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Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired driving among a high proportion of young adult drug users. EMDEs are late-night dance parties marked by a substantial number of young adult attendees and elevated drug involvement. No studies to date have examined drug-impaired driving in a natural environment with active drug and alcohol users.Six EMDEs were sampled in San Diego, California, and Baltimore, Maryland. A random sample of approximately 40 attendees per event were administered surveys about alcohol and other drug (AOD) use and driving status, given breath tests for alcohol, and asked to provide oral fluid samples to test for illicit drug use upon entering and exiting the events.Driving status reduced the level of alcohol use (including abstaining) but the impact on drug-taking was not significant. However, 62% of individuals who reported their intention to drive away from the events were positive for drugs or alcohol upon leaving. This suggests that these events and settings are appropriate ones for developing interventions for reducing risks for young adults.

Designated drivers are a popular strategy for avoiding drunk driving. However, studies have demonstrated that the strategy is often implemented poorly, resulting in diminished risk-reduction effectiveness. The purpose of this study was to test the efficacy of six interventions designed to reduce alcohol consumption among designated drivers.A total of 376 groups consisting of 1,412 pedestrians (57.8% men) were recruited as they crossed into Tijuana, Mexico, from San Diego, CA. Before crossing into Mexico, each group was assigned at random to one of six experimental conditions or to one control condition. The six interventions were designed to (1) cue the use of designated drivers, (2) change attitudes about designated drivers, (3) provide monetary rewards for driver sobriety, and (4) increase group supportive norms for proper designated driver use. Participant breath alcohol concentrations (BrACs) were collected before entering Mexico and on return to the United States.Using group members to deliver pro-designated driver messages significantly decreased driver and passenger BrACs relative to controls. Male drivers were more likely to return from Mexico with BrACs of zero if they were rewarded. Among female drivers, wearing a bracelet with the printed words "designated driver" in addition to cuing resulted in 9 of 10 drivers returning with BrACs equal to zero.These results demonstrate that designated driver sobriety can be enhanced through brief interventions, and proper use of the designated driver concept did not increase the risk of excessive alcohol consumption for passengers.

Objectives. In 1999, New Zealand lowered the minimum purchasing age for alcohol from 20 to 18 years. We tested the hypothesis that this increased traffic crash injuries among 15- to 19-year-olds. Methods. Poisson regression was used to compute incidence rate ratios for the after to before incidence of alcohol-involved crashes and hospitalized injuries among 18- to 19-year-olds and 15- to 17-year-olds (20- to 24-year-olds were the reference). Results. Among young men, the ratio of the alcohol-involved crash rate after the law change to the period before was 12% larger (95% confidence interval [CI]=1.00, 1.25) for 18- to 19-year-olds and 14% larger (95% CI=1.01, 1.30) for 15- to 17-year-olds, relative to 20- to 24-year-olds. Among young women, the equivalent ratios were 51% larger (95% CI=1.17, 1.94) for 18- to 19-year-olds and 24% larger (95% CI=0.96, 1.59) for 15- to 17-year-olds. A similar pattern was observed for hospitalized injuries. Conclusions. Significantly more alcohol-involved crashes occurred among 15-to 19-year-olds than would have occurred had the purchase age not been reduced to 18 years. The effect size for 18- to 19-year-olds is remarkable given the legal exceptions to the pre-1999 law and its poor enforcement.

The Preventing Alcohol-Related Convictions (PARC) program is a novel educational curriculum for first-time DUI offenders, with the ultimate goal of reducing DUI recidivism. It differs from traditional DUI education and prevention programs in that it does not suggest to DUI offenders that they must abstain from alcohol entirely or control their drinking to prevent a future DUI; rather, it teaches students to prevent a future DUI by not driving their cars to drinking events. Thus, the emphasis of the curriculum is on controlling driving rather than controlling drinking to avoid future DUI convictions. The implementation of the program is ongoing throughout the state of Florida. The current randomized study focused on intermediate outcomes relevant for DUI recidivism; specifically, individuals' readiness for change regarding drinking and driving, and their endorsement of a PARC planning and action approach (controlling driving) versus a traditional approach (controlling drinking). The current research demonstrated that the PARC program is effective in moving participants toward more readiness for change and toward a strategy of planning ahead to avoid driving to any venue in which drinking may occur. Future research will assess the ultimate effect on DUI recidivism.

Introduction In contrast to age, education, and gender, which have been studied more frequently, the role of race/ethnicity in shaping fatal stop sign running incidents has received relatively little attention. It has been shown that failing to follow traffic laws and regulations is a major cause of motor vehicle crashes (MVCs) in Latin America. Does this driving behavior in Latin America correspond to the Hispanic community in the United States? Are Hispanics more likely to be at-fault concerning stop sign crossing than other racial/ethnic groups in the United States? Method We took advantage of a 1990–1996 Fatality Analysis Reporting System (FARS) file with additional racial/ethnic information. Our file consisted of drivers who died in a MVC that occurred in an intersection where a stop sign was in place that involved one or more drivers with at least one of them failing to obey the traffic device. Descriptive statistics and logistic regressions were applied. Results Overall, we found no direct difference between African–American, White, and Hispanic drivers regarding stop sign running. However, we found that race/ethnicity does play an indirect role on this problem through its impact on drinking and driving as well as its interaction with age and gender. Conclusions We found a picture that is much more complex than what the initial hypothesis postulated. Race/ethnicity seems to play a role in shaping fatal stop sign running incidents, but the mechanisms by which such a role is played are complex and not fully understood. Impact on Industry The incidence and cost of fatal stop sign running crashes may be reduced if prevention policies targeting the most vulnerable groups could be developed.

