Drunk driving policies and breath test refusal in Taiwan.

Driving under the influence (DUI) is one of the major causes of traffic crashes in Taiwan, leading to huge medical expenditures and human capital loss. Although the authorities have enacted several policies to reduce drunk driving, most penalties are based on drunk drivers' alcohol levels. According to Taiwan regulations, drivers could pay a fine to refuse the breath test if they are not involved in a traffic collision, and there is no clear evidence showing that they are DUI. Therefore, increased sanctions for DUI may lead to increased breath test refusals. If breath tests for drunk driving could be refused with little or no punishments for drivers, then the detection of behavioral impairment would weaken, and the deterrent effect of DUI punishment would be limited. This research uses interrupted time-series analysis (ITSA) to examine how policy reforms from 2007 to 2020 affected driver's breath refusal rate in Taiwan. We find that said reforms that exclusively increase the punishment of DUI offenders did raise the refusal rate immediately and persistently, suggesting that more drunk drivers would refuse a breath test to avoid more severe DUI punishment. Policy reforms that increase penalties for drivers refusing to take breath tests may instantly lower the refusal rate, but the long-term effects are contingent upon the DUI punishment. It appears that drunk drivers could still decide on breath test refusal to avoid a DUI conviction if the punishment for refusing the test is less severe than that for DUI. Aggravating penalties for refusing breath tests would decrease the refusal rate and help reinforce DUI's deterrent effect. [ABSTRACT FROM AUTHOR]