Drink driving deterrents and self-reported offending behaviours among a sample of Queensland motorists

Problem

The efficacy of drink driving (driving under the influence, DUI) countermeasures to deter motorists from driving over the legal limit is extremely important when considering the personal and economic impact the offending behavior has on the community. This paper reports on an examination of 780 Queensland motorists' perceptions of legal and non-legal sanctions and their deterrent impact on self-reported offending behavior. Method: The data were collected via a telephone survey of motorists recruited from a random sample of all listed telephone numbers in the state, adjusted according to district population figures. Results: The results indicated that there were a range of legal and non-legal factors that were significantly associated with self-reported DUI including: the perceived risk of apprehension and license loss (legal factors); and concerns relating to the possibility of being involved in a crash and hurting another person (non-legal factors). However, additional multivariate analyses indicated that while both legal and non-legal factors significantly predicted self-reported DUI, higher alcohol consumption levels and more favorable attitudes to the behavior also appear to increase the likelihood of DUI. Discussion: The paper will outline the direct implications of the research project such as the development and promotion of countermeasures that both effectively deter motorists and address pro-offending attitudes. Impact on industry: The findings also highlight that DUI remains a relatively common behaviour among some motoring groups and that there is a need to extend current levels of enforcement as well as adopt innovative strategies to enhance the impact of these operations on the offending behaviour.     

Does seeing it make a difference? The self-reported deterrent impact of random breath testing

Introduction: Random Breath Testing (RBT) remains a primary method to both deter and apprehend drink drivers, yet a large proportion of road fatalities continue to be caused by the offense. Outstanding questions remain regarding how much exposure to RBT operations is needed to influence deterrence-based perceptions and subsequent offending. Method: Given this, licensed motorists (N = 961) in Queensland were recruited to complete a questionnaire either in the community (N = 741) or on the side of the road after just being breath tested (N = 243). Survey items measured different types of exposure to RBT operations (e.g., “seen” vs. “being tested”) and subsequent perceptions of apprehension as well as self-reported drink driving behaviors. Results: The key findings that emerged were: motorists were regularly exposed to RBT operations (both viewing and being tested), such exposure was not significantly correlated with perceptions of apprehension certainty, and a sizable proportion reported engaging in drink driving behaviors (e.g., approx. 25%), although roadside participants naturally reported a lower percentage of offending behaviors. Importantly, it was revealed that current “observations” of RBT was sufficient, but not actual levels of active testing (which needed to be doubled). Nevertheless, higher levels of exposure to RBT operations was found to be predictive of a lack of intention to drink and drive again in the future. Conclusions: This paper suggests that mere exposure to enforcement may not create the intended rule compliance, and that the frequency of exposure is also essential for the roadside.     

The law isn't everything: The impact of legal and non-legal sanctions on motorists' drink driving behaviors

IntroductionThe effectiveness of drink driving countermeasures (such as sanctions) to deter motorists from driving over the legal limit is extremely important when considering the impact the offending behavior has on the community. However, questions remain regarding the extent that both legal and non-legal factors influence drink driving behaviors. This is of particular concern given that both factors are widely used as either sanctioning outcomes or in media campaigns designed to deter drivers (e.g., highlighting the physical risk of crashing).MethodThis paper reports on an examination of 1,253 Queensland motorists' perceptions of legal and non-legal drink driving sanctions and the corresponding deterrent impact of such perceptions on self-reported offending behavior. Participants volunteered to complete either an online or paper version of the questionnaire.ResultsEncouragingly, quantitative analysis of the data revealed that participants' perceptions of both legal sanctions (e.g., certainty, severity and swiftness) as well as non-legal sanctions (e.g., fear of social, internal or physical harm) were relatively high, with perceptual certainty being the highest. Despite this, a key theme to emerge from the study was that approximately 25% of the sample admitted to drink driving at some point in time. Multivariate analyses revealed six significant predictors of drink driving, being: males, younger drivers, lower perceptions of the severity of sanctions, and less concern about the social, internal, and physical harms associated with the offense. However, a closer examination of the data revealed that the combined deterrence model was not very accurate at predicting drink driving behaviors (e.g., 21% of variance).Practical applicationsA range of non-legal deterrent factors have the potential to reduce the prevalence of drink driving although further research is required to determine how much exposure is required to produce a strong effect.     

