Objective To analyze the current situation of internet addiction and its influencing factors among middle school students in Hunan province.

Methods In 2022, a multi-stage stratified cluster sampling method was used to select a total of 127 624 middle school students from various counties and districts in Hunan province as research subjects. The chi-square test was used to compare the differences in internet addiction detection rates between groups, and multi-factor logistic regression analysis was used to analyze the influencing factors of internet addiction.

Results The detection rate of internet addiction among middle school students in Hunan province was 2.69%, with 2.79% for boys and 2.58% for girls. The internet addiction rate of boys was higher than that of girls, and both showed an upward trend with increasing grade (except for grade 12). Among the middle school students identified as having internet addiction, the most frequent symptoms were withdrawal symptoms (87.75%), tolerance symptoms (83.09%), and internet control disorders (79.45%). Multi-factor logistic regression analysis showed that higher grades (grade 8: OR = 1.681, 95%CI: 1.459 - 1.936; grade 9: OR = 1.881, 95%CI: 1.636 - 2.163; grade 10: OR = 1.756, 95%CI: 1.520 - 2.029; grade 11: OR = 1.853, 95%CI: 1.605 - 2.140; grade 12: OR = 1.612, 95%CI: 1.387 - 1.873), boarding school (OR = 1.748, 95%CI: 1.619 - 1.886), ethnic minority (OR = 1.147, 95%CI: 1.053 - 1.250), being beaten and scolded by parents (OR = 1.797, 95%CI: 1.652 - 1.954), depression (OR = 2.569, 95%CI: 2.376 - 2.778), being injured (OR = 1.342, 95%CI: 1.196 - 1.505), being bullied (OR = 2.022, 95%CI: 1.875 - 2.181), smoking (OR = 1.979, 95%CI: 1.794 - 2.184), and drinking alcohol (OR = 1.909, 95%CI: 1.755 - 2.076) were risk factors for internet addiction among middle school students; while being female (OR = 0.914, 95%CI: 0.850 - 0.983), school location in suburban counties (OR = 0.822, 95%CI: 0.763 - 0.884), and physical activity (exercise 1 - 3 d/week: OR = 0.609, 95%CI: 0.561 - 0.660; exercise 4 - 6 d/week: OR = 0.509, 95%CI: 0.454 - 0.571; exercise 7 d/week: OR = 0.466, 95%CI: 0.404 - 0.538) were protective factors against internet addiction among middle school students.

Conclusions The phenomenon of internet addiction among middle school students in Hunan province is relatively serious. It is recommended to intervene in high-frequency symptoms of internet addiction and its influencing factors to reduce the occurrence of internet addiction behavior among middle school students.