful especially if playing HP when our interlocutor is talking then it can make him angry and offended..." (FGD Female Student 8) But some of them consider it a natural thing to get important information. "It's natural when it comes to something important...." (WM Male Student)

Impact of Phubbing Behavior Physical Health Impacts
Most of the informants interviewed said they experienced physical complaints when using smartphones, such as headaches, anger, dizziness, forgetting to eat until the ulcer was broken, and others. For example, here is an excerpt related to the use of mobile phones in health: "If my lecture schedule is crowded for several days then my head will feel heavy and hot eyes because of too long using mobile phone...." (WM Male Student); "There is a health disorder, which is felt that headaches even eyes can also hurt because of the effects of radiation..." (FGD Female Student 2); "Yes, what I feel is usually neck strain and headaches..." (FGD Female Student 8); "Yes, it is a headache for the eyes and the head. The result of too long looking at the screens of smartphones and laptops, especially when doing tasks for hours..." (FGD Female Student 10).

Mental/Social Health Impacts
Most of the informants are very uncomfortable when they are with a phubber. They consider when together, they feel unappreciated or do not consider the existence of people next to them to interact socially. Here are quotes related to the use of mobile phones in mental health: "I think if I'm with someone who thinks I feel uncomfortable to let alone I talk to him and then he's busy with his smartphone...." (FGD Female Student 2); "I feel uncomfortable, disliked and disrespected because I feel unnoticed when talking and discussing something important...." (WM Male Student); "I do not feel comfortable; it would be nice if you are talking listen first after nothing is discussed then we do other activities or open social media...." (FGD Female Student 8); "Uncomfortable, feels like when we talk to him like it's not appreciated...." (FGD Female Student 10).

Discussion
According to Hanika (2015), phubbing is an abbreviation derived from the word phone and snubbing. The word phubbing is new, which the term is used to indicate the attitude of hurting the interlocutor. This hurt attitude occurs caused by excessive use of smartphones. Our research shows most informants already know about phubbing. Nowadays, the use of smartphones and the internet is a necessity, where a lot of daily activities require the use of smartphones and the internet. Based on these needs, the intensity of smartphone use in everyday life will also increase. In this study, it is known that the intensity of the use of informant smartphones ranges between 2 to 10 hours per day. Research conducted by Indrawati and Resti (2015) on students shows that the average student uses a smartphone above 5 hours per day, and activities carried out on smartphones include chatting, browsing, and downloading.
Research conducted by Madjid and Do Subuh (2019) obtained the results that students utilize social media for various things where most students use social media as a means of obtaining information through spectacle, then utilizing for communication sharing messages, and to get entertainment by watching and reading other people's posts, as well as the least of which is for economic benefits.
Social media can have a positive and negative impact on students. The positive impact is exchanging information and making it easier to get online literature. The negative impact can be on addiction to social media, which can change one's behavior and way of thinking (Drakel et al., 2018). The use of smartphones too often or for a long time makes a person not care about the surrounding environment, leading to phubbing behavior. Research conducted by Syifa (2020) obtained the results that the intensity of smartphone use also influences students' phubbing behavior.
In this study, it is known that the occurrence of phubbing behavior in informants occurs because of many things, including the need to get the latest information that causes informants to be more often seen on social media, to eliminate boredom, and to seek entertainment and to keep in touch with friends and parents. Excessive use of social media will make a person slowly lead to phubbing behavior. Research conducted by Ratnasari and Oktaviani (2020) found a significant positive link between mobile phone addiction and social media to phubbing behavior.
The use of smartphones for too long against the physical health of informants is that many informants experience headaches, soreness in the eyes, the strain on the neck, and many other complaints. Based on research conducted by Oroh et al. (2016), it is known that the use of smartphones with a long intensity causes a lack of physical activity and complaints in the eyes, and the wrong position when using a smartphone becomes a risk factor of primary headache.
The use of smartphones also affects the mental health of students, and this can be seen from the feelings of fear or anxiety that arise from the informant when he does not get the latest information, especially information about lectures, so that students have to look at often their smartphones. From the results of this study, it is known that most informants feel uncomfortable when with a phubber. This uncomfortable feeling is because the informant feels unappreciated and does not exist because a phubber is more focused on smartphones than another person. If this continues, it will affect the relationship or social interaction of someone who experiences phubbing. Many social relationships will be disrupted because of phubbing, one of which is friendship or friendship. This is in line with the results of research conducted by Ilham and Rinaldi (2019) revealed that there is an influence between phubbing and the quality of friendship in students; the higher the phubbing, the lower the quality of friendship. But, on the contrary, the lower the phubbing, the higher the quality of friendship. Other social impacts due to phubbing can also occur in the family environment. According to Alamudi (2019), the fracture of harmonious relations in the family can occur due to phubbing, and this is because the time that should be used to sit together and talk between family members is spent on focusing on smartphones so that harmonious relationships in the family can be disrupted.

Conclusion
Phubbing is an abbreviation derived from the word phone and snubbing. Phubbing is a new term used to express the attitude of hurting the interlocutor caused by excessive use of smartphones. A person begins to ignore the surrounding environment. There are many reasons behind phubbing on informants, including the need to obtain up-to-date information that causes informants to check social media more often, eliminate boredom, seek entertainment, and stay in touch with friends and parents. The impact of phubbing behavior on physical health is that many informants experience headaches, soreness in the eyes, the strain on the neck, and many other complaints. The impact of phubbing on the mental/social health of informants is the feeling of anxiety and fear when not getting the latest information, the feeling of discomfort when with a phubber, and also the disruption of social interactions caused by the feelings of the interlocutor who feel unappreciated. Therefore, it is recommended to remind the students not to use smartphones excessively.

Declaration of Conflicting Interest
None.

Funding
None.

Author Contributions
Concept generation, data collection, writing (MT), writing and editing of the manuscript (M), critically reviewed, and revision (ANW). All authors approved the final version of the article.