Prevalence of alcohol-impaired driving and riding in northern Ghana

Objective: The objective of this study was to determine the roadside prevalence of alcohol-impaired driving among drivers and riders in northern Ghana. The study also verifies motorists' perceptions of their own alcohol use and knowledge of the legal blood alcohol concentration (BAC) limit in Ghana.

Method: With the assistance of police, systematic random sampling was used to collect data at roadblocks using a cross-sectional study design. Breathalyzers were used to screen whether motorists had detectable alcohol in their breath and follow-up breath tests were conducted to measure the actual breath alcohol levels among positive participants.

Results: In all, 9.7% of the 789 participants had detectable alcohol, among whom 6% exceeded the legal BAC limit of 0.08%. The prevalence of alcohol-impaired driving/riding was highest among cyclists (10% of all cyclists breath-tested) followed by truck drivers (9%) and motorcyclists (7% of all motorcyclists breath-tested). The occurrence of a positive BAC among cyclists was about 8 times higher (odds ratio [OR] = 7.73; P < .001) and it was 2 times higher among motorcyclists (OR = 2.30; P = .039) compared to private car drivers. The likelihood for detecting a positive BAC among male motorists/riders was higher than that among females (OR = 1.67; P = .354). The odds for detecting a positive BAC among weekend motorists/riders was significantly higher than on weekdays (OR = 2.62; P = .001).

Conclusion: Alcohol-impaired driving/riding in Ghana is high by international standards. In order to attenuate the harmful effects of alcohol misuse such as alcohol-impaired driving/riding, there is the need to educate road users about how much alcohol they can consume and stay below the legal limit. The police should also initiate random breath testing to instill the deterrence of detection, certainty of apprehension and punishment, and severity and celerity of punishment among drink-driving motorists and riders.     

Cultural values and random breath tests as moderators of the social influence on drunk driving in 15 countries

IntroductionThe social influence on drunk driving has been previously observed in several countries. It is noteworthy, however, that the prevalence of alcohol in road fatalities is not the same in all countries. The present study aimed to explore whether cultural values and the number of roadside breath tests moderate the link between the perceived drunk driving of one's peers and self-reported behavior.MethodsBased on the European survey SARTRE 4, the responses of 10,023 car drivers from 15 countries were analyzed. Two cultural values, “tradition” and “conformism,” were identified as possibly being linked to social influence. Country scores for these values were taken from the European Social Survey. The number of random roadside breath tests per inhabitant was used as an indicator of drunk-driving enforcement in each country.ResultsA hierarchical multilevel modeling analysis confirmed the link between friends' drunk driving and one's own drunk driving in all countries, but the strength of the link was much stronger in some countries (e.g., Italy, Cyprus, and Israel) than in others (e.g., Finland, Estonia, and Sweden). Both the measured value of “tradition” and the number of alcohol breath tests were found to moderate the link between friends' and one's own drunk driving.Practical ApplicationsEuropean stakeholders should take into account cultural specificities of target countries when designing campaigns against drunk driving.     

Motorists' knowledge,attitudes and practices toward alcohol-impaired driving/riding in Ghana

Objectives: The main objective of this study was to establish the knowledge, attitudes, and practices toward drink driving/riding as a risk factor for road traffic crashes in 3 regional capitals in Ghana.

Methods: The study used a face-to-face approach to randomly sample motorists who were accessing various services at fuel/gas stations, garages, and lorry terminals in 3 cities in Ghana.

