Associations between driving under the influence or riding with an impaired driver and future substance use among adolescents

Objective: Risky driving behaviors among adolescents, such as riding with a drinking or impaired driver (RWID) or driving while under the influence (DUI) of alcohol or drugs, are significant public health concerns. Few studies have examined associations of RWID and DUI with future substance use and problems after controlling for baseline substance use. Given that the DUI/RWDD event may be a teachable moment to prevent future consequences (e.g., when injured or arrested), it is important to understand how this risk behavior relates to subsequent use and problems. This study therefore examined characteristics of adolescents who reported DUI and RWID and assessed their risk of future alcohol and marijuana use and consequences 6 months later.

Methods: Participants were 668 adolescents aged 12 to 18 (inclusive) recruited at 1 of 4 primary care clinics in Pittsburgh and Los Angeles as part of a larger randomized controlled trial. They completed surveys about their health behaviors at baseline and 6 months after baseline. We examined baseline characteristics of adolescents who reported DUI and RWID and then assessed whether past-year DUI and RWID at baseline were associated with alcohol and marijuana use and consequences 6 months after baseline.

Results: Fifty-eight percent of participants were female, 56% were Hispanic, 23% were Black, 14% were White, 7% were multiethnic or other, and the average age was 16 years (SD?=?1.9). At baseline, participants who reported RWID or DUI were more likely to be older, report past-year use of alcohol and marijuana, and more likely to have an alcohol use disorder or cannabis use disorder versus those who did not report RWID or DUI, respectively. At 6-month follow-up and after controlling for baseline demographics and baseline alcohol use, RWID was associated with more frequent drinking episodes in the past 3 months and greater number of drinks in the past month when they drank heavily. DUI at baseline was associated with more frequent heavy drinking episodes and alcohol and marijuana consequences 6 months later.

Conclusions: RWID and DUI are significantly associated with greater alcohol and marijuana use over time. This study highlights that teens may be at higher risk for problem substance use in the future even if they ride with someone who is impaired. Prevention and intervention efforts for adolescents need to address both driving under the influence and riding with an impaired driver to prevent downstream consequences.     

The alcohol interlock: an underutilized resource for predicting and controlling drunk drivers

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression (Marques et al., 2003) show that BAC elevations > .02-.04% are more potent predictors of repeat DUI (p < .0001) than even prior DUI (p < .006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec; .04% Alberta). Charts tracking the Monday-Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.     

The alcohol interlock: an underutilized resource for predicting and controlling drunk drivers

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression show that BAC elevations >.02-.04% are more potent predictors of repeat DUI (p<.0001) than even prior DUI (p<.006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec;.04% Alberta). Charts tracking the Monday-Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.     

Drinking and driving and perceptions of arrest risk among California drivers: Relationships with DUI arrests in their city of residence

Objective: Addressing drinking and driving remains a challenge in the United States. The present study aims to provide feedback on driving under the influence (DUI) in California by assessing whether drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; whether this is due to perceptions that one can get arrested for this behavior; and whether this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home).

Methods: This study consisted of a 2012 roadside survey of 1,147 weekend nighttime drivers in California. City DUI arrest rates for 2009–2011 were used as an indicator of local enforcement efforts. Population average logistic modeling was conducted modeling the odds of perceived high arrest likelihood for DUI and drinking and driving behavior within the past year.

Results: As the DUI arrest rates for the city in which the driver lives increased, perceived high risk of DUI arrest increased. There was no significant relationship between either city DUI arrest rates or perceived high risk of DUI arrest with self-reported drinking and driving behavior in the full sample. Among a much smaller sample of those most likely to drink outside the home, self-reported drinking and driving behavior was negatively associated with DUI arrests rates in their city of residence but this was not mediated by perceptions.

Conclusion: The results of the present study suggest that perceptions are correlated with one aspect of DUI efforts in one's community. Those who were more likely to drink outside the home could be behaviorally influenced by these efforts.     

