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 We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under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.     

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.     

Alcohol ignition interlock programs

The alcohol ignition interlock is an in-vehicle DWI control device that prevents a car from starting until the operator provides a breath alcohol concentration (BAC) test below a set level, usually .02% (20 mg/dl) to .04% (40 mg/dl). The first interlock program was begun as a pilot test in California 18 years ago; today all but a few US states, and Canadian provinces have interlock enabling legislation. Sweden has recently implemented a nationwide interlock program. Other nations of the European Union and as well as several Australian states are testing it on a small scale or through pilot research. This article describes the interlock device and reviews the development and current status of interlock programs including their public safety benefit and the public practice impediments to more widespread adoption of these DWI control devices. Included in this review are (1) a discussion of the technological breakthroughs and certification standards that gave rise to the design features of equipment that is in widespread use today; (2) a commentary on the growing level of adoption of interlocks by governments despite the judicial and legislative practices that prevent more widespread use of them; (3) a brief overview of the extant literature documenting a high degree of interlock efficacy while installed, and the rapid loss of their preventative effect on repeat DWI once they are removed from the vehicles; (4) a discussion of the representativeness of subjects in the current research studies; (5) a discussion of research innovations, including motivational intervention efforts that may extend the controlling effect of the interlock, and data mining research that has uncovered ways to use the stored interlock data record of BAC tests in order to predict high risk drivers; and (6) a discussion of communication barriers and conceptual rigidities that may be preventing the alcohol ignition interlock from taking a more prominent role in the arsenal of tools used to control DWI. Whether interlock programs can help public policymakers achieve their expressed goals of substantially reducing the level of impaired driving will remain uncertain until procedural barriers and intransigent judiciary practices can be overcome that provide for more systematic routine use of interlock programs. Despite strong effectiveness evidence in all studies to date, the real potential of this technology to reduce the road toll cannot be estimated until they are more widely adopted.     

An evaluation of the implementation of ignition interlock in California

Problem: This study evaluates the degree to which courts have implemented California's ignition interlock program, and surveys judges and district/city attorneys to identify barriers to implementing a successful interlock program. Method: There are three parts to the evaluation. In the first, a sample of drivers arrested for driving on a driving under the influence (DUI)-suspended driver license was examined to calculate the rate at which courts order interlocks for DUI-suspended drivers, as required by California law. The second part of the study used Department of Motor Vehicle (DMV) records to count the statewide rate of court-ignition interlock device (IID) orders across time and jurisdictions. The final part surveyed judges, district/city attorneys, and offenders installing an interlock to obtain information about their use of interlock, barriers to implementing an interlock program, and the effectiveness of the devices in preventing drinking and driving. Results: It was found that conviction rates for driving while suspended are low; that judges order interlocks for only a fraction of the convicted driving-while-suspended (DWS) offenders who should receive such an order; and that the majority of offenders who are ordered by the court to install an ignition interlock in their vehicle do not do so. Impact on Industry: Any successful interlock program will need to find a way to balance the inability of many offenders to pay for the devices, with the need for the industry to remain economically viable.     

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.     

Attitudes toward mandatory ignition interlocks for all offenders convicted of driving while intoxicated

Introduction: Ignition interlocks are effective in reducing alcohol-impaired driving recidivism for all offenders, including first-time offenders. Despite their effectiveness, interlock use among persons convicted of driving while intoxicated from alcohol (DWI) remains low. This cross-sectional survey of U.S. adults assessed public support for requiring ignition interlocks for all convicted DWI offenders including first-time offenders. The goal was to update results from a similar 2010 survey in light of new state requirements and increased interlock installations. Methods: Questions were included in the Porter Novelli FallStyles survey, which was fielded from September 28 to October 16, 2015. Participants were the 3,536 individuals who provided an opinion toward requiring ignition interlocks for all offenders. For analyses, opinion toward requiring interlocks for all offenders was dichotomized into ‘agree’ and ‘neutral/disagree.’ To handle missing data, 10 imputed datasets were created and pooled using fully conditional specification (FCS). Results: Fifty-nine percent of adults supported requiring interlocks for all DWI offenders. Multivariate analysis revealed that persons who did not report alcohol-impaired driving (AID) were 60% more likely to support requiring interlocks than those who reported AID. Having heard of interlocks also increased support. Support was generally consistent across demographic subgroups. Conclusions: Interlocks for all offenders have majority support nationwide in the current survey, consistent with previous reports. Support is lowest among those who have reported alcohol-impaired driving in the past 30 days. These results suggest that communities with higher levels of alcohol-impaired driving may be more resistant to requiring ignition interlocks for all convicted DWI offenders. Future studies should examine this association further. Practical applications: These results indicate that the majority of adults recognize DWI as a problem and support requiring interlocks for all offenders.     

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.     