Results: Over the previous 12 months, 24% of all motorists and 55% of motorists who were current alcohol users reported driving or riding a vehicle within an hour of alcohol intake. On average, motorists/riders who were current alcohol users consumed 4 standard drinks per drinking occasion. Generally, 83% of motorists who currently use alcohol walked, rode, or drove home after consuming alcohol away from their homes. Motorists/riders who reported drink driving were 4 times more likely to have had previous traffic violation arrests compared to those who reported no drink driving/riding (P =.001). Respondents were of the opinion that speeding was the major cause of traffic crashes, followed by driver carelessness, poor road conditions, inexperienced driving, and drink driving, in that order. Thirty-six percent of motorists who use alcohol had the perception that consuming between 6 and 15 standard drinks was the volume of alcohol that will take them to the legal blood alcohol concentration (BAC) limit of 0.08%. Compared to females, male motorists/riders were more likely to report drink driving (adjusted odds ratio [AOR] = 5.15; 95% confidence interval [CI], 2.31 to 11.47). Private motorists also reported a higher likelihood of drink driving compared to commercial drivers (AOR = 3.36; 95% CI, 1.88 to 6.02). Only 4% of motorists knew the legal BAC limit of Ghana and only 2% had ever been tested for drink driving/riding.

Conclusion: The volumes of alcohol that motorists typically consume per drinking occasion were very high and their estimates of the number of drinks required to reach the legal BAC limit was also very high. Provision of authoritative information advising motorists about safe, responsible, or low-risk levels of alcohol consumption is imperative. Many traffic violations including drink driving were reported, thus suggesting a need for enhanced policing and enforcement. However, given the low level of knowledge of the legal BAC limit, educating motorists about how many drinks will approximate the legal BAC should be intensified prior to an increase in enforcement; otherwise, the desired outcome of enforcement may not be achieved.     

Changes in driving behavior and cognitive performance with different breath alcohol concentration levels

OBJECTIVE: This study examines the changes in driving behavior and cognitive performance of drivers with different breath alcohol concentration (BrAC) levels. METHODS: Eight licensed drivers, aged between 20 and 30 years, with BrAC levels of 0.00, 0.25, 0.4 and 0.5 mg/l performed simulated driving tests under high- and low-load conditions. Subjects were asked to assess their subjective psychological load at specified intervals and perform various tasks. The outcome was measured in terms of reaction times for task completion, accuracy rates, and driver's driving behavior. RESULTS: The effects of BrAC vary depending on the task. Performance of tasks involving attention shift, information processing, and short-term memory showed significant deterioration with increasing BrAC, while dangerous external vehicle driving behavior occurred only when the BrAC reached 0.4 mg/l and the deterioration was marked. CONCLUSION: We can conclude that the cognitive faculty is the first to be impaired by drinking resulting in deteriorated performance in tasks related to divided attention, short-term memory, logical reasoning, followed by visual perception. On the other hand, increasing alcohol dose may not pose an immediate impact on the external vehicle driving behavior but may negatively affect the driver's motor behavior even at low BrAC levels. Experience and will power could compensate for the negative influence of alcohol enabling the drivers to remain in full steering control. This lag between alcohol consumption and impaired driving performance may mislead the drivers in thinking that they are still capable of safe steering and cause them to ignore the potential dangers of drunk driving.     

Comparative judgements of crash risk and driving ability for speeding behaviours

Introduction: Preliminary research has indicated that numerous drivers perceive their risk of traffic crash to be less than other drivers, while perceiving their driving ability to be better. This phenomenon is referred to as ‘comparative optimism’ (CO) and may prove to inhibit the safe adoption of driving behaviors and/or dilute perceptions of negative outcomes. The objective of this study was to investigate comparative judgments regarding crash risk and driving ability, and how these judgments relate to self-reported speeding. Method: There were 760 Queensland motorists comprised of 51.6% males and 48.2% females, aged 16–85 (M = 39.60). Participants completed either a paper or online version of a survey. Judgments of crash risk and driving ability were compared to two referents: the average same-age, same-sex driver, and the average same-age, same-sex V8 supercar champion. Results: Drivers displayed greater optimism when comparing their crash risk and driving ability to the average same-age, same- sex driver (respectively, 72%, 72.4%), than when comparing to a V8 supercar champion (respectively, 60%, 32.9%). When comparing judgements of crash risk and driving ability to a similar driver, it appears that participants in the present study are just about as optimistic about their risk of crash (i.e. 72%) as they are optimistic about their driving ability (i.e. 74.2%).     