Alcohol-impaired motorcyclists versus car drivers: A comparison of crash involvement and legal consequence from adjudication data

Introduction: Driving under the influence (DUI) increases the probability of motor-vehicle collisions, especially for motorcycles with less protections. This study aimed to identify commonalities and differences between criminally DUI offenses (i.e., with a blood alcohol concentration (BAC) of 80 mg/dL or higher) committed by motorcyclists and car drivers. Methods: A total of 10,457 motorcycle DUIs and 8,402 car DUIs were compared using a series of logistic regression models, using data extracted from the documents of adjudication decisions by the courts of Jiangsu, China. Results: The results revealed that offenders from the high-BAC group (i.e., 200 mg/dL or higher) accounted for more than 20% of the total DUI offenses, and were more likely to be involved in a crash and punished with a longer detention. Motorcyclists had a higher likelihood of crash involvement, and were also more likely to be responsible for single-vehicle crashes associated with higher odds of injury sustained, compared to alcohol-impaired car drivers. In the verdict, motorcycle offenders were more likely to receive a less severe penalty. Conclusions: Interventions are clearly required to focus on reducing in the high-BAC group of offenders. For alcohol-impaired motorcyclists, their risks of crash and injury against BAC climb more steeply than the risks for car drivers. The factors including frequent occurrences, uncertainty of detection, and short-term sentences may weaken the deterrence effect of the criminalization of motorcycle DUI. Practical Applications: The traffic-related adjudication data support traffic safety analysis. Strategies such as combating motorcycle violations (e.g., unlicensed operators or driving unsafe vehicles), undertaking education and awareness campaigns, are expected for DUI prevention.     

Alcohol problems among Swedish drunk drivers: differences related to mode of detection and geographical region

OBJECTIVE: To investigate the prevalence of alcohol problems in a representative sample of Swedish drivers suspected of drunk driving in comparison with control drivers and the general Swedish population in relation to mode and time of detection. Is the time of day or night or the detection mode important for the prevalence of alcohol problems and which are the best predictors for identifying alcohol problems among DUI offenders? METHODS: Two thousand and one hundred drivers (169 females) suspected of DUI offence during 1997-2001 who agreed to respond to the AUDIT questionnaire (Alcohol Use Disorders Identification Test) and 785 control drivers (266 females) not suspected of DUI recruited at general traffic controls were investigated. RESULTS: Both mode and time of detection were found to be important. The greatest impact on the prevalence of alcohol problems emanated from the predictors in the following order: high BAC; unlicensed driving; detection hours between 12.00 and 18.00, and age under 26 years. Age over 55 years and detection in general traffic controls were the two strongest factors negatively correlated to alcohol problems prevalence. The differences between regions with regard to alcohol problems incidence could only partly be explained by police routines and resources. CONCLUSIONS: Mode and time of detection affect the prevalence of DUI offenders with alcohol problems, and to a lesser degree also BAC level. Both the detection mode and the time of detection are significant for the proportion of identified DUIs with alcohol problems. Because the majority of committed DUI offenses are never identified, it is important to optimize the detection strategies of the police with the purpose of minimizing public damage and expenses.     

Breath alcohol ignition interlock devices: controlling the recidivist

This study compares the recidivism rates of two groups of Illinois drivers who had their driver's licenses revoked for alcohol-impaired driving and who received restricted driving permits. Drivers in both groups had more than two driving under the influence (DUI) actions against their record within 5 years or were classed as level III alcohol dependents. Drivers in one group were required to install breath alcohol ignition interlock devices in their vehicles and drivers in the other group were not. The research found that drivers with the interlock were one-fifth as likely to be arrested for DUI during the 1 year the device was installed as the comparison group, which did not have the device. However, once the ignition interlock was removed, drivers in this group rapidly returned to DUI arrest rates similar to those in the comparison group. These findings echo previous literature. Additionally, the study showed that this voluntary program in Illinois reached only 16% of the drivers who met the requirements for installing the interlock device. Finally, this study found that individuals who were removed from the interlock program and returned to revoked status continued to drive. Within 3 years, approximately 50% of this latter group were involved in a crash or were arrested for DUI or with an invalid driver's license. Conclusions drawn from the study suggest that the breath alcohol ignition interlock device is effective in preventing continued driving while impaired. However, the large-scale effectiveness of the device is limited since most of the drivers eligible for the device do not have it installed. To have a significant impact, the interlock device must represent a better alternative to drivers whose licenses were suspended or revoked because of alcohol arrests compared to remaining on revoked status without having the device installed. Finally the research suggests that, given the rapid return to predevice recidivism, the devices should remain installed until drivers can demonstrate an extended period of being alcohol free.     