This study evaluated the cross-border safety impact of extended drinking hours from 1:00 to 2:00 a.m., in licensed establishments in Ontario, Canada.This study examined patterns in total and alcohol-related casualties in: (1) Windsor, Ontario, Canada compared to Detroit, Michigan, US with a 2:00 a.m. closing time, and (2) Ontario compared to Michigan for overall trends. The criterion outcome indicators were: (1) monthly motor vehicle casualties (major injuries and fatalities) for the city-regions of Windsor and Detroit and (2) Ontario and Michigan monthly motor vehicle fatalities occurring between 11:00 p.m. and 3:00 a.m. for 4 years pre- and 3 years post-policy change. In order to examine cross-border drinking consequences, data were disaggregated to assess trends of motor vehicle injury collisions involving vehicles with US licence plates and with US drivers aged 16-20 in the Windsor region; similarly trends were assessed for motor vehicle injury collisions involving vehicles with Ontario licence plates in the Detroit region.The Windsor region total motor vehicle casualty data showed a non-significant pre-post increase, while the Detroit region showed a statistically significant decrease for total motor vehicle casualties. In the Windsor region, a significant increase was found for alcohol-related motor vehicle casualties after the drinking hours were extended. However, the Detroit region showed a statistically significant decrease in alcohol-related motor vehicle casualties concomitant with Ontario's drinking hour extension. No similar trends were found for the province of Ontario and the state of Michigan as a whole. Moreover, a significant decrease was found for injury collisions involving vehicles with Ontario licence plates in the Detroit region but no similar pattern was found for injury collisions involving vehicles with US licence plates and with 16-20-year-old US drivers in the Windsor region.These data seem to support a cross-border impact of the Ontario extended drinking policy. A significant increase in alcohol-related motor vehicle casualties was found in the Windsor region and concomitantly, significant decreases in total and alcohol-related motor vehicle casualties were found in the Detroit region after the extended drinking hours amendment. The Ontario government's belief that the extended drinking hour policy would "reduce the number of patrons who cross the border when Ontario's bars and restaurants close" may have been realized.

Driving under the influence (DUI) of alcohol is among the most common and serious alcohol-related problems experienced by US college students. Community-based prevention trials using environmental approaches to DUI prevention have been effective in reducing DUI. Such interventions remain untested in college settings. This study is the first to test the efficacy of an environmental prevention campaign to reduce DUI among college students.We used a quasi-experimental non-equivalent comparison group design to test the efficacy of the DUI prevention intervention. Students at the experimental university were exposed to a DUI prevention intervention that included a social marketing campaign, a media advocacy campaign and increased law enforcement (DUI checkpoints and roving DUI patrols).Students from two large public universities located along the US/Mexico border participated in the seven-semester study.In total, 4832 college students took part.Using telephone interviews of randomly selected students, we took pre- and postintervention measures of self-reported DUI.Self-reported DUI (past year) decreased significantly from pre-test to post-test (odds ratio = 0.55) at the intervention school, whereas rates at the comparison campus remained stable. The campus-intervention interaction was statistically significant (P0.05), suggesting that the campaign led to the observed change in DUI.Environmental DUI campaigns similar to those validated in community prevention trials can be effective in college settings. Further research, however, is needed to determine the robustness of the changes associated with such campaigns.

Purpose This scientific review provides a summary of the evidence regarding the benefits of reducing the illegal blood alcohol concentration (BAC) limit for driving and providing a case for enacting a .05 BAC limit. Results Fourteen independent studies in the United States indicate that lowering the illegal BAC limit from .10 to .08 has resulted in 5–16% reductions in alcohol-related crashes, fatalities, or injuries. However, the illegal limit is .05 BAC in numerous countries around the world. Several studies indicate that lowering the illegal per se limit from .08 to .05 BAC also reduces alcohol-related fatalities. Laboratory studies indicate that impairment in critical driving functions begins at low BACs and that most subjects are significantly impaired at .05 BAC. The relative risk of being involved in a fatal crash as a driver is 4 to 10 times greater for drivers with BACs between .05 and .07 compared to drivers with .00 BACs. Summary There is strong evidence in the literature that lowering the BAC limit from .10 to .08 is effective, that lowering the BAC limit from .08 to .05 is effective, and that lowering the BAC limit for youth to .02 or lower is effective. These law changes serve as a general deterrent to drinking and driving and ultimately save lives. Impact on Industry This critical review supports the adoption of lower illegal BAC limits for driving.

