ArticlePDF Available

A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers

  • Pacific Institute for Research and Evaluation (PIRE)
  • National Opinion Research Center at the University of Chicago


Introduction: To effectively address concerns associated with alcohol-related traffic laws, communities must apply comprehensive and well-coordinated interventions that account for as many factors as possible. The goal of the current research article is to examine and evaluate the simultaneous contribution of 20 underage drinking laws and 3 general driving safety laws, while accounting for demographic, economic, and environmental variables. Methods: Annual fatal crash data (1982 to 2010), policies, and demographic, economic, and environmental information were collected and applied to each of the 51 jurisdictions (50 states and the District of Columbia). A structural equation model was fit to estimate the relative contribution of the variables of interest to alcohol-related crashes. Results: As expected, economic factors (e.g., unemployment rate, cost of alcohol) and alcohol outlet density were found highly relevant to the amount of alcohol teens consume and therefore to teens' impaired driving. Policies such as those regulating the age of bartenders, sellers, or servers; social host civil liability laws; dram shop laws; internal possession of alcohol laws; and fake identification laws do not appear to have the same impact on teens' alcohol-related crash ratios as other types of policies such as those regulating alcohol consumption or alcohol outlet density. Conclusions: This effort illustrates the need for comprehensive models of teens' impaired driving. After simultaneously accounting for as many factors as possible, we found that in general (for most communities) further reductions in alcohol-related crashes among teens might be more rapidly achieved from efforts focused on reducing teens' drinking rather than on reducing teens' driving. Future efforts should be made to develop models that represent specific communities. Practical applications: Based on this and community-specific models, simulation programs can be developed to help communities understand and visualize the impact of various policy alternatives.
A comprehensive examination of U.S. laws enacted to reduce
alcohol-related crashes among underage drivers
Eduardo Romano, Michael Scherer, James Fell, Eileen Taylor
Pacic Institute for Research and Evaluation (PIRE), 11720 Beltsville Dr., Suite 900, Calverton, MD 20705, United States
abstractarticle info
Article history:
Received 15 January 2015
Received in revised form 18 May 2015
Accepted 13 August 2015
Available online 28 August2015
Young drivers
Fatal crashes
Introduction: To effectively address concerns associated with alcohol-related trafc laws, communities must
apply comprehensive and well-coordinated interventions that account for as many factors as possible. The goal
of the current research article is to examine and evaluate the simultaneous contribution of 20 underage drinking
laws and 3 general driving safety laws, while accounting for demographic, economic, and environmental vari-
ables. Methods: Annual fatal crash data (1982 to 2010), policies, and demographic, economic, and environmental
information were collected and applied to each of the 51 jurisdictions (50 states and the District of Columbia). A
structural equation model was t to estimate the relative contribution of the variables of interest to alcohol-
related crashes. Results: As expected, economic factors (e.g., unemployment rate, cost of alcohol) and alcohol
outlet density were found highly relevant to the amount of alcohol teens consume and therefore to teens' im-
paired driving. Policies such as those regulating the age of bartenders, sellers, or servers; social host civil liability
laws; dram shop laws; internal possession of alcohol laws; and fake identication laws do not appear to have the
same impact on teens' alcohol-related crash ratios asother types of policies such as those regulating alcohol con-
sumption or alcohol outlet density. Conclusions: This effort illustrates the need for comprehensive models of
teens' impaired driving. Aftersimultaneouslyaccounting for as many factorsas possible, we found that in general
(for most communities) further reductions in alcohol-related crashes among teens might be more rapidly
achieved from efforts focused on reducing teens' drinking rather than on reducing teens' driving. Future efforts
should be made to develop models that represent specic communities. Practical applications: Based on this
and community-specic models, simulation programs can be developed to help communities understand and
visualize the impact of various policy alternatives.
© 2015 National Safety Council and Elsevier Ltd. All rights reserved.
1. Introduction
To reduce the prevalence of impaired driving and other alcohol-
related problems among underage Americans, states have passed a bat-
tery of laws, such as minimum legal drinking age (MLDA), graduated
driver licensing (GDL), and zero tolerance laws. Evidence shows that
these efforts have greatly reduced the involvement of underage drivers
in alcohol-related fatal crashes (Chen, Gruenewald, & Remer, 2009; Fell,
Fisher, Voas, Blackman, & Tippetts, 2008; Shults et al., 2001; Toomey,
Rosenfeld, & Wagenaar, 1996; Voas, Torres, Romano, & Lacey, 2012;
Wagenaar & Toomey, 2002). Despite these efforts, motor vehicle
crashes remain the leading cause of death for young people aged 16 to
20 years in the United States, accounting for approximately 28% of
deaths in that age group (Subramanian, 2012). Young drivers aged 15
to 20 years make up between 8% and 9% of the U.S. population but
only about 6.4% of licensed drivers. However, they are involved in 18%
of the fatalities resulting from trafc crashes each year (National
Highway Trafc Safety Administration [NHTSA], 2014). Drivers aged
16 years have crash rates that are three times greater than those for
drivers aged 17 years, ve times greater than drivers aged 18 years,
and even two times greater than drivers aged 85 years (McCartt,
Shabanova, & Leaf, 2003). Explanations for why such a devastating
problem persists are varied, including concerns about alcohol laws no
longer being as effective as they were, or could be (Ferguson, Fields, &
Voas, 2000).
However, evaluating law effectiveness is not straightforward. There
is a complex and interrelated array of legal, demographic, and environ-
mental factors shaping the effectiveness of alcohol laws (Nelson et al.,
2013). Conceptually identical laws tend to vary from jurisdiction to
jurisdiction both regarding the number and type of provisions and
exemptions they contain (denoted in this document as the strength of
the law) as well as the way these laws are implemented (Fell,
Romano, & Voas, 2013; Voas & Fell, 2013). Alcohol-related trafc laws
may vary on effectiveness across population groups. For instance, recent
research indicates that although GDL laws reduced crash rates among
teenagers aged 16 to 17 years (Hartling et al., 2004; Shope & Molnar,
2003; Simpson, 2003), they have increased crash rates for drivers
Journal of Safety Research 55 (2015) 213221
Corresponding author at: Paci c Institute for Research and Evaluation, 11720
Beltsville Dr., Suite 900, Calverton, MD 20705-3111, United States. Tel.: +1 301 755
2724; fax: +1 301 755 2799.
E-mail address: (E. Romano).
0022-4375/© 2015 National Safety Council and Elsevier Ltd. All rights reserved.
Contents lists available at ScienceDirect
Journal of Safety Research
journal homepage:
aged 18 years (Fell et al., 2013; Masten, Foss,& Marshall, 2011)andhave
demonstrated reduced effectiveness among Latinos when compared
with other teens (Romano, Fell, & Voas, 2011). Drivers' socioeconomic
status (Hasselberg & Laamme, 2004; Laamme & Diderichsen, 2000)
also impacts the effectiveness of alcohol-related trafc laws. Changes
in the prevailing economic conditions, from unemployment rates to
ination rates (in particular, changes in the price of alcohol and gas),
further impact the effectiveness of trafclaws(Bezruchka, 2009;
Buziarsist, 2009; Chi et al., 2011). Furthermore, the effectiveness of
alcohol-related trafc laws also depends on the effectiveness of laws
and regulations not specictotrafc, such as those limiting the
availability of alcohol to youth (Gruenewald, Ponicki, & Holder, 1993;
Holder et al., 2000).