Exposure to the sobriety "Checkpoint Strikeforce" campaign in Maryland: impact on driver perceptions of vulnerability and behavior

OBJECTIVES: To compare drivers who were: (1) exposed to Maryland's sobriety "Checkpoint Strikeforce" campaign; (2) not exposed but were aware of it; and (3) neither exposed nor aware of it. This six-month campaign involved periodic road-side sobriety checkpoints, in which police attempted to detect and arrest drunk drivers and a series of radio Public Service Announcements (PSAs) that promoted public awareness. METHODS: A statewide sample of 1725 drivers were interviewed by telephone to determine their exposure to and awareness of this campaign, as well as their beliefs and behaviors concerning drunk driving and seat belt usage. RESULTS: Relatively few people (9.6%) were exposed in any way to the campaign; however almost 30% were aware of it. Significant increases in perceived vulnerability to arrest for drinking and driving were found among those who were exposed. There were no differences in reported drinking and driving, but seat belt usage in the last 30 days was higher among those who were exposed. There were no differences among those people who had been directly exposed to the campaign (i.e., personally gone through a sobriety checkpoint) and those who were indirectly exposed (i.e., knew a family member or someone else who went through a checkpoint). CONCLUSIONS: Exposure to a sobriety checkpoint was associated with increased perceptions of drink-driving risk (i.e., likelihood of getting caught by the police), which was not dependent upon having personally experienced it. Awareness without exposure appears to be insufficient to change perceived risk. The need to increase the reach and frequency of the sobriety "Checkpoint Strikeforce" campaign is indicated.     

An evaluation of Washington's driving while intoxicated law: Effect on drunk driving recidivism

The 1980 Washington driving while intoxicated (DWI) law was evaluated to determine its impact on the subsequent driving behavior of persons convicted of DWI. The major provisions of this law were mandatory jail sentences for conviction of DWI and a change in the definition of DWI. The law made it illegal per se for a person to drive with a blood alcohol level of .10% or more. The law was intended to reduce the drunk driving and accidents of individuals convicted of DWI as well as deter such behavior among the general driving population. The study assessed the deterrence effect of the law on convicted DWI offenders. It was found that individuals convicted under the provisions of this law had higher accident rates and drunk driving recidivism rates than individuals convicted under the previous law. These increases suggest that mandatory jail sentences may fail to deter subsequent acts of drunk driving. It was concluded that alternative legal sanctions for DWI (such as license suspensions or revocations) may be sufficiently stringent to produce both general and specific deterrence of drunk driving.     

Drug and drink driving by university students: an exploration of the influence of attitudes

The present study aimed to gather information on drug and alcohol use, the prevalence of drink and drug driving and attitudes to both in an undergraduate university cohort (n = 275). Further, the study aimed to contribute information to aid intervention program development by determining predictors of drink and drug driving behavior. The study examines both drug and alcohol use and the influence of attitudes toward driving while under the influence of alcohol and/or drugs. Results indicated that significant proportions of university students are engaging in the risk-taking behavior of driving under the influence of drugs (25%), alcohol (14%), or both (8%). The results suggest that attitudes toward driving under the influence of alcohol and/or drugs are a strong predictor of engaging in the behavior. Peer influence emerged as a major aspect of attitudes. The results of this study provide an important beginning to understanding drink and drug driving and the influence of attitudes in the university student body.     

Early impacts of alcoholic beverage warning labels: national study findings relevant to drinking and driving behavior

After November, 1989 Federal law required a standard health warning label on all alcoholic beverage containers sold for consumption in the U.S. Results are reported from a cross-sectional national household telephone interview survey of adults, occurring approximately 6 months after implementation of the warning labels (N=2000). Implications for health warnings with respect to information processing theory, the Health Belief Model, and other theories relevant to precaution adoption are briefly reviewed and two derivative hypotheses are tested using log-linear analysis. Relationships between various personal characteristics and (a) seeing the label and (b) recalling the driving impairment message are examined for consistency with theoretical expectations. We also examine associations between message recall, drinking style, and two precautionary behaviors undertaken to avoid drinking and driving. Adjusting for apparent false positives, approximately a quarter of the sample have noticed the label 6 months after its introduction; 16% recalled the specific driving impairment message. As hypothesized, exposure to the warning was predicted primarily by consumption pattern but also was associated with a personal salience factor, that is, ever having drunk alcohol so as to be at risk when driving. About a quarter of the heavy drinkers (5 drinks or more per occasion sometime and drinking at least weekly) who ever drank and drove saw the specific warning. Of two self-regulation strategies — limiting driving after drinking and limiting drinking when about to drive — the latter was the more prevalent. Both strategies were reported more by those who were heavy drinkers, those recalling the driving impairment message, and those perceiving driving after drinking to be very dangerous, than by other individuals.     