Breath alcohol ignition interlock devices: controlling the recidivist

This study compares the recidivism rates of two groups of Illinois drivers who had their driver's licenses revoked for alcohol-impaired driving and who received restricted driving permits. Drivers in both groups had more than two driving under the influence (DUI) actions against their record within 5 years or were classed as level III alcohol dependents. Drivers in one group were required to install breath alcohol ignition interlock devices in their vehicles and drivers in the other group were not. The research found that drivers with the interlock were one-fifth as likely to be arrested for DUI during the 1 year the device was installed as the comparison group, which did not have the device. However, once the ignition interlock was removed, drivers in this group rapidly returned to DUI arrest rates similar to those in the comparison group. These findings echo previous literature. Additionally, the study showed that this voluntary program in Illinois reached only 16% of the drivers who met the requirements for installing the interlock device. Finally, this study found that individuals who were removed from the interlock program and returned to revoked status continued to drive. Within 3 years, approximately 50% of this latter group were involved in a crash or were arrested for DUI or with an invalid driver's license. Conclusions drawn from the study suggest that the breath alcohol ignition interlock device is effective in preventing continued driving while impaired. However, the large-scale effectiveness of the device is limited since most of the drivers eligible for the device do not have it installed. To have a significant impact, the interlock device must represent a better alternative to drivers whose licenses were suspended or revoked because of alcohol arrests compared to remaining on revoked status without having the device installed. Finally the research suggests that, given the rapid return to predevice recidivism, the devices should remain installed until drivers can demonstrate an extended period of being alcohol free.     

Smoking is a marker of risky behaviors independent of substance abuse in injured drivers

OBJECTIVE: Smoking has been linked to disease and injury. The purpose of this study is to investigate the smoking habits of motor vehicular driver trauma center patients and their association with previous injury history and risky behaviors. METHODS: The studied population included 323 motor vehicular driver injury patients (123 smokers and 200 non-smokers) interviewed as part of a larger study of psychoactive substance use disorders at an adult Level I trauma center. Patients with head injuries, hospital stays of less than two days, and diminished cognition were excluded. Interviews included demographics (age, gender, race, marital status), socioeconomic status (SES; income, education, employment), risky behaviors (seatbelt non-use, drinking and driving, riding with drunk driver, binge drinking), and trauma history information (vehicular, assault, and other injuries). Substance abuse (alcohol and drug dependence) was evaluated in depth using DSM III-R criteria. Smokers and non-smokers were compared in relation to control and dependent variables using student's t test and chi-square (alpha = 0.05). Outcome variables included previous trauma history and risky behaviors. Multiple logistic regression models using step-down selection methods (alpha = 0.05) were constructed with risky behaviors and trauma history as dependent variables including demographics, SES and substance as independent variables. RESULTS: Smokers represented 38 percent of the 323 patients studied. Smokers (n = 123) were younger (34 vs. 43 years), more likely to be male (72 percent vs. 50 percent), not married (72 percent vs. 56 percent), and had higher rates of alcohol (29 percent vs. 9 percent) and drug dependence (14 percent vs. 3 percent) than non-smokers (n = 200). Educational achievement (20 percent vs. 15 percent less than high school) and income level (24 percent vs. 23 percent with less than $15,000 of yearly income) were not different between smokers and non-smokers. Smokers were more likely than non-smokers to have a history of prior vehicular trauma (48 percent vs. 26 percent), assault (25 percent vs. 9 percent), or other injury (50 percent vs 37 percent). The following injury-prone behaviors were also more common among the smokers than non-smokers: seatbelt non-use (49 percent vs. 29 percent), drinking and driving (38 percent vs. 15 percent), riding with drunk driver (38 percent vs. 13 percent), and binge drinking (68 percent vs. 26 percent). In multiple logistic regression models adjusting for demographics, SES, and substance abuse, smoking revealed significantly higher odds ratios (OR) for the following dependent variables: seatbelt non-use (OR = 2.9), riding with drunk driver (OR = 2.2), binge drinking (OR = 2.4), previous vehicular (OR = 2.0), and assault injuries (OR = 2.5). Smoking did not reach significance for drinking and driving and other (non-vehicular and non-assault) injury. CONCLUSION: Smoking is independently associated with risky behaviors and repeated history of vehicular or assault injury within the vehicular trauma population.     