The impact of mandatory versus voluntary participation in the Alberta ignition interlock program

Research has demonstrated that participation in an interlock program significantly reduces the likelihood of subsequent driving while intoxicated (DWI) convictions at least so long as the interlock device is installed in the vehicle. Despite the growing number of jurisdictions that allow interlock programs and the demonstrated success of these programs, the proportion of DWI offenders who actually have the device installed is minimal. In an effort to increase the proportion of offenders using interlocks, some jurisdictions require offenders to install an interlock as a condition of license reinstatement whereas others merely offer offenders a reduction in the period of hard suspension if they voluntarily participate in an interlock program. The objective of the present study was to determine the extent to which voluntary interlock participants are more or less successful in terms of subsequent recidivism than those for whom interlock program participation has been mandated. The issue was addressed using data from the interlock program in Alberta, Canada, which provides for both mandatory and voluntary participation. The recidivism experience of voluntary and mandatory interlock participants was examined both during and after the period of interlock installation. Cox regression revealed that, after controlling for (or equating) the number of prior DWI offenses, the survival rates of DWI offenders who were ordered to participate in the interlock program did not differ from those of voluntary participants. These results suggest that further use of mandatory interlock programs should be just as successful as voluntary programs when offenders share characteristics with those studied in Alberta.     

The impact of mandatory versus voluntary participation in the Alberta ignition interlock program

Research has demonstrated that participation in an interlock program significantly reduces the likelihood of subsequent driving while intoxicated (DWI) convictions at least so long as the interlock device is installed in the vehicle. Despite the growing number of jurisdictions that allow interlock programs and the demonstrated success of these programs, the proportion of DWI offenders who actually have the device installed is minimal. In an effort to increase the proportion of offenders using interlocks, some jurisdictions require offenders to install an interlock as a condition of license reinstatement whereas others merely offer offenders a reduction in the period of hard suspension if they voluntarily participate in an interlock program. The objective of the present study was to determine the extent to which voluntary interlock participants are more or less successful in terms of subsequent recidivism than those for whom interlock program participation has been mandated. The issue was addressed using data from the interlock program in Alberta, Canada, which provides for both mandatory and voluntary participation. The recidivism experience of voluntary and mandatory interlock participants was examined both during and after the period of interlock installation. Cox regression revealed that, after controlling for (or equating) the number of prior DWI offenses, the survival rates of DWI offenders who were ordered to participate in the interlock program did not differ from those of voluntary participants. These results suggest that further use of mandatory interlock programs should be just as successful as voluntary programs when offenders share characteristics with those studied in Alberta.     

Implementation of Washington State's zero tolerance law: patterns of arrests, dispositions, and recidivism

OBJECTIVES: Zero tolerance (ZT) laws have been effective in reducing alcohol-related crashes among underage drivers. However, enforcement in some states has not been rigorous, and ZT offenses may not be viewed as serious offenses. On July 1, 1994, the state of Washington implemented a ZT law that allowed police to request a test for alcohol on suspicion of either a ZT or driving-under-the-influence (DUI) offense. The present study examined effects of the ZT law on arrests and case dispositions among underage offenders as a function of blood alcohol concentration (BAC) and post-law patterns of recidivism. METHODS: Times-series analyses examined the effects of the ZT law on trends in arrests of underage drivers between 1991 and 1999. Based on arrest records matched with driver's license records, the effects of the law on dispositions of alcohol-related offenses among underage drivers were examined, and rates of recidivism among underage offenders were examined for the period following the ZT law. RESULTS: There was a substantial increase in arrests of underage drivers beginning immediately after implementation of the ZT law, especially among drivers with low BACs. The types of court or administrative dispositions received by underage offenders changed markedly after the ZT law was implemented. Underage offenders with lower BACs became far more likely to receive alcohol-related convictions and/or license suspensions. However, the percentage of underage offenders with higher BACs receiving DUI convictions declined as some of these offenders received the lesser ZT disposition. After the ZT law, underage offenders with BACs of 0.10 g/dL or higher were more likely to recidivate than those with lower BACs, but appreciable proportions of drivers were re-arrested for another alcohol offense, whatever the BAC and however they were penalized. CONCLUSIONS: Implementation of Washington's law indicates that a ZT law can increase the likelihood that an underage person will be sanctioned for drinking and driving. However, recidivism remains an issue as more than one in four underage drivers arrested with low BACs subsequently were re-arrested.     

An evaluation of the Swedish ignition interlock program

The Swedish alcohol ignition interlock program for driving while intoxicated (DWI) offenders, both first-time as well as multiple offenders, was launched as a pilot project in 1999. It is a volunteer program and differs in some respects from other programs: It covers a period of 2 years, it includes very strict medical regulations entailing regular checkups by a physician, it does not require a prior period of hard suspension, and it focuses strongly on changes in alcohol habits. Records from the 5 years prior to the offence showed that DWI offenders are generally in a high-risk category long before their offense, with a four to five times higher accident rate (road accidents reported by the police) and a three to four times higher rate of hospitalization due to a road accident. Only 12% of the eligible DWI offenders took part in the program and, of these, 60% could be diagnosed as alcohol dependent or alcohol abusers. During the program, alcohol consumption is monitored through self-esteem questionnaires (AUDIT) and five different biological markers. Our data show a noticeable reduction in alcohol consumption among the interlock users. This, combined with the high rate of compliance with the regulations, probably accounts for the fact that there was no case of recidivism during the program. Preliminary findings also suggest a reduction in the annual accident rate for interlock users while in the program. It still is too early to draw any conclusions concerning the rate of recidivism after completion of the program due to an insufficient amount of data for analysis. Nevertheless, the preliminary results are so promising that the program will now be expanded to cover all of Sweden as well as to include all driver's license categories.     