To effectively address the concerns associated with alcohol-related
trafc laws, communities must apply comprehensive and well-
coordinated interventions that account for as many factors as possible
(Holder, 1993; Holder, 2000; Holder et al., 2000; Holder, Saltz, Treno,
Grube, & Voas, 1997; Shults et al., 2009; Voas, 1997; Voas, Holder, &
Gruenewald, 1997). However, the interconnected factors contributing
to teens' drinking and driving and other alcohol-related problems
make the evaluation of laws difcult. Without a clear understanding of
which policies work better under different environments, communities
with a need for such policies and programs, and the means by which to
implement them, will nd it difcult to decide howto prioritize their re-
source allocation to ensure optimal results. In the past, researchers have
attempted to provide help to these communities by developing
computer-based simulation programs that simultaneously account for
a variety of factors, which could assist them in their policy decision-
making (Holder & Blose, 1987; Kibel & Holder, 1994). However, those
modeling attempts were both limited in their scope andwithout the
necessary maintenancelost much of their relevance. For these com-
munities, a simulation model could help them: (a) more fully address
the underage (i.e., younger than 21 years) impaired driving problem;
(b) evaluate the expected impact of the alternative policy changes;
and (c) inform policymakers and community stakeholders about the
likely impact of allocated resources.
Funded by the Ofce of Juvenile Justice and Delinquency Prevention
(OJJDP), the goal of this research effort is to begin developing the scien-
tic framework that will be needed for such a tool. More specically, the
goal of the current research article is to examine and evaluate the simul-
taneous contribution of 20 underage drinking laws and 3 general
driving safety lawsadministrative license revocation/suspension
(ALR/ALS), blood alcohol concentration (BAC) .08 per se, and seat belt
lawson the alcohol-related crash rates of underage drivers in the
United States. To address the complex environment in which laws
operate, we simultaneously control for the unique impact of variables
previously demonstrated to impact underage alcohol-related crashes.
These covariates include drivers' age and gender, unemployment
rates, vehicle miles traveled (VMT), cost of gasoline, cost of alcohol,
sobriety checkpoints (to account for law enforcement), alcohol outlet
density, and teen alcohol consumption.
2. Materials and methods
Annual fatal crash data (1982 to 2010), policies, and demographic,
economic, and environmental information were collected and applied
to each of the 51 jurisdictions (50 states and the District of Columbia).
Our analytical approach was based on setting the state and year as the
unit of analysis. The model we used, as well as the information and
the mechanisms used for analysis, are described below.
2.1. Model
Fig. 1 shows the model used in this effort. The outcome measure
appears on the rightmost side of the gure. Our model assumes that
for teenage drivers, the rates of alcohol-related fatal crashes in a certain
state and year depend directly on the teens' amount of driving and
alcohol (beer) consumption, the alcohol outlet density in that state
and year, and the MLDA-21 policies under study. The model assumes
that the number of miles driven by teenagers is inuenced by the cost
of gasoline and the unemployment rate (a broad measure of the
economic environment). It assumes that the amount of alcohol they
consume varies with the cost of alcohol (Chaloupka, 2009; A.C.
Wagenaar, M.J. Salois, & K.A. Komro, 2009), the unemployment rate,
and the sex of the driver (Wilsnack, Wilsnack, Kristjanson, Vogeltanz-
Holm, & Gmel, 2009). It also assumes that, for teenagers, the rate of
alcohol-related crashes in a certain state and year is inuenced by the
implementation of trafc safety laws not specically targeted to young
drivers (.08 BAC per se, ALR/ALS, and seat belt laws) (Shults et al.,
2001; Voas, Tippetts, & Fell, 2000). The model in Fig. 1 also assumes
that the number of sobriety checkpoints conducted in a certain year (a
proxy for law enforcement intensity) inuences the rate of alcohol-
related crashes (as reported by Shults et al., 2001). Finally, the model as-
sumes that the20 underage drinking lawshave a direct impact on teens'
crash rates, as well as an indirect impact through their inuence on
alcohol consumption. To increase legibility, the laws appear collapsed
in Fig. 1.
2.2. Data and measures
2.2.1. Underage drinking laws
Drawing from legal data gathered by the Alcohol Policy Information
System (APIS)
and the STOP Act Report to Congress on the Prevention
and Reduction of Underage Drinking
, we obtained the effective dates of
statutes for 20 types of underage drinking laws for each of the 51 juris-
dictions in the United States comprised of the 50 states and the District
of Columbia. A summary descriptionof the 20 laws with their provisions
and exemptions appears in Table 1. Based on the provisions and exemp-
tions, Fell et al. (2015) developed a measure of the strength of the law in
each jurisdiction. For a detailed description of each type of law, its com-
ponents and provisions, the scoring matrix, and the strength of the law
in each state, see Fell et al. (2015).
For modeling purposes, we followed Fell et al. (2015,2009,2014),
who operationalized the existence and strength of each type of law as
follows. First, we coded years in whichthe law took effect from January
through December as 1and years in which the law was not present at
any time as 0.Years in which the effective dates of laws were after Jan-
uary 1st were coded as a proportion that indicated the fraction of the
year in which the law became effective. For example, a law that became
effective in October of any given year would only have been relevant for
the last quarter of the year and as such,would be coded as .25while all
years prior to the effective date would be coded as 0and all years fol-
lowing the effective date would be coded as 1.However, simply
employing a dichotomous classication for each law as being either
enacted or not enacted would not capture the state-by-state nuance of
each policy area. States differ from each other in the components of a
policy area by including provisions and exemptions that vary from
state to state. To remedy this, in the current research we utilize the scor-
ing system developed by Fell et al. (2015), which assigns a numerical
value based on provisions and exemptions for each law on a state-by-
state basis. The resulting score is what we refer to as the strength of
the law. Importantly, provisions and exemptions for each law that
were deemed to have a greater impact on the overall effectiveness of
the law were given more weight in the law strength score than weaker
ones. This allowed us to take into account the unique impact of individ-
ual provisions and exemptions for each law in each state.
Because laws vary in the maximum number of provisions they can
accommodate, we standardizedfor modeling purposesthe number
https://www.s topalcoholabu eport_main/
214 E. Romano et al. / Journal of Safety Research 55 (2015) 213221
of provisions a law contains in each jurisdiction on a scale from 0 to 1 by
dividing the number of provisions implemented in a state by the total
number of possible provisions for that law. For example, after examin-
ing the number of provisions a possession law has in each state, our
previous research determined the total score of different provisions
was 11. Then using this scoring system, we determined that a state
had exemptions to the possession law that resulted in a score reduction
from 11 to 8. The state then had a score of 8 out of a possible 11. In this
case, a state with a score of 8 would have a standardized possession
score of 8/11 = .73. The nal measure of the strength of a law in a cer-
tain state and year was obtained by multiplying the standardized imple-
mentation score by the proportion of time in which the law was
implemented in that state. Following the example above, the variable
possession law in that state would have a value of 0(.73 × 0 = 0) in
years before the law was in place, a score of .18in the year it was
implemented (.73 × .25 = .18) if it was implemented in October and
only active for one quarter of that year, and a score of .73for every
year after (.73 × 1 = .73).