The US National Highway Traffic Safety Administration (NHTSA) has just announced that in 2010, 552 lives were saved by the minimum legal drinking age (MLDA) laws in force in all 50 states. The total savings reported by NHTSA dating back to 1975 is 28 315 lives [1]. Despite this major benefit, the MLDA has been under attack based principally on policy considerations [2]. Responding to this attack has been difficult because the strongest evidence for their effectiveness dates back to the 1980s, when states were enacting MLDA laws. During that time panel studies employing time–series analysis could pair states with and without MLDA laws. The results of those studies was overwhelmingly positive [3], perhaps the strongest evidence for any traffic safety policy. However, similar research has not been possible, as all 50 states enacted MLDA laws in 1988. Recently, a new methodology, regression discontinuity analysis for testing the effectiveness of the MLDA, has been applied both in the United States [4] and in Canada [5] that has shown new and important evidence for the effectiveness of the MLDA laws based on the increase in problem behavior which occurs when youths reach the minimum legal drinking age limit and are no longer subject to its restrictions. Of particular interest is the Callaghan, Sanches & Gatley [5] study of the effect of Canada's MLDA law. It is significant because of its focus on health benefits beyond traffic safety and because the Canadian provinces’ MLDAs are set at either age 18 or 19 years, the probable level in the United States should the current federal law supporting the age 21 limit be repealed. The authors have taken advantage of the broad coverage of Canada's national health system that provides access to impaired inpatient hospital care independent of income and varying insurance policies, which the authors note ‘provides near census estimates’ of all the problems they targeted. Besides a significant increase in traffic injuries, they found significant increases in suicides, alcohol poisonings and alcohol use disorders and, for men, injuries from varying sources such as falls, as young adults in Canada moved out from under the limitations of the MLDA law at age 18 or 19 years. This suggests that if the US MLDA laws were lowered to the 18–19-year age range, it would lose its protective value for 19- and 20-year-olds, but it would still provide significant protection to those who are younger. However, a critical factor not tested in the Callahan et al. study is the trickle-down effect of empowering 18-year-olds to purchase alcohol on the availability of alcohol to the 15–17-year-old high school age group. Currently in the United States, no high school student can purchase alcohol, but if the MLDA is lowered to age 18 high school seniors will have access to alcohol. The study in New Zealand by Kypri et al. [6] found that the effect of reducing the MLDA from 19 to 17 was principally evident in the increase in hospitalizations of 14- and 15-year-olds. Research on the potential trickle-down impact of a reduction of the MLDA to age 18 is particularly needed in view of the extensive evidence of the significance of early onset of drinking to adult impaired driving [7,8] and alcohol abuse problems [7–9]. The effectiveness of the MLDA, given the relatively low level of enforcement [10], has been impressive, and although enforcement of underage sales laws can be effective, it is expensive, as repeated enforcement crack-downs are required [11]. Thus, it is unlikely that further benefits will be achieved through police action. The greatest opportunity for strengthening MLDA laws and particularly early onset of drinking appears to lie in motivating parents to increase their engagement with their teenagers drinking. Currently, 99% of American drivers aged 16–20 and 97% of all adults view impaired driving as a significant threat to their safety [12]; consequently, additional education on that point might have little power to produce further progress. Less well understood are the risks of alcohol poisoning and alcohol use disorders related to early use of alcohol [7–9]. The Callaghan study (and the similar regression discontinuity study by Carpenter & Dobkin [4]) might be helpful in programs designed to encourage parents to be involved in the underage drinking problem, as they call attention to the impact of MLDA laws on non-highway issues. An interesting challenge for MLDA laws in the United States is the growing concern over drugged driving [13]. Those states that are enacting per se illegal laws for drugs generally specify that, as with alcohol, the legal level for drugged driving should be zero for those aged younger than 21 [14]. Policymakers need to consider the potential impact of reducing the minimum drinking age from 21 to 18 on the viability of the zero-tolerance law for alcohol and the implications for drugged-driving laws for drivers younger than age 21. Findings such as those of Callaghan et al. suggest that not maintaining zero limits for drug involvement will have serious effects on injury outside the driving area.

The growing recognition of the problem presented by illicit vehicle operation by those whose license has been suspended for driving while intoxicated (DWI) has led to the increasing use of vehicle sanctions. These sanctions include vehicle impoundment and forfeiture, vehicle registration cancellation, and vehicle interlocks as penalties for DWI and driving while suspended (DWS). This article reviews the current information available on the use and effectiveness of vehicle sanctions for reducing offender recidivism. In the United States, 14 states have impoundment laws that are widely used as sanctions for both DWI and DWS, with the length of the impoundment increasing with the number of previous offenses. These laws have been shown to reduce recidivism while the vehicle is in custody and, to a lesser extent, even after the vehicle has been released. Vehicle impoundment is also widely used in Canada and New Zealand. Although a larger number of U.S. states have laws providing for vehicle forfeiture for DWI or DWS, this sanction tends to be limited to multiple offenders and therefore impacts fewer drivers. Cancellation of the vehicle registration and the confiscation of the vehicle plates are increasing in popularity because the vehicle tags are the property of the state, rather than the vehicle owner. Vehicle alcohol interlocks have proven to be an effective method for reducing DWI offender recidivism while they are on the car, but appear to produce only limited post-treatment behavior change. Interlocks are widely used in the United States and Canada and are beginning to be implemented in Europe and Australia. The issues that arise in implementing vehicle sanction programs are discussed and the actions taken by states to deal with them are described.

Several thousand young Americans visit the bars in Tijuana, Mexico, each weekend night, raising concerns on both sides of the border. Measures implemented in San Diego, California, and Tijuana have successfully reduced the number of American visitors to Mexican bars. Although San Diego policies have been well-documented, this is the first article on investigation of measures enacted south of the border. Information on Tijuana alcohol policies was obtained from a survey of 29–36 bars from 1997 to 1999. The Tijuana police provided data on Americans arrested in Tijuana from 1998 to 1999. Our study found alcohol regulations are poorly enforced in Tijuana, suggesting that regulatory agencies are captured by bar owners. However, such a capture may be weakening. The importance of identifying and supporting Mexican interest groups, as opposed to the bar owners, as a mechanism to impede the capture of Tijuana's regulatory agencies is discussed. The number of Americans involved in alcohol-related crimes in Tijuana sharply decreased over time. However, such a success is largely related to the success of the San Diego efforts in reducing the number of American visitors to Tijuana. Also, by demonstrating the racial/ethnic heterogeneity of American visitors to Tijuana bars, our study points out the need for prevention policies designed north of the border to take such heterogeneity into account.

