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• Distracted driving and associated mortality are major public health issues. • Illinois enacted a comprehensive handheld phone ban in 2014. • We used difference-in-differences analyses to measure its impact on distracted driving. • The ban was associated with less talking on handheld phone while driving. • Also associated with more talking on handsfree phone while driving. Introduction: Distracted driving has been linked to multiple driving decrements and is responsible for thousands of motor-vehicle fatalities annually. Most U.S. states have enacted restrictions on cellphone use while driving, the strictest of which prohibit any manual operation of a cellphone while driving. Illinois enacted such a law in 2014. To better understand how this law affected cellphone behaviors while driving, associations between Illinois' handheld phone ban and self-reported talking on handheld, handsfree, and any cellphone (handheld or handsfree) while driving were estimated. Methods: Data from annual administrations of the Traffic Safety Culture Index from 2012–2017 in Illinois and a set of control states were leveraged. The data were cast into a difference-in-differences (DID) modeling framework, which compared Illinois to control states in terms of pre- to post-intervention changes in the proportion of drivers who self-reported the three outcomes. Separate models for each outcome were fit, and additional models were fit to the subset of drivers who talk on cellphones while driving. Results: In Illinois, the pre- to post-intervention decrease in the drivers' probability of self-reporting talking on a handheld phone was significantly more extreme than that of drivers in control states (DID estimate −0.22; 95% CI −0.31, −0.13). Among drivers who talk on cellphones while driving, those in Illinois exhibited a more extreme increase in the probability of talking on a handsfree phone while driving than those control states (DID estimate 0.13; 95% CI 0.03, 0.23). Conclusions: These results suggest that Illinois' handheld phone ban reduced talking on handheld phones while driving among study participants. They also corroborate the hypothesis that the ban promoted substitution from handheld to handsfree phones among drivers who talk on the phone while driving. Practical Applications: These findings should encourage other states to enact comprehensive handheld phone bans to improve traffic safety. [ABSTRACT FROM AUTHOR]

• Teen drivers are more likely than their older counterparts to text while driving (TWD). • Teen cellphone bans with all-driver texting bans are common in the United States. • Georgia and Illinois recently changed to all-driver handheld phone bans. • We compared changes in teen TWD in GA and IL to control states via difference-in-differences. • Both GA and IL experienced short-term reductions in teen TWD relative to control states. Teen drivers are more likely than their older counterparts to engage in distracted driving. Many states prohibit cellphone use for teen drivers, but only prohibit texting for all drivers. Evidence that these laws have been effective is mixed. We hypothesize that recent policy changes in Georgia and Illinois from teen cellphone bans with all-driver texting bans to all-driver handheld phone bans yielded short-term reductions in teen texting while driving. We analyzed Youth Risk Behavior Surveys in Georgia, Illinois, and control states North Carolina and Michigan. We estimated the reduction in texting while driving associated with policy changes via difference-in-differences models. In Illinois, 45.4 % of high school drivers texted while driving in 2013. After a 2014 policy change to an all-driver handheld ban, the percentage decreased in 2015 to 41.8 %, and decreased further in 2017 to 37.7 %. The adjusted DID estimate comparing Illinois to Michigan from 2013 to 2017 was −8.3 % (95 % CI: −15.5 % 1.1 %; p- value = 0.025). In Georgia, the percentage decreased from 37.5 % before the law to 30.8 % after, and the adjusted DID estimate comparing Georgia to North Carolina was −10.8 % (95 % CI: −19.0 %, −2.5 %; p- value = 0.011) than in North Carolina. Results support all-driver handheld phone bans to improve traffic safety for high school drivers. [ABSTRACT FROM AUTHOR]