2.2.2. BAC .08 per se law
The .08 BAC per se law targets adults by establishing a BAC limit for
drivers aged 21 years and older (when implemented, it reduced the BAC
limit in states from .10 to .08). Drivers at or above this BAC per se limit
are considered to be DWI; no other evidence is necessary. Despite not
being directly applicable to underage drivers (for which a BAC N.00
applies), the implementation of the adult-targeted per se law has been
shown to have a trickle-down impact on the drinking driver fatal
crash rates of drivers younger than 21 years (Fell et al., 2009; Voas,
2003). We used the NHTSA Digest of Impaired Driving and Selected
Beverage Control Laws, DOT HS 811796, July 2013 to determine in
which year a state passed a BAC .08 per se law (NHTSA, 2013a).
2.2.3. Administrative license revocation or suspension
The ALR or ALS law mandates that drivers arrested for driving while
intoxicated have their driver's licenses automatically suspended with-
out the intervention of the court. Because the evidence supporting the
benets of ALR/ALS to curb alcohol-related crashes is documented in
several studies (Klein, 1989; Voas, 2003; Voas et al., 2000; Wagenaar,
Maldonado-Molina, Ma, Tobler, & Komro, 2007), we decided to include
it in our model. We used data drawn from the Insurance Institute for
Highway Safety (IIHS, 2012) to determine the years a jurisdiction has
had an ALR/ALS law in place.
2.2.4. Seat belt laws
For seat belt laws, however, the evidence is strong that primary seat
belt lawslaws that allow ofcers to ticket for a seat belt violation per
seare more effective in curbing alcohol-related crash rates than
secondary lawslaws that only allow ofcers to ticket for a seat belt vio-
lation after the driver is stopped for another suspected trafc violation
(such as speeding). These data were obtained from NHTSA's Summary
of Vehicle Occupant Protection Laws (2006) to determine for each
jurisdiction and year in the database whether the jurisdiction has laws
dictating mandatory seat belt use (primary, secondary, or none). The
Cost of Gasoline
Cost of Alcohol
Female to Male
.08 BAC Laws
MLDA-21 Laws1,2
Seat Belt
Vehicle Miles
Alcohol Outlet
Ratio of Fatal Crashes
Fig. 1. Complete structural model. MLDA-21 lawsconsist of the followinglaws: possession, purchase, consumption, internal possession,use and lose, fake identicationminor, zero tol-
erance, graduated driver's license with nighttime restrictions, furni shing, age of serve rs, age of bartenders, age of sellers, keg re gistration, ret ail beverage service training, fake
identicationretail, social host prohibition, dram shop, social host civil liability, fake identicationproduction, and state control of alcohol. The regression weights are removed from
the current model for purposes of clarity. To see regression weights for these variables, see Table 2. Data for alcohol outlet density were only available for the State of California and
were run as a separate regression equation.
215E. Romano et al. / Journal of Safety Research 55 (2015) 213221
Table 1
Laws examined in this effort.
Law Description Provisions
Possession Prohibits the possession of alcoholic beverages by those younger than 21 years. There are three location exemptions possible, including private locations, private residence,
and parents' home. Additionally, there is an exemption for parental/spousal presence.
Purchase Illegal for minors to purchase alcoholic beverages. There is a provision that allows youth to purchase alcohol for law enforcement purposes.
Consumption Prohibits the observed consumption of alcohol by minors. There are three location exemptions possible, including private locations, private residence,
and parents' home. Additionally, there is an exemption for parental/spousal presence.
Internal possession Illegal for minors to have evidence of alcohol in their body (i.e., by breath test, urine, etc.). There are three location exemptions possible, including private locations, private residence,
and parents' home. Additionally, there is an exemption for parental/spousal presence.
Use and lose License sanctions against minors found drinking, purchasing, or in possession of alcoholic
Provisions if the law extends to purchase and possession laws, and if it is mandatory or
voluntary. There are additional provisions increasing the length of suspension and an
exemption placing the upper age limit at 21 years.
Use of fake identication among minors The use of false identication by a minor. Provisions for whether there are administrative procedures, judicial procedures, or both.
Zero tolerance Illegal for minors to drive with any measurable level of alcohol in their systems. Provisions for whether administrative and criminal sanctions are mandatory or discretionary
as well as the length of the sanction for each.
Graduated driver's license (GDL) A system in which beginning drivers are required to go through three stages of limited
driving privileges.
Implementation and length of nighttime and/or passenger restrictions.
Furnishing/selling Illegal to furnish alcoholic beverages to minors. There are three location exemptions possible, including private locations, private residence,
and parents' home. Additionally, there is an exemption for parental/spousal presence.
Age of on-premise alcohol sellers/servers Prohibition of those younger than 21 years to serve alcoholic beverages. Minimum service age for all three beverage types (beer, wine, spirits) and the presence of a
manager when alcohol is being sold.
Age of bartenders Prohibition of those younger than 21 years from bartending. Minimum service age for all three beverage types (beer, wine, spirits) and the presence of a
manager when alcohol is being sold.
Age of off-premise alcohol sellers/servers Prohibition of those younger than 21 years to sell alcoholic beverages. Minimum selling age for all three beverage types (beer, wine, spirits) and the presence of a
manager when alcohol is being sold.
Keg registration Prohibits sale or at least requires wholesalers or retailers to attach an identication number
to their kegs and collect identifying information from the keg purchaser. Extension of the information requiredincluding the purchaser's identication and the
address where the keg will be consumedthe type of warning issued to a purchaser, and
whether a deposit is required. Additionally, the state of Utah prohibits keg use entirely.
Responsible beverage service training Requirements for retail alcohol outlets to participate in programs aimed to prevent alcohol
sales and service to minors and intoxicated persons, and train managers and servers/clerks to
implement policies and procedures effectively.
Requirement of whether the program is mandatory or voluntary, who is trained by the
program, incentives for having a program, and type of establishments and licensees covered.
Retailer support for fake identication State provisions to assist retailers in avoiding sales to potential buyers who present false
identication (e.g., issuing distinctive driver licenses to minors).
Variations in provisions and/or extension of sanctions.
Social host Prohibitions against hosting underage drinking parties. Provisions include general or specic statutes, type of actions triggering a violation, type of
property covered, and knowledge standard for a violation. Additionally, there is also an
exemption for preventive actions.
Dram shop liability The availability of private action against commercial alcohol providers. Type of law. Exemptions for who may be sued and how standards of proof necessary for a
Social host civil liability Private cause of action against a non-commercial alcohol provider for injuries or damages by
an intoxicated guest.
Type of law. Exemptions for who may be sued and how standards of proof necessary for a
Transfer/production of fake identication Prohibits the production of false identication and/or the lending or transferring of
identication to another person.
Variations in whether the law is criminalized.
State control of alcohol The use of state-run retail distribution systems. Variations on which kind of beverage is state run (beer, wine, spirits).
See Fell et al. (2015) for a detailed description of the laws, their strength coding, and the provisions/exemptions considered for each.
216 E. Romano et al. / Journal of Safety Research 55 (2015) 213221
information from 2006 was carried up to 2010, as no change has occurred
in seat belt laws since then.
