WHAT WORKS IN REDUCING IMPAIRED DRIVING
By Toni Gantz
This is a version of an article prepared for the University of California Berkeley Traffic Safety Center Newsletter. The article discusses current trends and issues related to impaired driving prevention.
Despite progress during the past two decades in reducing alcohol-related crashes and fatalities, impaired driving remains a traffic safety priority in California and nationally. In 2000, alcohol-related traffic fatalities rose for the first time since 1995, according to the AAA Foundation for Traffic Safety. The National Highway Traffic Safety Administration (NHTSA) reports that in 2001, 41% of all highway deaths-a total of 17,448 deaths-involved alcohol; this was a slight increase from 2000.
"Largely the perception has been that this is a problem that's been solved, but it's still a problem. It's no different than any other issue - you have to still keep at it," said Pam Beer, a consultant to the Governors Highway Safety Association, which received a grant from NHTSA to conduct a nationwide review of comprehensive, community-based programs to reduce impaired driving.
"Public attention on drunk driving is not what it was -- we're competing with AIDS, national security, anthrax -- and that's competing for police and media and public attention," noted NHTSA Regional Program Manager Paul Snodgrass. Along with public attention, driving under the influence (DUI) arrests have also decreased over the past two decades, which many suggest may be linked in part to the increase in deaths. Approximately 1.5 million American drivers per year are now arrested for DUIs, compared to nearly 1.8 million arrests in the 1980s, according to the Bureau of Justice Statistics.
"In the 80s, there was a war on drunk driving and DUI arrests went up, and alcohol-related fatal crashes went down. In the 90s, the crashes were still down, and DUI arrests also were down. Now the crashes have gone up, but the DUI arrests are still going down - that's a problem, and that's been the situation for the last 2-3 years," stated Snodgrass. "More crackdown may be needed now."
A broad approach
During the 1980s and 1990s, legislative changes, increased law enforcement, highly visible advocacy, public education, and tougher prosecution and punishment were all components of the "war on drunk driving." Many credit this combination of interventions with the reductions in drunk driving witnessed during those decades. According to Beer, "We have made tremendous gains in this country because we attacked it from all different perspectives - public education, law enforcement, having tougher laws, and more prosecution. If you want to make long-term change in reducing impaired driving, you need to raise awareness, enforce the laws, and have penalties."
About two-thirds of drivers arrested or convicted of DUI are first-time offenders, according to the AAA Traffic Safety Foundation. Because a significant portion of alcohol-related fatalities involve people who are not habitual or "hard-core" DUI offenders, efforts to reduce drunk driving need to reach beyond problem drinkers.
"What we see is that impaired driving is an issue that affects everyone," stated Ron Miller, Grant Coordinator for Mothers Against Drunk Driving (MADD) California. "In terms of what can be done about it, we have to look at a broad approach."
Connection between alcohol consumption and drinking and driving
Efforts seeking to reduce impaired driving have ranged from environmental approaches targeting alcohol availability, sales, and service within a community, such as ordinances that limit the number of alcohol outlets in an area, to approaches targeting individual driving behavior, such as the designated driver public awareness campaign.
Studies have indicated that drinking and driving can be reduced even if alcohol consumption remains constant. Snodgrass cited research in Australia and Britain showing reductions in drunk driving despite very high per capita alcohol consumption, and stated that alcohol consumption in the United States has been pretty steady in the past 20 years, while drinking and driving has decreased. "Efforts to get people to not drive after drinking have reduced crashes better than getting people not to drink," he stated.
Peter Roeper, an Associate Research Scientist at the Pacific Institute for Research and Evaluation's Prevention Research Center in Berkeley, Calif., noted that programs focusing specifically on drunk driving have been shown to be effective, but the effectiveness of programs focusing on reducing alcohol consumption and impairment more broadly is uncertain. "To the extent that the proportion of people who drink and drive has decreased, drinking has decreased, and this has been the effect of programs specifically focusing on drunk driving," stated Roeper.
Current studies and Beer's recent findings suggest that long-term reductions in impaired driving crashes and fatalities occur when communities combine efforts that target drinking and driving behaviors with efforts that result in broader environmental changes. For example, in Salinas, California, a program combining highly publicized sobriety checkpoints, responsible beverage service training, and limits on alcohol availability at public events and retail outlets was implemented between 1993 and 1996. An evaluation of the program showed it to be effective in reducing traffic injuries and impaired driving over a sustained period of time.
Interventions over the past twenty years have succeeded not only in reducing the incidence of impaired driving and the crashes and fatalities that can result from it, but also in changing the norms related to driving after drinking. According to Roeper, "It is clear that drinking and driving is less accepted, and that heavy drinking is less accepted," but exactly how this was achieved is less clear. However, several factors have been acknowledged, including changes in beverage service practices, law enforcement efforts, and public awareness of the issue.