A community driving under the influence (DUI) study of declining arrests

Abstract

Objective: Recent news reports in 2016 indicated that across Miami–Dade County, Florida, driving under the influence (DUI) arrests have decreased substantially. The objective of this research was to determine the reasons for the decline in DUI arrests from 2009 to 2016. Are there fewer impaired drivers on the roads? Can DUI enforcement and prosecution be improved?

Methods: The following methods were used in this study: (1) Analysis of existing DUI arrest and crash data; (2) conducting and analysis of a telephone survey of reported knowledge, attitudes, and behaviors concerning impaired driving; (3) conducting and analysis of roadside surveys on the roads on weekend nights in Miami–Dade County; (4) information from focus group discussions with police and prosecutors in Miami–Dade County; and (5) a comprehensive review of the best DUI prevention practices and enforcement strategies used across the country.

Results: DUI arrests decreased 64% in Miami–Dade County between 2009 and 2016. This was a significantly larger decrease than has occurred in the State of Florida as a whole (34%) and in the United States (29%) over the same time period. The decline was not due to any decline in DUI behavior in the county.

Conclusions: Based upon the data and information gathered in this project, the following actions were recommended for Miami–Dade County: (1) County police chiefs need to find ways to overcome law enforcement apathy toward DUI enforcement and persuade their traffic enforcement officers to be proactive rather than reactive when it comes to identifying and making impaired driving stops. (2) County police agencies should join forces to conduct more sobriety checkpoints. Checkpoints are safer for both the police and the drivers going through them and serve as a general deterrent to impaired driving. (3) An interagency DUI task force or team of 5 to 7 officers should be established within the county. These officers would be solely dedicated to DUI enforcement and paid for by each individual agency or under a grant from the state or federal government.     

Impaired driving enforcement practices among state and local law enforcement agencies in the United States

IntroductionAlcohol-impaired driving (DUI) persists as a substantial problem, yet detailed data on DUI enforcement practices are rarely collected. The present study surveyed state and local law enforcement agencies about their DUI enforcement activities.MethodTelephone interviews were conducted with law enforcement liaisons in state highway safety offices. Officers from a nationally representative sample of municipal, county, and state law enforcement agencies were also interviewed about their agency's DUI enforcement activities, including the types of enforcement, frequency of use, and whether activities were publicized. Response rates were 100% among law enforcement liaisons, 86% among county agencies, 93% among municipal agencies, and 98% among state agencies.ResultsBased on the highway safety office survey, 38 states conducted sobriety checkpoints in 2011. Nationally, 58% of law enforcement agencies reported that they conducted or helped conduct sobriety checkpoints during 2011–12, with 14% of all agencies conducting them monthly or more frequently. The vast majority (87%) of agencies reported conducting dedicated DUI patrols. However, dedicated DUI patrols were less likely to be publicized than checkpoints. Less than a quarter of agencies reported using passive alcohol sensors to improve detection of alcohol-impaired drivers.ConclusionsResults show that 38 states conducted sobriety checkpoints in 2011, little changed from a previous survey in 2000. Despite evidence of effectiveness, many agencies do not conduct frequent, publicized DUI enforcement or use passive alcohol sensors.Practical applicationsThe survey suggests that there are several areas in which impaired driving enforcement could be improved: increasing the frequency of special enforcement, such as sobriety checkpoints and/or dedicated patrols; publicizing these efforts to maximize deterrent effects; and using passive alcohol sensors to improve detection of alcohol-impaired drivers.     