Longitudinal examination of underage drinking and subsequent drinking and risky driving

INTRODUCTION: Alcohol use, alcohol misuse, and risky driving from adolescence into young adulthood were compared by drinking onset age. METHODS: Surveys were administered in Grades 5/6, 6/7, 7/8, 10, 12, and at approximately age 23. Participants were placed into Drinking Onset groups based on self-reported alcohol use frequency on the adolescent surveys. Driving records were examined in three age periods: under 21, 21-25, and 26+. RESULTS: The earliest drinking initiators reported higher alcohol use and misuse on each survey, and were more likely to have risky driving offenses before age 21 and to have alcohol driving offenses in all three age periods. DISCUSSION: The earliest drinking initiators engaged in risky drinking behavior and risky driving behavior that was consistently higher than those with later drinking initiation, beginning in adolescence and persisting well into young adulthood.     

The effect of a campus-community environmental alcohol prevention initiative on student drinking and driving: results from the "a matter of degree" program evaluation

OBJECTIVE: Motor vehicle crashes involving alcohol are a major contributor to morbidity and mortality among college students in the United States. This study evaluates the effect on drinking and driving outcomes of the "A Matter of Degree" program, a campus-community coalition initiative to reduce college binge drinking. METHODS: We used a quasi-experimental longitudinal study design that compared student responses at 10 colleges participating in the program and students attending 32 similar colleges that did not participate in the program. We also divided the program sites into two groups of five according to their level of program implementation and compared each with the non-program colleges. We examined driving after any alcohol consumption and driving after five or more drinks among drinkers who drove one or more times a week per month and riding with a high or drunk driver among all students at these colleges beginning in 1997 through 2001. Outcomes were based on data collected from repeated cross-sectional surveys using the Harvard School of Public Health College Alcohol Study. Analyses were conducted using MLwiN multilevel statistical software. RESULTS: We found significant reductions in driving after drinking, driving after five or more drinks and riding with a high or drunk driver at the program colleges relative to the comparison colleges. Further analyses indicated that these reductions among the AMOD program colleges occurred at the sites with high program implementation relative to comparison sites, while no statistically significant change was noted at the program sites with low implementation. The program effect on the two drinking and driving outcomes appeared to be mediated by frequent binge drinking, while significant decline in the riding with an intoxicated driver outcome was not mediated by the individual's drinking. CONCLUSIONS: Campus-community based environmental alcohol prevention is a promising approach for reducing alcohol-impaired motor vehicle crashes among this population.     

Perceptions of alcohol-impaired driving and the blood alcohol concentration standard in the United States

IntroductionAlthough the number of alcohol-impaired driving (AID) fatalities has declined over the past several years, AID continues to be a serious public health problem. The purpose of this effort was to gain a better understanding of the U.S. driving population's perceptions and thoughts about the impacts of lowering the blood alcohol concentration (BAC) driving standard below.08% on AID, health, and other outcomes.MethodsA questionnaire was administered to a nationally representative sample of licensed drivers in the U.S. (n = 1011) who were of age 21 or older on driving habits, alcohol consumption habits, drinking and driving habits, attitudes about drinking and driving, experiences with and opinions of drinking and driving laws, opinions about strategies to reduce drinking and driving, general concerns about traffic safety issues, and demographics.ResultsOne-third of participants supported lowering the legal BAC standard, and participants rated a BAC standard of .05% to be moderately acceptable on average. 63.9% indicated that lowering 30 the BAC to .05% would have no effect on their decisions to drink and drive. Nearly 60% of respondents lacked accurate knowledge of their state's BAC standard.ConclusionsPublic support for lowering the BAC standard was moderate and was partially tied to beliefs about the impacts of a change in the BAC standard. The results suggest that an opportunity for better educating the driving population about existing AID policy and the implications for lowering the BAC level on traffic injury prevention.Practical applicationsThe study results are useful for state traffic safety professionals and policy makers to have a better understanding of the public's perceptions of and thoughts about BAC standards. There is a clear need for more research into the effects of lowering the BAC standard on crashes, arrests, AID behavior, and alcohol-related behaviors.     