This report reviews breath test data captured by the alcohol ignition interlock, a device that prevents a car from starting when BAC (breath alcohol concentration) is elevated.The predictors were elevated BAC test rates from ignition interlock equipped cars of traffic offenders convicted of DUI (driving under the influence of alcohol) and who used interlocks for 6-18 months. Outcome data were future DUI convictions.Québec and Alberta, Canada.Approximately 10000 interlock users from these two culturally distinctive English- and French-speaking Provinces.Predictor patterns were analyzed from among 23 million breath tests. Repeat DUI convictions accumulated up to several years after interlock removal were studied as an outcome to be predicted by the rate of BAC testsor = 20 mg/dl (0.02%) while the interlock was installed. Data were analyzed with sensitivity and survival methods.A median of eight interlock breath tests per day per driver were logged (a rate of 3000 tests/year). Less than 1% of all tests were over 0.02%, but the rate of elevated BAC tests, particularly those taken at 7-9 a.m., strongly predicts repeat DUI offenses 2 years hence. The interlock record is an unobtrusive measure of drinking behavior and can be used to profile driver risk.With new legal mandates, North American use of these DUI control devices is increasing rapidly from the current 5% penetration rate. Interlock data may eventually come to serve as a useful adjunct for patient monitoring by alcohol counselors as well as by courts and motor vehicle authorities.

The objective of this paper is to discuss the benefits and risks of providing drinkers with tools that allow them to estimate their blood alcohol concentration (BAC), and to examine the field usability of one commercially available tool. Drinking and driving laws are specified in terms of the driver's BAC, and there is concern that the absence of a method for drivers to accurately estimate their BAC level limits their ability to determine whether they can drive legally. A number of devices that provide a method for the individual to estimate or measure their BAC have been developed. Although some of these devices--such as the "know your limit" (KYL) cards--have been widely distributed, their effectiveness in encouraging good driving decisions have rarely been tested. This article describes a pilot study on the field usability of the Guardian Angel (GA) personal alcohol test in a field setting. The GA test analyzes saliva samples from drinking and indicates under which BAC category they fall (.00 -.04;.04 -.08;.08+). The research examined whether drinkers could, in natural drinking environments, correctly administer and interpret the test results. The methodology involves sampling drinkers on a weekend night on and around the grounds of a large West Coast university as they traveled between off-campus parties, bars, and their dorms. They were asked to assess their own intoxication and impairment, then self-administer and interpret the Guardian Angel test. After interpreting the test, participants were asked to reassess their intoxication and impairment levels, and were given a breath BAC test using a calibrated unit. The results revealed that although the majority of drinkers' were able to administer the GA test, their interpretations did not correspond with actual BACs. The interpretations of the GA test produced false-negatives, underestimating actual BACs. Drinkers perceived themselves to be less intoxicated, on average, after interpreting the GA test results. In conclusion, this research addresses potential pros and cons of providing BAC information to drinkers. It underscores the importance of testing BAC estimation tools under field conditions and the potential risks associated with tests that do not produce accurate results.

Recent research indicates that cell phone use can distract drivers from safe vehicle operation. However, estimates of the prevalence of cell phone use while driving have been limited to daytime hours and low-speed roadways. This paper describes the results of a study to estimate rates of cell phone use and other distractions by examining approximately 40,000 high-quality digital photographs of vehicles and drivers on the New Jersey Turnpike. The photographs, which originally were collected as part of a separate study, were taken both during the day and during the night and at different locations across the span of the Turnpike. A radar gun linked to the camera recorded the speeds of vehicles as they passed. This provided us with the speeds of every vehicle photographed, and allowed us to determine population counts of vehicles. A panel of three trained coders examined each photograph and recorded the presence of cell phone use by the drivers or any other distracting behavior. Demographic information on the driver was obtained during previous examinations of the photographs for an unrelated study. A rating was considered reliable when two out of the three coders agreed. Population estimates (and confidence intervals) of cell phone use and other distractions were estimated by weighting the cases by the inverse probability of vehicle selection. Logistic regression was used to predict cell phone use from demographic and situational factors. The results indicated that the most frequent distraction was cell phone use: 1.5% of the drivers on the Turnpike were using cell phones compared to the 3 to 4% use rates reported in the National Occupant Protection Use Survey (NOPUS) surveys conducted during the daytime on lower speed roadways. The Turnpike survey indicated that cell phones were used less on weekends and at night, and when the driver was exceeding the speed limit or had a passenger in the car.

Problem: By 2030, there will be approximately 70 million older people (65+) in the United States, more than twice their number in 2000. This increase also represents an increased percentage of older licensed drivers. Thus, it is important to understand the special circumstances of how they may be involved in traffic crashes. Method: This study used the Fatality Analysis Reporting System (FARS), which is a census of all fatal crashes occurring in the United States over the last two decades maintained by the National Highway Traffic Safety Administration (NHTSA), to study the special characteristics of fatal crashes involving females older than 70 years. Results: The results indicate that senior women are overrepresented in crashes that occur under the “safest” conditions, on roads with low speed limits, in daylight, when traffic is low (not at rush hour), when the weather is good, and when the roads are dry.

Objective: In this article we test the efficacy of an intensive norms social marketing campaign to reduce heavy drinking among college students living in a residence hall. Method: We employed a pretest-posttest nonequivalent comparison group design. The study was conducted in two (experimental and comparison) comparable residence halls located in a large urban public university. We attempted a census at each hall, and pre- and postintervention data were collected in public areas of each residence hall. Relative sample sizes were approximately 60% in the experimental hall (both waves) and 38% in the comparison hall. Results: The campaign successfully corrected students' misperceptions of drinking norms but had no effects, or counterintuitive effects, on drinking behaviors. Conclusions: Despite the popularity of this approach, universities would be prudent to proceed with care before adopting this approach wholesale.