2.2.5. Sobriety checkpoints
Sobriety checkpoints were derived from previous research conducted
by Fell and colleagues (2003), who examined the frequency with which
sobriety checkpoints were conducted in each of the 51 jurisdictions, cod-
ing them as 0if checkpoints were illegal or otherwise not conducted, 1
if they were conducted infrequently (e.g., only during holidays), and 2if
they were conducted frequently (e.g., on a monthly or weekly basis). As
we were not aware of any publication examining sobriety checkpoint fre-
quency in the same manner, the checkpoint strengths listed in Fell et al.
(2003) were considered constant through 2010.
2.2.6. Fatal crashes
Annual trafc fatality data were derived from NHTSA's Fatality
Analysis Reporting System (FARS) (NHTSA, 2013b). FARS is a continu-
ous census of vehicular crashes that resulted in the death of an individ-
ual within 30 days following the incident. The database also contains
information on the drivers' BAC, either collected from blood or imputed
when missing (Subramanian, 2002). We gathered data from 1982 to
2010, which allowed for the inclusion of all the measures needed for
analysis. Based on that information, for each state and year (our unit
of analysis), we computed the ratio of the number of alcohol-related
crashes among drivers aged 15 to 20 years divided by the number of
non-alcohol-related crashes among drivers of the same age group.
This ratio, called the crash incidence ratio (CIR), was used instead of
the number of crashes as an outcome measure to reduce bias in the
estimates as it allows for a better control of crash exposure over other
standardizing variables (Voas, Tippetts, Romano, Fisher, & Kelley-
Baker, 2007). The CIR took into account that drivers in the same age
group tend to face similar driving exposure (therefore equally affecting
both the CIR numerator and denominator), leaving alcohol (also
impacting the numerator) as the sole determinant of variation in the
CIR (Voas et al., 2007).
2.2.7. Sex of the driver
Previous research indicated that the sex of a teenage driver was a
strong indicator in both alcohol consumption (Wilsnack et al., 2009)
and fatal crash rates (Fell, 1977; Fell, Tippetts, & Voas, 2010). As such,
we deemed it necessary to include a measure of driver sex in the
model. We computed the ratio of females to males from data obtained
from the U.S. Census Bureau for each year of the current study
2.2.8. Alcohol use (beer)
Prior research indicated that when it comes to consuming alcohol,
though they consumed wine and spirits, underage drivers were more
likely to consume beer (Siegel et al., 2013). As such, we used beer
consumption in each state for those aged 15 years and older. Although
it would have been ideal to identify alcohol consumption only among
underage drivers, these data werenot available and statewide percapita
beer consumption was used as a proxy for teen beer consumption. Per
capita beer consumption rates were obtained for individuals aged
15 years and older by year and state from the annual publication of
the National Institute on Alcohol Abuse and Alcoholism's Alcohol
Epidemiologic Data System (2012).
2.2.9. Alcohol outlet density
Alcohol outlet density was deemed an important addition to the
current model as previous literature found that an increase in alcohol
outlet density allows underage populations to accessalcohol more read-
ily through commercial outlets, family members, and social networks
(Chen et al., 2009), resulting in signicant increases in the rates of pur-
chasing and consuming alcohol (Rowland, Toumbourou, & Livingston,
2014) and, subsequently, motor vehicle crashes (Gruenewald &
Johnson, 2010). Information on alcohol outlet density was obtained
only for California from the California Department of Alcohol Beverage
Control. Because California state-specic data did not differ signicantly
in terms of laws and outcome measures, it was deemed appropriate to
merge alcohol outlet density information into the national model.
2.2.10. Vehicle miles traveled
VMT were derived from Federal Highway Administration (FHWA)
data. The FHWA produces an annual estimate of total VMT by state
and year. Because the FHWA only offers annual data at the state level,
stratication by sex was not possible. As such, VMT for all drivers was
used in the current analyses.
2.2.11. Gasoline taxes
As the cost of gasoline was found to be too volatile for meaningful sta-
tistical comparison, gasoline tax rateswereusedastheyweredeemedto
be more stable and consistent indicators of market uctuations, signi-
cant enough to impact VMT and trafc fatalities (Grabowski & Morrisey,
2004). Gasoline tax rates were obtained from the Tax Foundation
(2014). Gasoline prices were adjusted for rate of ination (Consumer
Price Index) and expressed in 2,010 dollars.
2.2.12. Alcohol taxes
Alcohol consumption has been directly associated with the cost of
alcohol, among youth in particular (Chaloupka, 2009; Chaloupka,
Saffer, & Grossman, 1993; Wagenaar, Salois, & Komro, 2009). Rather
than using alcohol prices to account for the cost of alcohol, many
researchers have preferred using alcohol excise taxes, which are more
stable and less dependent on local and sudden uctuations (Wagenaar
et al., 2009). In this effort, we used alcohol excise taxes to control for
the cost of alcohol on alcohol consumption. Alcohol excise taxes were
derived from the Tax Foundation (2014). Alcohol prices were adjusted
for rate ination and expressed in 2,010 dollars.
2.2.13. Unemployment rates
Unemployment statistics were derivedfrom the U.S. Bureau of Labor
Statistics, which publishes monthly employment statistics by state (U.S.
Bureau of Labor Statistics, 2014).
2.3. Data analysis
Based on the model in Fig. 1, we computed the direct and indirect ef-
fect the variables had on the outcome of interest (teens' alcohol-related
crash rates), as well as on the intermediate variables (VMT, alcohol
[beer] use). The data were analyzed using structural equation modeling
(SEM) techniques with Analysis of Moment-Based Structures (AMOS
v.21), an SPSS-based package (IBM SPSS Inc., Chicago, IL). SEM is a sta-
tistical technique frequently used to estimate causal relationships
based on qualitative assumptions represented in a path diagram.
3. Results
3.1. Direct effects
All regression estimates and p-values for the current model are
displayed in Table 2.Signicant regression estimates indicate that a sin-
gle unit increase in the predictor variable would result in a change in the
outcome variable. For example, the predictor variable gas tax is signi-
cant (p= .048) and results in an estimated .322 change in the
outcome variable VMT. This means that for every unit increase in gas
tax, there is a 32.2% corresponding decrease in VMT. Direct effects are
also indicated in Fig. 1. Ideally, t statistics for a structural model
would yield a nonsignicant χ
statistic (Barrett, 2007), a comparative
tindex(CFI)andnormedt index (NFI) of 0.95 or greater (Hu &
Bentler, 1999), and a root mean square error of approximation
(RMSEA) between 0.05 and 0.10 (MacCallum, Browne, & Sugawara,
217E. Romano et al. / Journal of Safety Research 55 (2015) 213221
1996). Based on these guidelines, the current model displayed relatively
low tmodel t statistics: χ
/df = 24.92***, CFI = 0.352, NFI = 0.348,
RMSEA = 0.190. However, t statistics are merely considered guide-
lines and should be considered acceptable if they are comparable to t
statistics previously established in the eld (Bollen, 1989). We found
the t statistics of the current model comparable to those established
by Fell and colleagues (2015;2009) in previous research and, as such,
retained the model.
3.1.1. Intermediate variable: vehicle miles traveled
Table 2 shows that the amount of teens' driving was highly
inuenced by the cost of gasoline, the health of the economy (measured
by the unemployment rate), and the ratio in the number of female to
male teens in the stateyear unit.
