Impaired driving remains a significant public health problem in the United States. Although impressive reductions in alcohol-related fatalities occurred between 1982 and 1997, during which all 50 States enacted the basic impaired-driving laws, progress has stagnated over the last decade. Substantial changes in the laws and policies or funding for the enforcement of the criminal offense of driving while intoxicated (DWI) are needed for further substantial progress in reducing alcohol-related crash injuries. However, research indicates that evidence-based laws in the 50 States and current best practices in DWI enforcement are not being fully adopted or used. It seems, however, that effective operations, such as the low-staff check points that are routinely applied in many communities, could be extended to many more police departments. In addition, several enforcement methods have been proposed but never fully tested. KEY WORDS: Problematic alcohol use; prevention; alcoholrelated injury prevention; alcoholrelated crash; alcoholrelated fatal crash; traffic accident; impaired driving; driving while intoxicated; driving under the influence; impaireddriving laws; drinkinganddriving laws; law enforcement; roadside sobriety checkpoint; blood alcohol content
In 1988, the U.S. Surgeon General'sWorkshop on Drunk Driving called attention to the broad range of strategies that affect the problemof 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, impaireddriving 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, centuryold measure of deterring vehicle operators from driving while intoxicated (DWI) through laws (see table for a summary of these laws), law enforcement, and publiceducation programs. A case can be made that general deterrence strategies have had the most immediate and largest impact on 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 twothirds 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 trafficcrash 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 alcoholrelated fatal crashes. An analysis of fatalcrash 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 impaireddriving laws, and the level of impaireddriving enforcement that might moderate the influence of BAC on crashes. …