DUI offenders' perceptions and misperceptions of basic alcohol information

This paper describes the perceptions and misperceptions of basic alcohol and DUI-related information held by two groups of subjects: first-time DUI offenders and multiple-DUI offenders. The results revealed that both samples of subjects were well informed regarding some basic information (e.g., tolerance, elimination of alcohol from the body by the liver, effect of several drinks on increased likelihood of accident) and that the multiple-DUI offenders appeared more knowledgeable on several items (e.g., penalty for refusing breath test, beverage equivalency). These results tend to discredit the knowledge-deficit model of DUI prevention/education/rehabilitation, and an alternative coping skills model is proposed.     

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.     

A note on the effectiveness of the house-arrest alternative for motivating DWI offenders to install ignition interlocks

Introduction

The effectiveness of ignition interlocks at reducing drunk driving has been limited by the ability of driving-while-intoxicated (DWI) offenders to avoid court orders to install the devices.

Methods

In a pilot program in New Mexico, four Santa Fe County judges imposed home confinement (via electronic monitoring bracelets) on offenders who claimed to have no car or no intention to drive. Interlock installation rates for Santa Fe County were compared with all other counties in New Mexico over a 2-year program and 2-year post-program period.

Results

During the two program years, 70% of the drivers convicted of DWI in Santa Fe County installed interlocks, compared to only 17% in the other counties, but when the program was terminated, the Santa Fe installation rate fell by 18.8 percentage points.

Summary

Mandating the alternative sanction of house arrest led to the highest reported interlock installation rate for DWI offenders.

Impact on Industry

Impaired driving is a substantial expense to employers, particularly when it bars driving that interferes with employment. Interlocks provide a method of protecting the public while permitting the offender to drive sober. This study was directed at increasing interlock use by DWI offenders.     

Barriers to interlock implementation

This commentary reviews current and past vehicle interlock programs for impaired driving offenders with a focus on the challenges that courts and motor vehicle departments face in attempting to implement mandatory programs as required by current federal legislation. There are few offenders in interlock programs compared to the large number of impaired drivers arrested each year. This suggests that, to increase participation, courts will have to threaten more severe sanctions for those offenders who reject interlock programs. A combination of electronic house arrest with interlock programs is suggested as a method of maximizing interlock use.     

Barriers to interlock implementation

This commentary reviews current and past vehicle interlock programs for impaired driving offenders with a focus on the challenges that courts and motor vehicle departments face in attempting to implement mandatory programs as required by current federal legislation. There are few offenders in interlock programs compared to the large number of impaired drivers arrested each year. This suggests that, to increase participation, courts will have to threaten more severe sanctions for those offenders who reject interlock programs. A combination of electronic house arrest with interlock programs is suggested as a method of maximizing interlock use.     

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.     

Implied-consent laws: A review of the literature and examination of current problems and related statutes

Problem

A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.

Method

This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.

Results

Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.

Discussion

Laws and policies that may reduce the number of refusals are discussed.

Impact on industry

Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.     

Driving under the influence of alcohol and the effects of alcohol prohibition—Case study in Serbia

Objective: The purpose of this study is to provide an overview of the prevalence of driving under the influence of alcohol (DUI) according to day of the week, specific roads (urban/rural), daytime or nighttime, and vehicle category. In addition, this study examines how the prohibition of selling alcoholic drinks in shops and supermarkets (not in restaurants) after 10 p.m. has affected the prevalence of DUI.

Method: Breath alcohol concentration (BrAC) was collected from all drivers through police checkpoints at 54 locations in Serbia. In this study, 17,945 drivers were tested in urban areas and 19,507 in rural areas. The relationship between DUI during the prohibition on alcohol sales in Belgrade and other large cities in Serbia was determined using logistic regression.

Results: On average, every 100th driver in traffic in Serbia was DUI (0.99%). This study shows that the 0 blood alcohol concentration (BAC) limit for motorcyclists does not have an influence on DUI. Moreover, motorcyclists represent the category with the highest share of DUI, with a statistically significantly larger difference compared to drivers of other vehicle categories. These results may be a consequence of the fact that a large number of drivers drive both motorcycles and other vehicle categories (cars or mopeds), so the different BAC limits for nonprofessional drivers may create confusion about the legal BAC limit.

Conclusions: This study suggests that the required legal BAC limit for nonprofessional drivers should be the same. The prohibition of selling alcoholic drinks in Belgrade after 10 p.m. does not decrease the prevalence of DUI.