Surrogate measures of alcohol involvement in fatal crashes: Are conventional indicators adequate?

The problem of alcohol-related highway fatalities has led a majority of states to enact new legislative countermeasures. Because few states consistently collect information on alcohol involvement in fatal crashes, the evaluation of the effectiveness of these countermeasures has relied on surrogate measures of alcohol involvement. Using data from the U.S. Department of Transportation's Fatal Accident Reporting System (FARS), this study addresses the following questions: (a) Which of the several surrogate measures used are most likely to reflect alcohol involvement in fatal crashes? and (b) Do the trends in these surrogate measures provide an accurate appraisal of the true trends in alcohol-involved fatal crashes? The authors conclude that nighttime fatal crashes are the best surrogate measure of alcohol-involved crashes, but that surrogate measures may not accurately mirror trends in alcohol-involved fatal crashes over time, particularly in small states or over short durations. All drivers in fatal crashes should be given blood alcohol level (BAL) tests to most accurately assess the effects of drunk driving countermeasures.     

Underage drinking: frequency, consequences, and interventions

OBJECTIVES: To examine the frequency of underage drinking, driving after drinking and alcohol-related crashes, trends in these behaviors, and promising interventions. METHODS: We examined drinking and drinking- and-driving behaviors reported in the United States in the 2001 U.S. National Household Survey of Drug Abuse, the Centers for Disease Control and Prevention 2001 Youth Risk Behavior Survey, the 1992 National Longitudinal Alcohol Epidemiologic Study, and the 1999 National Survey of Drinking and Driving conducted for the National Highway Traffic Administration. We also examined the 1999 European School Survey Project on Alcohol and Other Drugs. Alcohol-related fatal crashes were examined from the U.S. Fatality Analysis Reporting System. Evaluation of interventions to reduce teenage drinking and driving after drinking were reviewed. RESULTS: In the United States, 19% of youth ages 12-20 consumed five or more drinks on an occasion in the past 30 days. Although European nations have lower legal drinking ages (16-18) than in the United States (21), similar proportions engage in underage drinking. In two-thirds of European countries, a greater percentage of 15-16 year-olds drank five or more drinks on an occasion in the past month than in the United States. In both the United States and Europe, the earlier people begin to drink, the greater the likelihood of developing alcohol dependence and other alcohol-related problems, including alcohol-related crash involvement, during adolescence and adult years. During the past 20 years alcohol-related traffic deaths among people younger than 21 have been cut in half in the United States, but progress has halted since 1995 and the problem is still large. Interventions shown by research to reduce alcohol-related crashes among youth include raising the legal drinking age to 21, zero tolerance laws, and some interventions that are family, school, or community based. CONCLUSIONS: Despite research showing that a variety of interventions can reduce underage drinking and alcohol-related crash fatalities, the frequency of these behaviors remains high and the average age of drinking initiation is declining in the United States. Efforts are needed to enhance publicized enforcement of underage drinking laws. Comprehensive community interventions that include enforcement of these laws also are needed.     

Teenage driving after using marijuana or drinking and traffic accident involvement

Anonymous random digit dialing telephone surveys of nearly 6000 16–19 year old respondents were conducted in Massachusetts and Upstate New York in 1979–1981. These surveys explored frequency of driving after using marijuana, driving after drinking, respondent accident involvement in the year prior to the interview, and a variety of other respondent characteristics. Frequency of driving after using marijuana and after drinking were each associated with greater accident involvement. To isolate the accident risk of driving after marijuana use, respondents who drove after drinking were excluded from a logistic regression analysis. This analysis also controlled for the distance respondents drove and several respondent demographic characteristics. Compared to respondents who did not drive after marijuana use, teenageers who drove after smoking marijuana on at least 6 occasions per month were 2.4 times more likely to be involved in traffic accidents. Those who drove after marijuana use on at least 15 occasions per month were 2.9 times more likely to have an accident.