3.1.2. Intermediate variable: alcohol use
Table 2 shows that per capita beer consumption was signicantly af-
fected, decreasing with an increase in the cost of alcohol, but increasing
with an increase in the density of alcohol outlets in a jurisdiction and the
number of female teens relative to that of males. Alcohol use was also
affected (reduced) by BAC .08 per se laws and fake identication laws
(minors and production).
3.1.3. Outcome variable: fatal crashes
Increases in alcohol-related crash ratios among teens were signi-
cantly associated with a direct increase in teens' alcohol (beer)
consumption, VMT, and an increase in the ratio of female to male
teens in the state. Decreases in teens' alcohol-related crash ratios were
associated with sobriety checkpoints, seat belt laws, ALR/ALS laws, .08
BAC per se laws, and the following MLDA-21 laws: fake identication
(minors and retail), possession, purchase, social host civil liability, use
and lose, and zero tolerance. Conversely, fatal alcohol-related crashes
increased when keg registration laws increased, an unexpected nding
also reported by Fell et al. (2009).
3.2. Total (direct and indirect) effects
Direct effects such as those shown in Fig. 1 and Table 2 only tell part
of the story. Factors may also indirectly contribute to crash risk through
their impact on intermediate factors. After taking all direct and indirect
effects also into account, Table 3 shows the total effect (i.e., direct and
indirect effects) of all factors under consideration on the ratio of
alcohol-related teen fatal crashes. As shown in Table 3, the three factors
with the largest impact on the alcohol crash ratio were the ratio of female
to male teens in the state and the fake identication (retail) law (reducing
crash rates), and teens' alcohol (beer) consumption (increasing crash
rates). Other important contributing factors (reducing crash rates) were
the level of alcohol outlet density and the fake identication (minor),
possession, purchase, use and lose, and zero tolerance laws.
4. Discussion and conclusions
Similar to Fell et al. (2009), we found that possession and purchase
laws signicantly predicted a decrease in underage drinking to non-
drinking drivers in the FARS dataset. However, Fell et al. detected a nota-
ble 16% decrease in FARS ratios for possession and purchase composite
scores, while we found only a 4.1% and a 4.5% decrease, respectively.
This difference is likely due to the methodology involved in the measuring
and analysis of these two distinct laws. Primarily, Fell et al. (2009) used a
dichotomous classication of laws in the original study, and as possession
Table 2
Regression weights and signicance level for direct effects on alcohol-related crash ratios and teen alcohol use.
Vehicle miles traveled Beer consumption Teen alcohol crash ratios
Predictor Estimate p-value Estimate p-value Estimate p-value
Gas tax rate .322.048––––
Alcohol tax rate ––.055.037––
Unemployment rate .517b.001
.023 .546 ––
Ratio of female to male drivers .888b.001
BAC .08 laws ––.104b.001
Sobriety checkpoints ––––.022b.001
ALR/ALS laws ––––.075b.001
Seat belt laws ––––.038b.001
Underage drinking laws
Age of bartender laws ––.050 .351 .007 .457
Age of seller laws ––.054 .402 .018 .106
Age of server laws ––.021 .807 .029 .052
Consumption laws ––.017 .771 .007 .445
Dram shop laws ––.033 .573 ––
Fake identicationminor laws ––.028.043
Fake identicationProduction laws ––.069 .271 .008 .443
Fake identicationretail laws ––.189.049
Furnishing laws ––.117 .416 ––
GDL nighttime laws ––––.004 .779
Internal possession laws ––.048 .701 .030 .154
Keg registration laws ––.162 .122 .149b.001
Possession laws ––.124 .107 .032.043
Purchase laws ––.047 .525 .040.040
Responsible beverage service laws ––.059 .578 ––
Social host civil laws ––.021 .704 .047b.001
Social host prohibition laws ––.036 .708 .004 .825
State control of alcohol laws ––.043 .827 .006 .836
Use and lose laws ––.051 .688 .085b.001
Zero tolerance laws ––.007 .917 .072b.001
Intermediate variables
Beer consumption ––––.152b.001
Alcohol outlet density
––.122.002.003 .233
VMT ––––.043.004
Data for alcohol outlet density was only available for the State of California and was run as a separate regression equation.
Indicates statistical signicance (pb.05).
218 E. Romano et al. / Journal of Safety Research 55 (2015) 213221
and purchase laws were implemented simultaneously, the collinearity
between these two laws made separate examination impossible. In the
current research, however, we incorporated the strengths of laws. The
variability inherent in the law strengths allowed us to overcome the ob-
stacle of collinearity and measure these laws separately resulting in a
change in variations attributable to each law.
Overall, social host civil liability was also found to predict a nonsig-
nicant 1.4% decrease in underage drinking ratios, a nding consistent
with Fell and colleagues (2014). Fake identicationminor and
retailresulted in a 14.1% and 9.3% overall reduction in underage
alcohol-related fatal crash ratios. This nding was somewhat surprising
as Fell and colleagues (2014) reported neither fake identication
minor nor retail to be a signicant predictor of FARS ratios. This was
likely the result of the culmination of several design factors. First
and foremost, the structural model proposed in the current study
differed from those used by Fell et al. (2014) in that ours included
several additional control factors, including economic considerations
(i.e., alcohol and gasoline taxation), sex of drivers, and alcohol outlet
densities. This resulted in a substantially altered model, which would
necessarily require a redistribution of variance among individual pre-
dictors. Further, Fell et al. (2014) used a non-standardized law scoring
component, which may have limited the predictable impact of each
law. In the current research, we used standardized law strengths,
which could result in better tting data and increased predictability of
the laws on FARS ratios.
Similar to previous research on the impact of MLDA-21 laws on
alcohol-related fatal crash ratios among adolescents, we found that
use and lose laws and zero tolerance laws both demonstrated a signi-
cant impacton underage alcohol-related fatal crash ratios, evenafter ac-
counting for all other co-factors. Specically, we found that use and lose
laws predicted a 6.9% overall decrease in crash ratios, while zero toler-
ance laws predicted a 3.3% decrease. This is similar to previous research,
which founda 5% decrease for both use and lose laws and zero tolerance
laws (Fell et al., 2009).
Consistent with ndings by Fell et al. (2009), keg registration laws
demonstrated a 2.4% overall increase in underage alcohol-related fatal
crash ratios over the study period. Fell et al. theorized that by making
it more difcult to acquire kegsand thereby more difcult to acquire
beerunderage populations may be prone to consuming spirits instead
of beer. As spirits have higher alcohol content, intoxication may be more
likely and an increase in drunk driving and fatal crashes may be
The implementation of GDL nighttime restriction laws was found to
cause a 4.5% decrease in underage alcohol-related fatal crash ratios. This
seems in line with previous research ndings on the benets of those
nighttime restrictions (Fell, Todd, & Voas, 2011; Hartling et al., 2004;
Shope & Molnar, 2003; Simpson, 2003). Also as expected, alcohol outlet
density was found to be an importantpredictor of alcohol use among in-
dividuals younger than 21 years (Chen et al., 2009; Rowland et al.,
2014). Althoughalcohol outlets were not directlyrelated to crash ratios,
their overall total impact on alcohol-related crash ratios was still found
to be signicantly positive due to an indirect effect through alcohol use.
This was consistent with previous work by Gruenewald and Johnson
(2010), who found that a 10% increase in alcohol outlet density was as-
sociated with up to a 150% increase in single-vehicle nighttime crashes.