Boating-related drowning in Australia: Epidemiology,risk factors and the regulatory environment

Objective: Recreational boating is a popular pastime in many high income countries, and is a leading activity prior to drowning. This study reports on unintentional fatal drowning associated with boating-related incidents in Australia. Methods: A total population, retrospective, cross sectional design examined all boating-related unintentional drowning deaths between July 1, 2005 and June 30, 2015. Variables examined included age, sex, location of drowning incident, vessel type, activity, presence of alcohol/drugs, and lifejacket wear. Relative risk (with a 95% confidence interval) was calculated using fatal drowning rates per 100,000 population and rates per 100,000 registered vessels. Chi square analysis and non-parametric tests for significance were applied. Statistical significance was deemed p < .05. Results: A total of 415 people drowned while boating during the study period, 91.8% male and 35.7% aged between 25 and 44 years. Men were 10 times more likely to drown when boating than females (RR = 10.64 CI:7.55–14.97). Over one-quarter (28.7%) of incidents involved alcohol, in 30.6% drugs were identified (31.3% were illegal) and 90.4% were not wearing a lifejacket. Children were more at risk of drowning on a houseboat than adults (RR = 7.13; CI:1.61–31.61). Females were more likely to drown than males when using a personal watercraft (RR = 10.53; CI:2.75–40.33). Conclusion: Boaters may be taking unnecessary risks by disregarding safety regulations, such as not wearing lifejackets and substance use (such as alcohol and illegal drugs). Boating in remote locations presents a high risk of drowning. While safety regulations are in place, enforcement and behavior change remain challenges. Practical application: Findings support recommendations for increased enforcement of alcohol-related regulations and introducing drug-testing for boaters. Consistency of boating safety regulations, especially around lifejacket wear, is recommended to influence behavior change. The effectiveness of current lifejacket regulations need to be critically evaluated in the context of increasing wear rates for adults and children.     

Seat belt use and fit among drivers aged 75 years and older in their own vehicles

Objective: This article aims to describe seat belt wearing patterns and quality of seat belt fit among drivers aged 75 years and older. A secondary aim is to explore associations between body shape, comfort, and seat belt use patterns.

Methods: This is an observation and survey study of a cohort of 380 drivers aged 75 years and over. During home visits, photographs were taken of the drivers in their vehicles for later analysis of belt fit and a short survey was also administered to collect demographic data and information about seat belt use and comfort. Seat belt fit and use of belt and seat accessories were analyzed from the photographs.

Results: Data from 367 participants with photographs were analyzed. Whereas 97% reported using a seat belt and 90% reported their seat belt to be comfortable, 21% reported repositioning their seat belt to improve comfort. Good sash and lap belt fit were achieved in 53 and 59% of participants, respectively, but only 35% achieved overall good fit. Both poor sash and lap belt fit were observed in 23% of participants. Drivers who were in the obese category had over twice the odds (95% confidence interval [CI], 1.2–4.1) of having a poor lap belt fit than those in the normal body mass index [BMI] range, and drivers who were overweight had 1.8 times the odds (95% CI, 1.1–2.9) of having poor lap belt fit. Older females also had twice the odds (95% CI, 1.3–3.5) of poor lap belt fit compared to older males, regardless of BMI. Sash belt fit did not vary significantly by BMI, stature, or gender. However older drivers who reported that they had not made any adjustments to the D-ring height had 1.7 times the odds of having poor sash belt fit than those who made adjustments (1.2–2.9). Females were 7.3 times more likely to report comfort problems than males (95% CI, 3.2, 16.3) but there was no association between reported comfort and BMI or seat belt fit. Drivers who reported comfort problems had 6 times the odds (3.2–13.6) of also reporting active repositioning of the belt.

Conclusions: The results suggest that older drivers face challenges in achieving comfortable and correct seat belt fit. This may have a negative impact on crash protection. Belt fit problems appear to be associated with body shape, particularly high BMI and gender. There is a need for further investigation of comfort accessories; in the interim, older drivers and occupants should be encouraged to use features such as D-ring adjusters to improve sash belt fit.     

Do speeding tickets reduce the likelihood of receiving subsequent speeding tickets? A longitudinal study of speeding violators in Maryland