Associations between driver training, determinants of risky driving behaviour and crash involvement

The core aim of the study is to examine associations between formal and informal practical driver training as well as driving experience on the one hand and young drivers’ safety attitudes, self-assessment of driving ability and self-reported driver behaviour on the other hand. An additional aim is to examine the associations between attitudes, self-assessment and behaviour on the one hand and crash involvement on the other hand. The results are based on a self-completion questionnaire survey conducted among a representative sample of Norwegian drivers aged 18–20 years (n = 1419). The results showed that there were small yet significant associations between driver training, on the one hand and traffic safety attitudes and risky driving behaviour on the other hand. The amount of formal driver training was negatively associated with the respondents’ evaluation of their driving skills; although the amount of lay instruction was positively associated with such self-evaluation. The results also showed that attitudes as well as self-assessment of driving ability were significantly associated with self-reported risk behaviour. This was especially true for attitudes related to rule violations. There was a strong association between crash involvement and exposure (measured as months holding a licence). Young novice drivers’ crash involvement seems stronger associated with driving skills (manifested as self-assessment of driving ability) than safety attitudes and self-reported driver behaviour. The consequences of the results for driver training and accident prevention are discussed.     

Miss-and-run: Factors contributing to two-vehicle phantom vehicle crashes in Florida

Objective: Phantom vehicle crashes (PVCs), or miss-and-run crashes, are a topical issue in car insurance coverage because of controversies over testimony and compensation. However, no peer-reviewed literature has examined the perceptions and deliberations involved in this infrequent type of car crash. A novel taxonomy of roadway traffic crashes is proposed in this study on the basis of whether physical collisions did occur (hit or miss) and whether the perpetrators stayed at the crash scene (stay or run). In this way, this study poses the issue of PVCs within the scope of traffic safety research and aims to investigate the statistically significant factors that are likely to induce PVCs.

Methods: A binary logistic regression method was adopted to model the probability and occurrence of 2-vehicle PVCs (TV-PVCs) in Florida. Data derived from the Crash Analysis Reporting system in 2012–2014 consisted of 45,319 2-vehicle crashes, of which 1,376 (3.04%) were confirmed as positive TV-PVCs. Sixteen factors with 50 variables on crash information, roadway characteristics, and environmental conditions were included in the original consideration of the TV-PVC model.

Results: The results indicated that a 2-vehicle crash is more likely to be a PVC when the crash happens on weekends, on roadways with no traffic control or speed control, full access control; on curving and sloping roadways; on roadways of National Highway System; and in low-density and other areas. A TV-PVC is less likely to occur on dry roads, in daylight, or at intersections or driveways. Moreover, alcohol involvement in a 2-vehicle crash is associated with hit-and-stay crashes than PVCs, and uninsured motorists are more likely to be the victims of PVCs because they tend to avoid physical collisions due to the potential self-paid loss.

Conclusions: Several conclusions for better understanding the occurrence of PVCs are proposed for traffic management departments and car insurers. Cautious driving behavior including concentrated attention and deliberate lane changes should be encouraged for motorists to engage in appropriate levels of driving freedom, and drunk driving should be strictly supervised to keep motorists behind the wheel conscious. Car insurance is encouraged to compensate for economic loss resulting from roadway crashes. Road monitoring systems with well-performing illumination devices are recommended to help drivers provide potent testimony for compensation claims.     