At a Marine Corps base near the Mexican border, off-base alcohol- related incidents increased when serving alcohol to personnel under age 21 on the base was no longer permitted. The bars across the Mexican border, where the legal drinking age is 18, are an important source of alcohol for the Marine enlisted men. To reduce cross-border drinking, the base command instituted a "chit" system requiring enlisted men to receive written permission to cross the border. This study evaluates the effectiveness of that policy.Breath test surveys of American youths returning from Tijuana to San Diego County provided counts and blood alcohol concentration (BAC) of marines returning from a night of drinking in Mexico before and after the "chit" policy. Comparison counts and breath tests for Navy personnel from a San Diego base not affected by the "chit" policy were available for the same time periods.The number of underage marines returning from Mexican bars was reduced by 78%, and of those the number with illegal (or = .08%) BACs was reduced by 84%. There was no significant change for the comparison group of sailors.It appears that the "chit" policy was highly effective at least for the 6-month post-period covered by this study. This apparent success influenced the implementation of the "chit" policy on all naval facilities in the San Diego area.

This study examines whether differences in two risk factors for crash-related injury for children-riding with a drinking driver and failure to use restraints-are related to various driver characteristics such as age, gender, ethnicity and drinking.Data on driver blood alcohol concentration (BAC), use of restraints and certain demographics were drawn from the Fatality Analysis Reporting System. Ethnicity data came from the Multiple Cause of Death File and socioeconomic information from the US Census. The use of restraints by child passengers and the drinking of alcohol by adult drivers are examined as a function of age, gender and membership of five racial/ethnic groups: White American, Black American, Native American, Asian/Pacific Islander American and Hispanic American. This study covers 160,770 drivers and 12,266 children younger than 16 years killed in motor vehicle crashes from January 1,1990 to December 31,1996.As might be expected, analyses of fatally injured drivers showed that, compared with men, women were more likely to be accompanied by children at the time of their crash, but those children were more likely to be restrained than if travelling with men. Drivers who had been drinking at the time of their crash were less likely to be transporting children and those children were less likely to be restrained. Analyses of killed children indicated that some ethnic groups, compared with White drivers, were more likely to be BAC-positive and children were less likely to be restrained.These findings underscore the continuing need to understand cultural factors in traffic safety and develop and disseminate culturally appropriate education programs.

The research describes the characteristics and motivations of youthful San Diego County residents who patronize the bars and nightclubs in Tijuana, Mexico.Two random-digit-dial surveys of San Diego County residents-one group aged 18-20 years and one aged 21-30 years-was conducted during a 2-year period. Those who reported having visited the bars in Tijuana in the last year were compared with those who had not.All respondents were residents of San Diego County, California, USA.The study comprised 2200 youths between 18 and 30 years of age.The interview protocol included questions covering demographic characteristics, drinking and drug-use history, experience with Tijuana bars, and ratings of bar features in San Diego and Tijuana.About half of the 18-20-year-olds and a third of the 21-30-year-olds reported visiting bars in Tijuana at least once in the past 12 months. Race, age, gender, heavy drinking and drug-use history were significantly associated with visits to Tijuana bars. The price of alcohol and the perceived freedom to get drunk in Tijuana bars were considered attractive features leading to cross-border drinking.The features of the alcohol service in Mexican bars that attract youthful drinkers (low cost and liberal availability of alcohol, lack of formal controls, and presence of heavy drinkers) are similar to those present in other drinking locales that lead to drunkenness. Thus, a better understanding of the characteristics and motivations of the US youths patronizing bars in Tijuana can lead to improved interventions to reduce heavy, risky drinking.

To evaluate a large drunk-driving enforcement program at the US/Mexican border to reduce the number of youths crossing the border to drink in Tijuana. This paper also describes the research data used to develop and manage the program. Data from a border breath-test survey were used to dramatize the problem and gain public support for action. The data were also used to help design the enforcement effort and measure progress in reducing the cross-border drinking problem.The number of news events generated around the occurrence of special enforcement efforts were used to measure project activity and to predict changes in the numbers of youths crossing into Mexico, their returning BACs and reductions in alcohol-related crashes during a 3-year period.An urban county on the Mexican border.Underage youths aged 18-20 years and young adults aged 21-30 years residing in San Diego County.Immigration and Naturalization Services provided population counts of the number of individuals crossing each weekend night from Tijuana into the United States through the San Ysidro border facility. Breath-test surveys of a random sample of these returning crossers provided data on the number of US residents visiting bars and nightclubs in Tijuana and on alcohol consumption at Tijuana bars and nightclubs. Night-time had-been-drinking crash data involving young drivers in several California counties served as an outcome measure of public health and safety.Analysis of data involving more than 2 million pedestrians returning from Tijuana indicated that the Operation Safe Crossing program reduced the number of late-night crossers by 31.6%.Effective use of data through media advocacy programs to support an enforcement effort can reduce alcohol-related crashes.