Interestingly, the economic variables that had been so inuential in
shaping the intermediate variables (e.g., VMT, alcohol [beer] consump-
tion) did notappear to have a signicant overall contribution to alcohol-
related crash rates.
The main focus of the current research was to examine the impact of
underage alcohol policies on beer consumption and underage fatal
crash ratios of drinking to nondrinking drivers after accounting for envi-
ronmental, population, economic, and enforcement factors. As expect-
ed, many of the ndings of this effort have been previously reported
in the literature. New to this effort is the comprehensive and simulta-
neous evaluation of these contributors to teens' alcohol-related crash
This effort illustrates the need for comprehensive models of teens'
impaired driving. In examining the overall contribution of teens' drink-
ing and driving to teens' alcohol-related crash rates, we found that al-
though a reduction in teens' drinking rates translated into reductions
in teen's rates of impaired driving fatal crashes, reducing the amount
of miles traveled by teens apparently will not have such effect. We inter-
pret this nding as indicative that the problem of drinking and driving
among teens is related more to the relative risk of the alcohol they
consume than to their driving. Compared with older drivers, teens are
inexperienced, risky drivers, and current policies (e.g., GDL with night-
time restrictions) have been effective in reducing such risks. Therefore,
after simultaneously accounting for as many factors as possible, we
found evidence suggesting that in general (for most communities)
further reductions in alcohol-related crashes among teens might be
more rapidly achieved from efforts focused on reducing teens' drinking
rather than on reducing teens' driving.
To this regard and as expected, economic factors (unemployment
rate, cost of alcohol) and the environment (alcohol outlet density) are
highly relevant to the amount of alcohol teens consume. There is
ample evidence showing that increasing the cost of alcohol and/or reduc-
ing alcohol availability reduces teens' alcohol consumption. Although
economic factors do have a direct effect on alcohol consumption, and al-
cohol consumption is one of the largest contributors to teens' crash risk,
economic factors do not show a signicant overall contribution to
alcohol-related crash rates. However, alcohol outlet density remained
closely associated with alcohol-related crash risks. Again, we interpret
this nding as indicative of the effect economic environment has on
teens' crash risk, mainly through teens' alcohol consumption.
Also of interest are the set of laws and policies that after accounting
for all other factors do not seem to have a signicant impact on teens'
alcohol-related crashes. Policies such as those regulating the age of bar-
tenders, sellers, or servers; social host civil liability laws; dram shop
laws; internal possession laws; and fake identication (production)
Table 3
Regression weights and signicance level for total effects on fatal crash ratios.
Predictor Total effect size
Age of bartender laws 0.1%
Age of seller laws 0.9%
Age of server laws +3.2%
ALR/ALS laws 7.0%
Consumption laws 0.5%
Dram shop laws 0.5%
Fake identicationminor laws 7.2%
Fake identicationproduction laws 1.0%
Fake identicationretail laws 10.6%
Furnishing laws 11.7%
GDL nighttime laws 0.4%
Internal possession laws 2.3%
Keg registration laws +12.4%
Possession laws 6.4%
Purchase laws 4.9%
Responsible beverage service laws +0.9%
Social host civil laws 4.4%
Social host prohibition laws 0.2%
State control of alcohol laws +0.4%
Use and lose laws 8.5%
Zero tolerance laws 7.3%
.08 BAC per se law 8.8%
Seat belt laws 3.8%
Beer consumption +15.2%
VMT 0.0%
Ratio of female to male drivers 124.1%
Sobriety checkpoints 2.2%
Alcohol tax rate 1.0%
Alcohol outlet density +3.4%
Gas tax rate 1.5%
Unemployment rate 0.2%
Indicates statistical signicance (pb.05).
219E. Romano et al. / Journal of Safety Research 55 (2015) 213221
laws do not have a signicant impact on teens' overall alcohol-related
crash ratios. Nevertheless, their lack of signicance should not be
interpreted as irrelevant. Rather than examining the impact of individ-
ual laws on reducing teens' involvement in alcohol-related crashes,
we should examine the impact of the entire body of legislation on
such crashes. Although some individual laws may appear to be nonsig-
nicant contributors to risk reduction, these laws may complement
others andcontribute to the collective effectiveness of these laws. In ad-
dition, while our outcome measure was drinking driver rates in fatal
crashes, some of these MLDA-21 laws may impact underage alcohol
consumption, binge drinking, and alcohol-related suicides and/or homi-
cides, or may delay theonset age of drinking by youth, which would not
be adequately represented in our analyses.
Having said that, it is important to acknowledge that laws and policies
differ in their individual contributions to the abatement of teens' impaired
driving. Such a difference must be taken into account by communities
willing to address the problem of teens' impaired driving. To do so, com-
munities must decide on the set of policies they need to enact based on
the set of policies they already have in place and the resources available.
Communities need to choose and enact the policies that would allow
them to efciently achieve the desired result. It is with this regard that
this effort becomes most usefulby providing a broad framework for
states and communities to: (a) examine the potential impact of alcohol-
related policies on teen drinking and driving, and (b) determine the utility
of devoting limited resources to implementing new policies and/or
strengthening existing policies to curtail underaged drinking and driving.
More specic models should be developed to target speciccommunities.
Based on these models, simulation programs could be developed to help
communities understand and visualize the impact of policy alternatives. A
simulation model similar to the one described here, which allows users to
predict how individual changes in law strengths could impact underage
drinking and driving, would help inform the decision-making process.
The current research is meant to serve as the foundation for such a
simulation. The structural model proposed and tested in the current en-
deavor examined the unique contributions of 20 underage drinking
laws, administrative license revocation/suspension, .08 per se BAC limits,
seat belt laws, economic factors, environmental factors, and driver factors
on the alcohol-related crash rates of underage drivers in the United States.
Each of these components was selected because previous research indi-
cated its potential impact on underage drinking and driving and/or fatal
crashes. Future research will examine how slight alterations of each of
the variables proposed in the current model impact predicted FARS ratios
for underage drivers. By doing so, we will begin to develop a tool that
could be used to inform researchers, advocates, policymakers, and com-
munity groups in their efforts to understand how implementing new or
altering existing policies may impact underage drinking and driving and
maximize gains made by limited resources.
This effort is not free of limitations. The impact of some of the laws
may be dampened by the use of ratios in our outcome measure and by
the relatively low number of states that have enacted those particular
laws (i.e., internal possession, age of servers, and state control of
alcohol). Alcohol outlet density data were only available in the State of
California, while all other data were available on a national level.
Although this was a necessary limitation given the extreme variation
in recordsof alcohol outlets from state to state and by year, it neverthe-
less may affect the impact of this variable in the model. Additionally, the
current research examines the impact of these laws on alcohol-related
outcomes only (i.e., per capita beer consumption and underaged
alcohol-related FARS ratios). This may to some extent obscure the effec-
tiveness of these laws in preventing adverse non-alcohol related out-
comes, which may be evident in some of the more general laws
(e.g., GDL nighttime restrictions, seatbelt safety). Although this would
have been beyond the scope of the current study, in considering the ef-
fectiveness of all laws, additional outcomes may be necessary. Perhaps
the most important limitation of this study is that despite its relative
comprehensiveness, it was not possible to incorporate all the factors
that have been shown to contribute to the underage drinking and driv-
ing problem into the model. Such incorporation would have caused the
model to become intractable. Subsequently, it is possible that by ignor-
ing some of these potentially contributing factors, we somehow biased
the results. To this regard, a possible way to address this limitation in fu-
ture research efforts is to circumscribe the comprehensive analyses of
underage drinking problems to individual communities or regions,
each with specicidentied problems and risk factors.