OBJECTIVE: Speeding tickets are the most commonly used tool to deter speeders, yet little is known about how speeding citations affect individual drivers' behavior over time. This study examined the effects of being cited for speeding and types of legal consequences on drivers' subsequent speeding citations, which are an indicator of speeding behavior. METHODS: A cohort of 3,739,951 Maryland licensed drivers were identified and followed for one year. Drivers were categorized by whether or not they received a speeding citation in May 2002. Among those cited for speeding in May 2002, drivers were grouped by type of penalty (fines and points; probation before judgment [PBJ, which results in fines but no points]; or no legal consequences). The relative risks (RR) and 95 percent confidence intervals (CI) of receiving a speeding citation during follow-up were compared between drivers ticketed and not ticketed in May 2002, as well as among different penalty groups. Cox proportional hazards regression modeling was used to adjust for potential confounders, including age, gender, alcohol-impaired driving, and residence. Kaplan-Meier survival functions were used to examine timing of violations. RESULTS: Young drivers and male drivers were more likely to receive a speeding citation. Drivers who received a speeding citation in May 2002 had almost twice the risk of receiving a speeding citation during follow-up, compared with those not cited for speeding that month (RR 1.6, 95% CI 1.52-1.68). Overall legal consequences had no significant effect on the risk of receiving a repeat speeding citation relative to ticketed drivers who escaped those consequences (RR 0.98, 95% CI 0.84-1.15); however, stratified analyses showed a significant decrease in repeat citations among females (RR 0.75, 95% CI 0.63-0.90) and drivers who received PBJ (RR 0.81, 95% CI 0.67-0.96). Kaplan-Meier curves showed that the study group of speeders had a significantly shorter time between May 2002 until receipt of a speeding citation than controls. Among penalty groups, significantly shorter times until receipt of another citation were observed among drivers escaping consequences or receiving fines/points compared with drivers receiving fines/PBJ. CONCLUSIONS: Drivers who receive speeding citations are at increased risk of receiving subsequent speeding citations, suggesting that speeding citations have limited effects on deterrence in the context of the current traffic enforcement system. When comparing different penalties, PBJ is associated with a reduced rate of recidivism more than stronger penalties; however, it is unclear whether the reduction primarily is attributable to the penalty itself or to characteristics of drivers receiving PBJ. Increasing drivers' perceptions that they are at risk of being caught speeding may improve the effectiveness of speeding law enforcement.     

Policing the drunk driver: measuring law enforcement involvement in reducing alcohol-impaired driving

INTRODUCTION: With many thousands of deaths still annually attributable to driving under the influence (DUI), it remains imperative that we continually address the problem of producing and sustaining effective countermeasures, and that we subject these efforts to empirical scrutiny. This article presents relevant findings from state-wide datasets. RESULTS: A formula generating a potentially useful metric for assessing aspects of the DUI prosecutorial chain is presented, focusing on the rate of proactive DUI arrests. While in need of cautious interpretation due to issues of inherent inaccuracies in large databases, small numbers of crashes and/or arrests in multiple jurisdictions, and the lack of replication in other states, the analyses show no relationship between the level of DUI arrest activity and DUI-related crashes. This finding brings into question the efficacy of the many millions of dollars devoted each year to targeted DUI enforcement, as it is currently being implemented. CONCLUSIONS: Results are discussed in terms of developing adequate disincentives to DUI so as to raise general deterrence via dramatic increases in proactive DUI enforcement and then engaging in pervasive and persistent social marketing of such efforts to maximize the perception that arrest and punishment for DUI is always imminent, that penalties will be swift, certain, and severe. It is echoed that accurate data need to be collected at all levels of the DUI arrest and prosecution process in every jurisdiction within a state, so as to facilitate the empirical assessment of countermeasure efficacy in reducing alcohol-related crashes. IMPACT ON INDUSTRY: Given that this work needs to be replicated, the impact on the traffic safety industry is potentially huge. The present data indicate that law enforcement efforts to further abate DUI-related crashes are apparently ineffective, though likely necessary to maintain reductions achieved in the 80s and early 90s. Thus, to attain additional systematic reductions, a dramatic increase in enforcement will be necessary as will a diversification of abatement efforts, including an increase in aggressive social marketing tactics to positively impact our traffic safety culture by making DUI universally unacceptable (for a discussion of this latter issue and on the use of positive reinforcement to change driver behavior, see Dula & Geller, 2007).     