Determine the effect of a partial sales ban on cross border drinking in Mexico.On weekend evenings, thousands of youths (younger than 21 years) and young adults (21 to 25 years) residing in communities along the U.S. border cross over into Mexico to patronize all-night bars where the drinking age is 18 rather than 21 years and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, across the border from El Paso, Texas, implemented a 2 AM bar closing policy replacing the previous 5 AM closing time. Breath alcohol tests of pedestrians at the Juárez/El Paso border before and after the policy change were compared with a similar sample of pedestrians at the Tijuana, Mexico/San Diego, California border.At the Juárez/El Paso border, the total number of youths with positive BACs returning from Juárez after 3 AM when the bars were closed was reduced 89%, whereas the number returning between midnight and 3 AM remained unchanged. There was no change in either period at the Tijuana/San Diego comparison site.Early closing of the bars in Juárez reduced the number of youths returning after 3 AM to the United States with positive BACs.

Approximately 30,000 alcohol ignition interlocks, which are designed to prevent the operation of a vehicle if the driver has been drinking, are in use in the US and Canada. Ignition interlock programs are also being initiated in Sweden and Australia. The best-controlled studies that are currently available suggest that ignition interlocks are effective in reducing impaired driving recidivism while on the vehicle. However, in the US, the practical effectiveness of these devices is limited because only a small number of offenders are willing to install them in order to drive legally. This paper reports on a study of a court policy that created a strong incentive for impaired driving offenders to install interlocks by making traditional penalties, such as jail or electronically monitored house arrest, the alternative to participation in an interlock program. Comparison of the recidivism rates of offenders subject to this policy with offenders in similar, nearby courts, not using interlocks, indicated that the policy was producing substantial reductions in DUI recidivism.

This study assessed whether persons who begin drinking at younger ages are more likely to report drunk driving and alcohol-related crash involvement over the life course, even after controlling analytically for diagnosis of alcohol dependence, years of drinking alcohol, and other personal characteristics associated with the age respondents started drinking. A national survey asked 42,862 respondents the age that they started drinking, whether they drove after drinking too much, and whether they were in motor-vehicle crashes because of their drinking. This analysis focused on 27,081 (65%), who reported ever drinking in their lifetime. The earlier the age respondents started drinking, the more likely they were to report driving after drinking too much and being in a motor-vehicle crash because of their drinking even after adjusting for current/ever diagnosis of alcohol dependence, number of years respondents had been drinking, and other characteristics and behaviors associated with the age respondents started drinking. Particularly, among persons who were never alcohol-dependent, those who began drinking in each age group under 21, relative to those starting at age 21 or older, were more likely to report "ever" and "in the past year" being in a crash after drinking too much. The traffic safety benefits of delaying drinking may extend well beyond the legal drinking age of 21.

The aim of this report has been to use information contained in the alcohol ignition interlock recorder to determine whether systematic analysis of it can be used to predict which DUI offenders will recidivate during the first 2 years after the interlock is removed. The interlock record was accumulated during a 4-year intervention study in Alberta, Canada. Data from more than 5.5 million breath tests collected during interlock use were analyzed retrospectively after allowing repeat DUI offenses to accumulate for up to 2 years post-interlock. The rate of interlock warns at low BAC (0.02-0.04%) and fails at higher BAC ( > 0.04%) were found to be predictive of later repeat DUI. The interlock record was used along with selected driver record variables and questionnaire data to identify predictor sets. CHAID segmentation analysis was used to identify combinations of predictor variables; these were joined with sensitivity analysis to compare different predictor combinations. Several variables, but primarily more prior DUIs and more interlock warns and fails logged during the first 5 months of interlock usage predict greater than 60% of repeat DUI with a false positive rate of less than 10%.

ContextHigh-risk alcohol consumption patterns, such as binge drinking and drinking before driving, and underage drinking may be linked to traffic crashes and violent assaults in community settings.ObjectivesTo determine the effect of community-based environmental interventions in reducing the rate of high-risk drinking and alcohol-related motor vehicle injuries and assaults.Design and SettingA longitudinal multiple time series of 3 matched intervention communities (northern California, southern California, and South Carolina) conducted from April 1992 to December 1996. Outcomes were assessed by 120 general population telephone surveys per month of randomly selected individuals in the intervention and comparison sites, traffic data on motor vehicle crashes, and emergency department surveys in 1 intervention-comparison pair and 1 additional intervention site.InterventionsMobilize the community; encourage responsible beverage service; reduce underage drinking by limiting access to alcohol; increase local enforcement of drinking and driving laws; and limit access to alcohol by using zoning.Main Outcome MeasuresSelf-reported alcohol consumption and driving after drinking; rates of alcohol-related crashes and assault injuries observed in emergency departments and admitted to hospitals.ResultsPopulation surveys revealed that the self-reported amount of alcohol consumed per drinking occasion declined 6% from 1.37 to 1.29 drinks. Self-reported rate of "having had too much to drink" declined 49% from 0.43 to 0.22 times per 6-month period. Self-reported driving when "over the legal limit" was 51% lower (0.77 vs 0.38 times) per 6-month period in the intervention communities relative to the comparison communities. Traffic data revealed that, in the intervention vs comparison communities, nighttime injury crashes declined by 10% and crashes in which the driver had been drinking declined by 6%. Assault injuries observed in emergency departments declined by 43% in the intervention communities vs the comparison communities, and all hospitalized assault injuries declined by 2%.ConclusionA coordinated, comprehensive, community-based intervention can reduce high-risk alcohol consumption and alcohol-related injuries resulting from motor vehicle crashes and assaults.