The research and preparation of this manuscript were conducted
under a grant from the Ofce of Juvenile Justice and Delinquency
Prevention, U.S. Department of Justice (2012-AH-FX-0005). Points of
view or opinions in this document are those of the authors and do
not necessarily represent the ofcial position or policies of the U.S.
Department of Justice.
Barrett, P. (2007). Structural equation modeling: Adjudging model t. Personality and
Individual Differences,42,815824.
Bezruchka, S. (2009). The effect of economic recession on population health. Canadian
Medical Association Journal,181(5), 281285.
Bollen, K. A. (1989). Structural equations with latent variables. New York, NY: John Wiley.
Buziarsist, J. (2009). Economic crisis on public health. Archives of Public Health,67(3), 97.
Chaloupka, F. J. (2009). Alcoholic beverage taxes, prices and drinking. Addiction,104(2),
191192 [Commentary].
Chaloupka, F. J., Saffer, H., & Grossman, M. (1993).Alcohol control policies and motor vehicle
fatalities: National Bureau of Economic Research.
Chen, M. -J., Gruenewald, P. J., & Remer, L. G. (2009). Does alcohol outlet density affect
youth access to alcohol? Journal of Adolescent Health,44(6), 582589.
Chi, G., Zhou, X., McClure, T. E., Gilbert, P.A., Cosby, A.G., Zhang, L., ... Levinson, D. (2011).
Gasoline prices and their relationship to drunk-driving crashes. Accident Analysis and
Prevention,43(1), 194203.
Fell, J. C. (1977). Aprole of fatal accidents in volving alcohol. Washington, DC: U.S.
Department of Transportation, National Highway Trafc Safety Administration.
Fell, J. C., Ferguson, S. A.,Williams, A. F., & Fields, M. (2003). Whyare sobriety checkpoints
not widely adopte d as an enforceme nt strategy in the U nited States? Accident
Analysis and Prevention,35(6), 897902.
Fell, J. C., Fisher, D. A., Voas, R. B., Blackman, K.,& Tippetts, A. S. (2008). The relationship of
underage drinki ng laws to reductions in drinking drivers in fatal crashes in the
United States. Accident Analysis and Prevention,40, 14301440.
Fell, J. C., Fisher, D. A., Voas, R. B., Blackman, K., & Tippetts, A. S. (2009). The impact of un-
derage drinking laws on alcohol-related fatal crashes of young drivers. Alcoholism:
Clinical and Experimental Research,33(7), 12081219.
Fell, J. C., Romano, E., & Voas, R. B. (2013). A national evaluation of graduated driver li-
censing laws in the United States. 20th International Council on Alcohol, Drugs and
Trafc Safety (Vol. August 25 to 28, 2013). Brisbane, QLD, Australia: International
Council on Alcohol, Drugs and TrafcSafety(ICADTS).
Fell, J. C., Scherer, M., Thomas, S., & Voas, R. B. (2014). Effectiveness of social host and fake
identication laws on reducing underage drinking driver fatal crashes. TrafcInjury
Prevention,15(Sup 1), S64S73 (Special Issue). doi: 10.1080/15389588.2014.928929.
Fell, J. C.,Tippetts, A. S., & Voas,R. B. (2010). Drinkingcharacteristics of drivers arrested for
driving while intoxicated in two police jurisdictions. TrafcInjuryPrevention,11(5),
Fell, J. C.,Todd, M., & Voas, R. (2011). A nationalevaluation of the nighttime and passenger
restriction components of graduated driverlicensing. Journalof Safety Research,42(4),
Fell, J., Thomas, S., Scherer, M., & Fisher, D. A. (2015). Scoring the strengths and weak-
nesses of underage dri nking laws in the Unit ed States. World Medical a nd Health
Policy (in press).
Ferguson, S. A., Fields, M., & Voas, R. B. (2000). Enforcement of zero tolerance laws in the
US Prevention section. In H. Laurell, & F. Schlyter (Eds.), Alcohol, drugs and trafc
safety T 2000: Proceedings of the 15th International Conference on Alcohol, Drugs
and Trafc Safety, May 2226, 2000. 2.(pp.713718). Stockholm, Sweden: ICADTS.
Grabowski, D. C., & Morrisey, M. A. (2004). Gasoline prices and motor vehicle fatalities.
Journal of Policy Analysis and Management,23(3), 575593.
Gruenewald, P. J., & Johnson, F. W. (2010). Drinking, driving, and crashing: A trafc-ow
model of alcohol-related motor vehicle accidents. Journal of Studies on Alcohol and
Drugs,71(2), 237248.
Gruenewald, P. J., Ponicki, W. R., & Holder, H. (1993). The relationship of outlet densities
to alcohol consumption: A time series cross-sectional analysis. Alcoholism: Clinical
and Experimental Research,17(1), 3847.
Hartling, L., Wiebe, N., Russell, K., Petruk, J., Spinola, C., & Klassen, T. P. (2004). Graduated
driver licensing for reducing motor vehicle crashes among young drivers. Cochrane
Database of Systematic Reviews,2Art. No.: CD003300.pub003302.
Hasselberg, M., & Laamme, L. (2004). Children at risk in trafc: Improvement potentials
in the Swedish context. Acta Paediatrica,93(1), 113119.
220 E. Romano et al. / Journal of Safety Research 55 (2015) 213221
Holder, H. D. (1993 ). Prevention of alcohol-related accidents in the community. Addiction,
88(7), 10031012.
Holder, H. D. (2000). Community prevention of alcohol problems. Addictive Behaviors,
25(6), 843859.
Holder, H. D., & Blose, J. O. (1987). The reduction of community alcohol problems: Computer
simulation experiments in three counties. Journal of Studies on Alcohol,48(2), 124135.
(2000). Effect of community-based interventions on high-risk drinking and alcohol-
related injuries. Journal of the American Medical Association,284(18), 23412347.
Holder, H. D., Saltz, R. F., Treno, A. J., Grube, J. W., & Voas, R. B. (1997). Evaluation design for a
community prevention trial: An environmental approach to reduce alcohol-involved
trauma. Evaluation Review,21(2), 140165.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for t indexes in covariance structure
analysis: Con ventional cr iteria versus new alternati ves. Structural Equation
Insurance Institute for Highway Safety (2012). Alcohol-impaired driving state laws. Re-
trieved December 10, 2012, from http://www.i topics/laws/ dui?
Kibel, B. M., & Holder, H. D. (1994). Dynamic systems-modeling as a means to estimate
community-based prevention effects. In L. M. Collins, & L. A. Seitz (Eds.), Advances
in data analysis for prevention intervention research (National Institute on Drug Abuse
Monograph 142) (pp. 404446). Washington, DC: Superi ntendent of Documents,
U.S. Government Printing Ofce.
Klein, T. M. (1989). Changes in alcohol-involved fatal crashes associated with tougher state
alcohol legislation. Washington, DC: National Highway Trafc Safety Administration.
