Academic journal article Alcohol Research

Preventing Impaired Driving Opportunities and Problems

Academic journal article Alcohol Research

Preventing Impaired Driving Opportunities and Problems

Article excerpt

In 1988, the U.S. Surgeon General's Workshop on Drunk Driving called attention to the broad range of strategies that affect the problem of impaired driving (U.S. Department of Health and Human Services 1989). Research presented at the workshop ranged from the effects of pricing, availability, advertising, marketing, and general epidemiology of alcohol consumption and alcohol problems to safety education, impaired-driving laws, sanctions, and treatment programs for offenders. The proceedings of that workshop demonstrated that impaired driving involves extremely broad public health aspects that cannot be covered in this brief article. Rather, this article reviews only the traditional, century-old measure of deterring vehicle operators from driving while intoxicated (DWI) through laws (see table for a summary of these laws), law enforcement, and public-education programs. A case can be made that general deterrence strategies have had the most immediate and largest impact on the problem.

THE PROBLEM

There are more registered vehicles in the United States than there are licensed drivers to operate them. It is therefore not surprising that in a country where two-thirds of the citizens drink alcohol, impaired driving is a significant public health problem. In the United States, alcohol has been associated with traffic crashes for more than 100 years, as indicated by the publication of the first scientific report on the effect of drinking by operators of "motorized wagons" in 1904 (Quarterly Journal of Inebriety 1904). The National Highway Traffic Safety Administration (NHTSA) estimated that impaired driving resulted in more than 14,000 deaths and 500,000 injuries in 2000 and cost society $51 billion in that year (Blincoe et al. 2000). Although alcohol consumption is legal for U.S. citizens aged 21 or older, it is illegal in all States to drive with a blood alcohol concentration (BAC) of 0.08 g/dL or greater (NHTSA 2004). In 2008, there were an estimated 11,773 traffic-crash fatalities involving drivers with BACs of 0.08 g/dL or higher (NHTSA 2009). Each year, more than 1.4 million drivers are arrested for DWI or driving under the influence (DUI) in the United States (Federal Bureau of Investigation 2008).

EVIDENCE THAT LAWS ADDRESSING IMPAIRED DRIVING CAN BE EFFECTIVE

From 1983 to 1997, the United States experienced a remarkable reduction in alcohol-related fatal crashes. An analysis of fatal-crash data from 1982 to 2005 estimated that five basic alcohol safety laws accounted for 44 percent of the reduction in fatal crashes, as shown in figure 1 (Dang 2008). This analysis included data from the Fatality Analysis Reporting System (FARS), which collects data on all fatal crashes occurring in the United States and is maintained by the NHTSA, as well as data from several other sources to account for factors such as age, gender, per capita alcohol consumption, time of day and day of the week the crash occurred, presence of important impaired-driving laws, and the level of impaired-driving enforcement that might moderate the influence of BAC on crashes. Figure 1 (upper light-shaded area, labeled "Contribution of demographic factors") shows the reductions in fatal crashes that Dang's analysis indicated can be attributed to the aging of the population and the increase in the proportion of female drivers, because female and older drivers have fewer alcohol-related fatal crashes. The dark band [labeled "Contribution of alcohol consumption (particularly beer)"] in figure 1 indicates the small reduction that can be attributed to the minor drop in per capita alcohol consumption over the 24-year study. The lower shaded area (labeled "Contribution of state alcohol laws") in figure 1 shows the proportion of the total reduction that Dang's analysis attributed to five basic alcohol safety laws enacted by most of the States during that period. Figure 2 (Dang 2008) shows the trends in the enactment of those five laws: (1) illegal-per-se laws, which make it illegal for a driver to have a BAC of 0. …

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