To re-examine and refine estimates for alcohol-related relative risk of driver involvement in fatal crashes by age and gender as a function of blood alcohol concentration (BAC) using recent data.Logistic regression was used to estimate age/gender specific relative risk of fatal crash involvement as a function of the BAC for drivers involved in a fatal crash and for drivers fatally injured in a crash, by combining crash data from the Fatality Analysis Reporting System with exposure data from the 1996 National Roadside Survey of Drivers.In general, the relative risk of involvement in a fatal vehicle crash increased steadily with increasing driver BAC in every age/gender group among both fatally injured and surviving drivers. Among 16-20 year old male drivers, a BAC increase of 0.02% was estimated to more than double the relative risk of fatal single-vehicle crash injury. At the midpoint of the 0.08% - 0.10% BAC range, the relative risk of a fatal single-vehicle crash injury varied between 11.4 (drivers 35 and older) and 51.9 (male drivers, 16-20). With only very few exceptions, older drivers had lower risk of being fatally injured in a single-vehicle crash than younger drivers, as did women compared with men in the same age range. When comparable, results largely confirmed existing prior estimates.This is the first study that systematically estimated relative risk for drink-drivers with BACs between 0.08% and 0.10% (these relative risk estimates apply to BAC range midpoints at 0.09%.) The results clearly show that drivers with a BAC under 0.10% pose highly elevated risk both to themselves and to other road users. 2000)

AIMS: To evaluate patterns of blood alcohol concentration (BAC) and driving logged on the ignition interlock recorder and to assess whether this event record is a useful outcome measure for a behavioral intervention. DESIGN: Descriptive analyses of recorder data and multivariate analysis of the predictors of high BACs associated with a motivational intervention for driving-under-the-influence (DUI) offenders using an interlock. SETTING: Two interlock service centers in Alberta, Canada. PARTICIPANTS: 1309 first-time and multiple DUI offenders who agreed to participate during interlock installation. INTERVENTION: A human-services (supportive guidance) intervention based on motivational interviewing and pragmatic counseling was delivered to interlock users in Calgary, but not to interlock users in Edmonton, Canada. MEASUREMENTS: This report summarizes the patterns and predictors of BAC warnings (0.02-0.039%) (20-39 mg/dl) and failures (> or = 0.04) (> or = 40 mg/dl) from more than 3 million in-vehicle breath tests. Data come from three sources: driver records, questionnaires and the interlock. FINDINGS: From the beginning to the end of the interlock use period, there was a significant linear decline in the proportion of positive BAC driving to total driving. After controlling for prior offenses, demographics and reported drinking levels, offenders in the intervention site (Calgary) were less likely to have recorded fail BACs than were offenders in the control site (Edmonton). The temporal patterns of BAC fails with the interlock mimic the high-risk periods for DUI arrests and alcohol-involved fatal crashes. CONCLUSIONS: The interlock successfully blocks drinking and driving during high-risk periods. Preliminary recorder data suggest the services intervention may be affecting DUI behavior.

OBJECTIVES: From 1985 to 1995, drivers younger than 21 years experienced a 50% drop in fatal crashes involving alcohol. This study addresses whether the decrease is explained by young drivers' drinking less or by their separating drinking from driving. METHODS: Nighttime roadside surveys were conducted in 3 communities to test drivers' breath and administer questionnaires on drinking practices. From 1992 to 1996, 34,898 drivers (21% of whom were younger than 21 years) were interviewed. RESULTS: Although drivers younger than 21 years were more likely to have consumed 6 or more drinks on at least 1 occasion during the previous month, a smaller percentage of younger drivers than of older drivers had blood alcohol concentrations of 0.01 or higher. CONCLUSIONS: Younger drivers are more likely than drivers older than 21 years to separate drinking from driving.

Driving while suspended by individuals who have been convicted of an impaired driving offense is a significant highway safety problem. Such offenders present four times the risk of involvement in a fatal crash at a blood alcohol concentration (BAC) over 0.10. A previous report by the authors demonstrated that a vehicle immobilization program in Franklin County (Columbus), Ohio, significantly reduced driving-under-the-influence (DUI) recidivism rates for multiple DUI offenders. This study evaluated a somewhat different application of the same law in Hamilton County (Cincinnati), Ohio, where vehicles were impounded rather than immobilized, and obtained similar results--a reduction in repeat DUI offenses by multiple offenders both while their vehicles were being held by the police and after they were returned to the offenders.

Following the same general principles of its two predecessors in 1973 and 1986, the 1996 National Roadside Survey of weekend, nighttime drivers in the 48 contiguous states interviewed and breath tested over 6000 noncommercial four-wheel vehicle operators between September 6 and November 9, 1996. Results indicated that the total number of drinking drivers fell by about one-third between 1986 and 1996; however, there was no significant change in the number of drivers at blood alcohol concentrations (BACs) at or above 0.05. Compared to 1973, the proportion of women drivers on the roads during weekend nights has increased significantly. Moreover, relative to males, the proportion of female drivers who have been drinking has increased over the last decade. The number of drivers under the age of 21 with a BAC at or above 0.10 decreased significantly from 1986 to 1996.

A social-psychological model of underage drinking and driving (DUI) and riding with drinking drivers (RWDD) was tested with data from a random digit dial telephone survey of 706 16-20-year-old drivers from seven western states in the United States. Consistent with the model, a structural equations analysis indicated that DUI and RWDD were primarily predicted by (a) expectancies regarding the physical risks of DUI, (b) normative beliefs about the extent to which friends would disapprove of DUI, (c) control beliefs about the ease or difficulty of avoiding DUI and RWDD and (d) drinking. Expectancies concerning enforcement had a significant effect on RWDD, but not on DUI. Among the background and environmental variables included in the analysis, only night-time driving and age had significant direct effects on DUI and RWDD. Drinking and involvement in risky driving had indirect effects on DUI and RWDD that were mediated through expectancies and normative beliefs. Males, European Americans, Latinos, respondents who drove more frequently and respondents who were less educated held beliefs that were more favorable toward DUI and RWDD, drank more and engaged more frequently in risky driving. As a result, such individuals may be at greater risk for DUI and RWDD.