For example, Snodgrass related that alcohol-serving establishments are now far less likely to turn out drunk drivers in parking lots than they were twenty years ago. "At one point, the bar staff would walk out with the person who was drunk and help him locate his car," he stated. "There used to be horrible lawsuits, and the restaurants lost a lot of money." The standards have changed not only for retail sellers and servers of alcohol, but also for informal servers, such as party hosts.
Many believe the rise in sobriety checkpoints and visible enforcement also affected norms. "The fact that people think they're going to be arrested might contribute to norms change," said Roeper. Snodgrass echoed this, stating, "Research shows that people respond more to the risk of being caught than the information about the [public health] risks of drinking and driving Nothing's more educational or memorable than a police officer pulling you over and asking you if you've been drinking tonight."
Probably most often credited with the successful norms change over the past two decades are organizations like MADD. Marilyn Sabin, Assistant Director of Operations for the California Office of Traffic Safety, noted that "MADD has done some amazing mind changing over the years," citing MADD's role in bringing about increased enforcement, prosecution, and punishment of DUIs, as well as tougher DUI laws, such as the lowering of the legal intoxication level in many states.
MADD, which was founded by Candace Lightner in 1980 after her daughter was killed in a drunk driving crash, is a grassroots organization with local chapters across the country. MADD has enjoyed strong public support, which may account for the success of many of its advocacy and educational efforts.
"MADD brought the issue to people's attention," stated Roeper. "MADD is one of the most impressive intentional social change efforts that have existed. The norms have changed and a lot of it is because people like MADD have made it a public concern."
Still, many acknowledge that changes in impaired driving norms and behaviors were a result of a concerted effort, as opposed to any single organization. "We would not have had the success we've had without organizations like MADD, but MADD in and of itself couldn't do it alone. Once they came on board, they needed the support of everyone else -- you need penalties and consequences, or in other words, strong enforcement and good laws," stated Beer.
Role of law enforcement
One important component in reducing drunk driving is highly publicized and visible enforcement. "Preventing drunk driving is not all a police program, but it needs to come back to that," said Snodgrass. In addition to having good laws, "the general deterrence idea is important-people need to think they're going to get caught."
Law enforcement plays a significant role in reducing impaired driving, but using law enforcement effectively requires publicizing local enforcement efforts, as opposed to merely increasing the amount of arrests or law enforcement patrolling in an area. According to Roeper, "If you have more police patrolling for drunk drivers, you don't have much effect, but sobriety checkpoints have more effect because public concern is raised before the checkpoints happen. Arrests don't touch that many people, but at a sobriety checkpoint, you've communicated to 1,000 people."
"The perceived likelihood and the perceived chance of arrest are important. This is why sobriety checkpoints are very effective. There was a study of two states that did checkpoints -- one publicized the checkpoint, and one did not. There was a drop in crashes in the state that publicized, and not much change in the other state," noted Snodgrass.
Similarly, a change in impaired driving laws is likely to have more effect if consistently and visibly enforced. After lowering the legal blood alcohol concentration (BAC) limit from .10 to .08 in 1990, California witnessed a 12% reduction in DUI crashes. Snodgrass attributes this largely to the media and enforcement that increased public awareness of the change.
Role of media
Media is critical not only in "creating the sense that you're going to get caught" but in promoting general safety messages and impaired driving programs. "The media is very, very important," stated Roeper. "It was critical in promoting the designated driver idea, which is basically a social program that tells people they should be safer, as opposed to just instilling the fear of getting arrested."
In addition, the media can keep the issue of impaired driving in the public's eye. As Miller noted, "Media has a huge role in constantly keeping the issue on the forefront. There are 17,448 alcohol-related deaths a year -- and that's too many. Law enforcement can't do it alone."
The media can also lose interest or become saturated, though, which can affect the implementations of impaired driving interventions. For example, Snodgrass observed, "If you have mobilizations too often, the media won't want to cover them -- they're not news."
What communities can do
There is no single solution to reducing impaired driving, and a variety of partners are required for interventions to be effective in the long term. "If I had advice for communities, it would be, get involved, form a task force. The police can't do it themselves. Schools, public health people, grocery stores -- they all need to be working together," offered Snodgrass.
Coalitions between the public health departments, courts, schools, and the police are a good first step, and efforts coordinated by these groups should include community-based organizations. "Having community programs involved is nearly a requirement," said Roeper, stating that "MADD writ small" is very effective within communities. "On the base, it's public energy that's going to rule the day."
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