The effectiveness of alternative transportation programs in reducing impaired driving: A literature review and synthesis

Introduction: Studies have shown that approximately half of arrested intoxicated drivers had their last alcoholic drink at a licensed bar or restaurant. Current efforts to prevent intoxicated patrons from leaving licensed establishments and driving home have been only partially successful. Since a high proportion of drinkers drive to their drinking destination, promoting the use of alternative transportation (AT) – including safe ride shuttles, free or subsidized taxi and ridesharing services, voluntary or paid designated driver programs, and more accessible public transportation – is an important strategy for preventing impaired driving. The primary goal of this study was to review and synthesize the findings of research studies designed to test the effectiveness of AT programs in reducing alcohol-impaired driving. A secondary goal was to report if using AT has led to any unintended consequences, in particular greater alcohol consumption. Method: We identified relevant academic articles, new articles, government reports, and other documents (English only) through the University of Chicago library, Google Scholar, and Google Search. We also included published articles recommended by peers. Key search terms included: alternative transportation; safe rides; designated driver; alcohol-impaired driving; alcohol consumption, cost effectiveness; and reduce drunk driving. Initially, we identified 168 potentially relevant sources, of which only 57 were academic articles. After a thorough review, we narrowed down the number of relevant articles to 125 including some background articles and government reports. Results: Some AT programs produced reductions in one or more of the following outcomes: (1) impaired driving; (2) impaired driving crashes; (3) driving under the influence (DUI) arrests; and (4) traffic crashes in general, but others were not shown to be effective. A few programs resulted in greater self-reported alcohol use, but there were no significant findings indicating that drinking when using AT led to an increase in alcohol-related harms such as public intoxication, assaults, or other alcohol-related crime. Of the studies that conducted a cost-benefit analysis, most showed that AT programs yielded a positive benefit, but these studies did not include a sufficient number of variables to be considered true cost-benefit analyses. Conclusions: There is mixed evidence regarding the effectiveness of AT programs. Evaluations with more rigorous quasi-experimental and experimental designs are needed to identify which types of AT programs work best for different types of communities and target groups. Practical Applications: The literature review and synthesis revealed that the most successful AT programs typically have some of these attributes: (1) social acceptance; (2) high level of public awareness; (3) low cost; (4) year-round availability; (5) provide rides to and from drinking venues; (6) several sponsors that provide funding); (7) user convenience; and (8) perceived safety.     

Prevalence of alcohol among nonfatally injured road accident casualties in two level III trauma centers in northern Ghana

Background: Alcohol use is pervasive among motorists on the road in Ghana; however, we do not know the extent to which this behavior is implicated in road accidents in this country.

Objectives: The main objective of this research was to establish the prevalence of alcohol in the blood of nonfatally injured casualties in the emergency departments (EDs) in northern Ghana.

Method: Participants were injured road traffic crash victims, namely, pedestrians, cyclists, motorcyclists, and drivers seeking treatment at an ED. The study sites were 2 level III trauma centers located in Wa and Bolgatanga. Participants were screened for alcohol followed by breath tests for positive participants using breathalyzers.

Results: Two hundred and sixty-two accident victims visited EDs, 58% of whom were in Wa. Among the victims, 41% were hospitalized and 57% experienced slight injuries. The vast majority (76%) of the casualties were motorcyclists, 13% were pedestrians, 8% were cyclists, and 2% were drivers. Casualties who had detectable alcohol in their blood were predominantly vulnerable road users. In all, 34% of participants had detectable blood alcohol concentrations (BACs) and the mean BAC for all casualties who tested positive and could give definitive BACs was 0.2265 (226 mg/dl). The prevalence of alcohol use was 53% among cyclists, 34% among motorcyclists, 21% among pedestrians, and 17% among drivers. Male casualties were more likely to test positive for alcohol than females. In addition, the prevalence of alcohol was significantly higher among injured casualties in Bolgatanga compared to Wa.

Conclusion: There was a high prevalence of alcohol use among nonfatally injured casualties in northern Ghana and injury severity increased with BAC. AUDIT screening in the hospital, alcohol consumption guideline, road safety education with an emphasis on minimizing or eliminating alcohol consumption, and enhanced enforcement of the BAC limit among motorists are recommended.     

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.