Drinking can increase the risk of injury and death depending on the activity or situation in which the drinkers find themselves. As a result, strategies to prevent or reduce the risk of alcohol-related trauma are best directed at drinking patterns or at drinking settings that involve risk or harm. The review of potential prevention strategies in this chapter identifies alternatives that have actually been implemented to reduce alcohol problems, whether they have been evaluated or not, and the available research evidence concerning the potential effectiveness of each strategy.

Health professionals concerned with the prevention of chronic diseases have accumulated over 20 yr of experience in programs designed to reduce cardiovascular disease (CVD). Some of these studies were carried out in clinical settings or in worksites.1,2 Other studies in CVD prevention were directed at the entire populations in communities and involved comprehensive approaches combining community organization and multichannel health education.3–7These earlier studies represent a rich source of both technical expertise and practical experience that alcohol problem prevention professionals should consider before they design similar projects. However, because most knowledge of community-based public health interventions derives from programs to reduce high-risk medical conditions, the relevance of the medical trials for the management, design, and implementation of alcohol problem prevention should not be automatically assumed.8,9 For these reasons, the development of a comprehensive community-based program for prevention of alcohol-related injuries and deaths requires attention to linkage of public education and community organizers with agencies involved in regulatory and environmental policies. Strategies used in such interventions will require many innovations beyond those used for other health domains to insure their relevance to alcohol-related trauma.

While national accident record systems appear to provide an attractive method of comparing the effectiveness of traffic safety programs, differences in definitions, data collection methods and file structure may lead to misleading conclusions. Variations in crash definitions and methods for measuring alcohol involvement are described and illustrated with data from US crash files. Examples of international comparisons are provided.

This paper describes the need and rationale for developing a phases model for guiding alcohol-problem prevention research. A phased approach to prevention research is consistent with such models developed for other health areas including heart disease, cancer, and drug testing. Such a model in alcohol prevention research can provide a means for (1) locating how far research has progressed along a continuum from basic or pre-intervention research to full implementation of preventive action, (2) identifying gaps in research, and (3) determining the level of empirical proof which exists for one or more prevention strategies prior to widespread dissemination.

This critique refutes Zador's claim [1976] that Alcohol Safety Action Projects, as large scale social programs have been ineffective. The discussion takes issue with Zador's comparison groups, statistical design, statistical methods, and use of 12-month fatality totals for data analysis. In addition to weaknesses and deficiencies in these areas, the authors find Zador's conclusion unfounded based on the analysis presented.

The effectiveness of drunk driving enforcement patrols is generally assumed. However, few adequate evaluations are available in the traffic safety literature. The U.S. Department of Transportation funded a special program in Stockton, a city with a population of 120,000 in the central valley of California, to test the effectiveness of special drunk driving patrols on weekend evenings, applied within a setting in which no other major alcohol safety programs were present. The objective of this effort was to determine the effectiveness of a "traditional" approach to enforcing driving while impaired (DWI) laws; one in which innovative procedures such as sobriety checkpoints were not used. The results indicated that nighttime collisions in Stockton were reduced during the three and a half year period of the special enforcement program.

Studies were reviewed to determine the extent to which drivers arrested for driving while intoxicated (DWI) and crash-involved drivers impaired by alcohol are similar in age. Data indicate that younger drivers are substantially underrepresented in the DWI arrest population relative to their presence in the alcohol-related crash population. Overall, the proportion of arrested drivers less than age 20 was only one-fourth to one-third the proportion of these drivers involved in fatal crashes, and for those aged 20-29 it was two-thirds to three-fourths. The reasons for the underrepresentation of young drivers in the arrested population are not fully known and require further study. Youthful drivers constitute the major part of the alcohol-related crash problem, and effective ways to address this population most at risk should be sought.

The integration of the man in the Mercury system is discussed in terms of his contribution to system reliability and flexibility. Eight basic flight tasks are described. In addition, the contributions of the astronauts to the development of the Mercury vehicle are outlined. Also considered are the possible applications of Mercury human factors experience to future space flight programs.

Success in-flight training is a result of the interaction of a number of factors. To evaluate stress test, this criterion must be modified to reflect only the actions of those factors which could logically be expected to be predicted by behavior in an experimental stress situation. By the same token, if the stress situation is to be predictive of success in the performance of hazardous duty, then it must involve factors, and to such an assignment. And the present study one factor of success In flight training, the reaction to the threat of flying hazards, is considered. Over indications of anxiety, in a portion of Naval preflight training which involves realistic threat to the students' safety, are used as a measure of stress tolerance. Preliminary study of the relationship of this measure to the tendency to develop anxiety in the later flight training is reported. This study represents in advance over the previous flight selection studies in that the stressors are quite realistic and the criterion shows some refinement. Language: en

Taylor has suggested that where a negative relationship exists between intelligence and scores on her anxiety questionnaire, it is due to the ability of the more intelligent Ss to “outguess” the anxiety scale and present themselves in a favorable light. 84 naval cadets took the Taylor scale under instructions to give the “best” answer. Under these conditions a statistically significant correlation of —.29 between the Taylor scores and ACE scores was obtained. Where 319 Ss were given the scale under “normal” circumstances, the correlation was only .06. These results are interpreted as supporting Taylor's position.