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Objective: To estimate the effect of the 2005 Victorian mandatory personal flotation device (PFD) wearing regulations on PFD use by occupants of small (hull length ≤4.8 m) power recreational vessels., Design: Before-after observational study investigating the probability of PFD use among occupants of small vessels before and after the regulations were introduced compared with the probability of use by their counterparts on large power vessels (hull length >4.8-12 m) who were not required to wear PFDs before or after the regulations were introduced in the low-risk conditions in which observations occurred., Methods: Statewide observation surveys of boaters were conducted in peak boating periods between January and March 2005 (prelegislation) and 2007 (postlegislation). Data collection included size of vessel, age and sex of boaters, life jacket use, boat type, activity of boaters, type of waterway and weather and water conditions. Logistic regression modelling tested whether there were statistically significant differences in the change in the relative odds of occupants wearing PFDs from the preintervention to the postintervention period in small compared with large power recreational vessels., Results: The probability of PFD use increased from 22% to 63% on small power vessels compared with 12% to 13% on large vessels. Regression analysis showed a high statistically significant increase in the odds of PFD use on small vessels relative to large vessels (OR 6.2, 95% CI 4.2 to 9.3, p<0.001). No statistically significant effect on use on large vessels was associated with the regulation (OR 1.27, 95% CI 0.94 to 1.70, p=0.15). Relative to large vessels, on small vessels the odds of PFD use increased significantly in both sexes, all age groups, all vessel types and activity groupings except for towed water sports where the increase was only marginally statistically significant., Conclusions: The legislative intervention was successful in increasing PFD wearing in small vessels. However, visible enforcement and tougher penalties are needed to optimise compliance., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Objective: To assess life jacket use among Washington State boaters and to examine the relationship between life jacket use and boating laws., Methods: A statewide observational survey of boaters was conducted between August 2010 and September 2010. Data collection included age, sex, life jacket use, boat type, and weather and water conditions., Results: Among 5157 boaters, 30.7% wore life jackets. Life jacket use was highest among groups required by state law: personal watercraft users (96.8%), people being towed (eg, water-skiers) (95.3%) and children 0-12 years old (81.7%). Children and youth were more likely to use a life jacket if any adult in the boat wore a life jacket: 100% versus 87.2% for 0-5 years, 92.8% versus 76.7% for 6-12 years and 81.4% versus 36.1% for 13-17 years. Adult role modelling was particularly beneficial for adolescents aged 13-17 years, who were not covered by a life jacket law. In multivariable analysis, the presence of at least one adult wearing a life jacket was associated with a 20-fold increased likelihood that adolescents were also wearing a life jacket., Conclusions: Highest life jacket use was strongly associated with laws requiring use and with adult role modelling. Legislation requiring life jackets for ages 13-17 years and social marketing encouraging adult life jacket wear in the company of children and youth are promising strategies to increase life jacket use in Washington State., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)