Evaluating 24/7 Sobriety Program participant reoffense risk

Objective: Our study investigated risk factors in survival among a subpopulation of drivers in North Dakota’s 24/7 Sobriety Program. Participants mandated for a second driving-under-the-influence of alcohol (DUI) arrest were studied for a three-year interval that commenced with the start date for a 360-day enrollment. Method: A Stratified Cox regression model was developed to compute the hazard ratios for survival. A subsequent DUI-related offense as event of interest. Relation to the explanatory variable array that could be construed from administrative records were investigated. Results: Older drivers were 6.31 times more likely to reoffend than the younger driver cohort of 18–35-years. The survival curve slope showed the fastest decline in the 361-day to 730-day interval. Neither gender nor residence region was a significant predictor in DUI reoffense over the three-year monitoring interval. Preliminary work suggests reoffense was more likely if an individual had program history prior to this court mandated 360-day term in the 24/7 Sobriety Program for a second DUI. The program experience finding was unexpected but could not be studied in greater detail due to data and resource limitations. Conclusions: Administrative records access created a novel opportunity to explore an evolving impaired driving prevention strategy that has shown early promise. Individual driver survival in and after the 24/7 Sobriety Program was studied for three-years. Findings show age, post-program time interval, and possibly program history as areas to explore to improve survival rates. Driver DUI offense were most common shortly after program completion. Although limited to a single state, findings increase knowledge for refining strategies designed to impact driver subpopulations at higher risk for reoffense.     

Preventing alcohol-related convictions: the effect of a novel curriculum for first-time offenders on DUI recidivism

OBJECTIVE: To determine whether DUI offenders can better avoid future drinking and driving by controlling their vehicle usage rather than by controlling their drinking. METHODS: Using a randomized experimental post-test only design, 9,571 first-time DUI offenders were randomly assigned to receive one of two 12-hour educational programs: a traditional DUI curriculum or the PARC (Preventing Alcohol-Related Convictions) curriculum, which uses a novel theoretical approach to preventing DUI recidivism. Whereas traditional programs focus on participants controlling their drinking to avoid future drinking and driving, the PARC curriculum focuses on participants controlling their driving. Instead of trying to control alcohol consumption after driving to a drinking venue (previously found to be a flawed strategy), PARC teaches students to make a decision before leaving home not to drive to a drinking event, thus greatly limiting the possibility of drinking and driving. Driving records were obtained from the Florida Department of Motor Vehicles using driver's license numbers to assess DUI recidivism rates among the students in the PARC and Traditional curricula for the first year following program participation and again at 2 years post-intervention. RESULTS: Binary logistic regression analyses revealed that offenders receiving the PARC curriculum exhibited significantly lower 1-year and 2-year recidivism rates than those receiving the Traditional curriculum. The effect was consistent across two different measures of recidivism, and across gender, race, ethnicity, and location. CONCLUSION: Results suggest that the PARC educational approach may be more effective than the traditional approach in reducing DUI recidivism.     

Bicyclist fatalities involving heavy goods vehicles: gender differences in risk perception, behavioral choices, and training

Objectives: Females are typically involved in fewer collisions when pedal cycling than males. However, female cyclists appear to be overrepresented in the number of fatal collisions involving heavy goods vehicles (HGVs). These collisions often involve cyclists passing HGVs on the side furthest from the HGV driver (nearside). It is hypothesized that this pattern of fatalities may be partly due to differences in how males and females perceive the risk associated with various cycling maneuvers. It is also hypothesized that this difference may be overcome with advanced training. Methods: 4,596 UK cyclists completed an online questionnaire in which they reported their level of cycle training and rated the risk they perceived to be associated with various cycling maneuvers, the likelihood that they would engage in them, and history of collision involvement. Results: Females perceived a slightly greater level of risk to be associated with cycling. However, males differentiated between the risks involved in nearside and offside overtaking to a greater extent than females. Risk perception was significantly correlated with the reported likelihood that participants would engage in risky maneuvers such as overtaking on the nearside and also with past collision prevalence. Advanced cycling training was correlated with higher levels of perceived risk associated with overtaking on the nearside; however, basic cycle training was not. Conclusions: Cyclists who do not correctly differentiate between the risks associated with nearside and offside overtaking may be more at risk of being involved in HGV-related collisions. Advanced cycling training is linked to more accurate risk perception. To reduce fatalities, public awareness campaigns should focus on the increased risk of nearside overtaking and encourage cyclists to take advanced training.     

Child passenger restraint use and emergency department--reported injuries: a special study using the National Electronic Injury Surveillance System-All Injury Program, 2004

INTRODUCTION: In 2004, more than 180,000 child passengers aged 相似文献