Laamme, L., & Diderichsen, F. (2000). Social differences in trafc injury risks in childhood
and youthA literature review and a research agenda. Injury Prevention,6(4), 293298.
MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determina-
tion of sample size for covariance structure modeling. Psychological Methods,1(2),
Masten, S. V., Fo ss, R. D., & Marsha ll, S. W. (2011). Graduated driver licensing and
fatal crashes involving 16- to 19-year-old drivers. Journal of the Ame rican Medical
Association,306(10), 10981103.
McCartt, A. T., Shabanova, V. I., & Leaf, W. A. (2003). Driving experience, crashes and traf-
c citations of te enage beginnin g drivers. Accident Analysis and P revention,35,
National Highway Trafc Safety Administrat ion (2006). Summary of vehicle occupant
protection laws: Seventh edition (current as of January 1, 2006). Washington, DC: U.S.
Department of Transportation, National Highway Trafc Safety Administration.
National Highway Trafc Safety Administration (2013a). Digest of impaired drivingand se-
lected beverage control laws. (DOT HS 811 796) Washington, DC: U.S. Department of
Transportation, National Highway Trafc Safety Administration.
National Highway T rafc Safety Administration (2013b). Fatality analysis reporting sys-
tem data les, 19822010. Retrieved May 3, 2013, from
National Highway Tr afc Safety Adminis tration (2014). trafc safety facts 2012 data:
Young drivers. (DOT HS 812 019) Washington, DC: US Department of Transportation,
National Highway Trafc Safety Administration.
National Institute on Alcohol Abuse and Alcoholism (2012). Apparent per capita alcohol
consumption: National, state, and regionaltrends, 19772012. Washington, DC: Nation-
al Institute of Health, National Institute on Alcohol Abuse and Alcoholism.
S. (2013). Efcacy and the strength of evidence of U.S. alcohol control policies. American
Journal of Preventive Medicine,45(1), 1928.
Romano, E., Fell, J., & Voas, R. B. (2011). Theroleofraceandethnicityontheeffectofgrad-
uated driver licensing laws in the United States. Annals of Advances in Automotive
Rowland, B., Toumbourou, J. W., & Livingston, M. (2014). The association of alcohol outlet
density with illegal underage adolescent purchasing of alcohol. Journal of Adolescent
Shope, J. T., & Molnar, L. J. (2003). Graduated driver licensing in the United States: Evalu-
ation of results from early programs. Journal of Safety Research,34(1), 6369.
Shults, R. A., Elder, R. W., Nichols, J. L., Sleet, D. A., Compton, R., & Chattopadhyay, S. K. (2009).
Effectiveness of multicomponent programs with community mobilization for reducing
alcohol-impaired driving. American Journal of Preventive Medicine,37(4), 360371.
Shults, R. A., Elder, R. W., Sleet, D. A., Nichols, J. L., Alao, M. O., Carande-Kulis, V. G., ...
Thompson, R. S. (2001). Reviews of evidence regarding interventions to reduce
alcohol-impaired driving. American Journal of Preventive Medicine,21(4 Suppl), 6688.
Siegel, M., DeJong, W., Naimi, T. S., Fortunato, E. K., Albers, A. B., Heeren, T., ... Rodkin, S.
(2013). Brand-s pecic consumption of alcohol amo ng underage youth in the
United States. Alcoholism: Clinical and Experimental Research,37(7), 11951203.
Simpson, H. M. (2003). The evolution and effectiveness of graduated licensing. Journal of
Safety Research,34,6369.
Subramanian, R. (2002). transitioning to multiple imputation A new method to estimate
missing blood alcohol concentration (BAC) v alues in FARS. ( DOT HS 809 403).
Washington, DC: Mathematical Analysis Division, National Center for Statistics and
Analysis, National Highway Trafc Safety Administration, U.S. Department of Trans-
portation Retrieved from
Subramanian, R. (2012). Motor vehicle trafc crashes as a leading cau se of death in the
United States, 2008 and 2009. (DOT HS 811 620) Washington, DC: U.S. Department
of Transportation, National Highway of Trafc Safety Administration Retrieved from
Tax Foundation (2014). State sales, gasoline, cigarette, and alcohol tax rates by state. Re-
trieved October 30, 2014, from
Toomey, T. L., Rosenfeld, C., & Wagenaar, A. C. (1996). The minimum legal drinking age:
History, effectiveness, and ongoing debate. Alcohol Health and Research World,20(4),
U.S. Bureau of Labor Statistics (2014). Regional and state unemployment (Annual). Re-
trieved October 30, 2014, from
Voas, R. B. (1997). Drinking and driving prevention in the community: Program planning
and implementat ion. Addiction,92(Supplement 2), S201S219.
Voas, R. B. (2003). Robert F. Borkenstein: An appreciation. Addiction,98(3), 371372.
Voas, R. B., & Fell, J. C. (2013). Strengthening impaired-driving enforcement in the United
States. Trafc Injury Prevention,14(7), 661670.
Voas, R. B.,Holder, H.D., & Gruenewald, P. J. (1997). The effect of drinking and driving in-
terventions on a lcohol-involve d trafc crashes within a comprehensive community
trial. Addiction,92(Suppl. 2), S221S236.
Voas, R. B., Tippetts, A. S., & Fell, J. C. (2000). The relationship of alcohol safety laws to
drinking drivers in fatal crashes. Accident Analysis and Prevention,32(4), 483492.
Voas, R. B., Tippetts, A. S., Romano, E., Fisher, D. A., & Kelley-Baker, T. (2007). Alcohol in-
volvement in fatal crashes under thr ee crash exposure measures. TrafcInjury
Prevention,8(2), 107114.
Voas, R. B., Torres, P., Romano, E., & Lacey, J. H. (2012). Alcohol-related risk of driver fatalities:
An update using 2007 data. Journal of Studies on Alcohol and Drugs,73(3), 341350.
Wagenaar, A. C., & Toomey, T. L. (2002). Effects of minimum drinking age laws: Review
and analysesof the literature from 1960 to 2000. Journal of Studies on Alcohol,Supple-
ment No. 14,206225.
Wagenaar, A. C., Maldonado-Molina, M., Ma, L., Tobler, A., & Komro, K. (2007). Effects of
legal BAC limits on fatal crash involvement: Analyses of 28 states from 1976 through
2002. Journal of Safety Research,38,493499.
Wagenaar, A. C., Salois, M. J., & Komro, K. A. (2009). Effects of beverage alcohol price and
tax levels on drinking: A meta-analysis of 1003 estimates from 112 studies. Addiction,
Wilsnack, R. W., Wilsna ck, S. C., Kristjanson, A. F., Vogeltanz-Holm , N. D., & Gmel, G.
(2009). Gender and alcohol consumption: Patterns from the multinational GENACIS
project. Addiction,104(9), 14871500.
Eduardo Romano is a senior research scientist at PIRE in Calverton, MD. His past work in-
volved estimating the incidence and cost of national and state intentional and unintentional
injuries, and the evaluation of Mexican policies aimed to deter binge drinking by young
American visitors in Tijuana (Mexico). As a principal investigator (PI), he has participated
in efforts funded by the National Institutes of Health (NIH) to evaluate the involvement in
crash-risk situations of women and different minority groups; as well in a project funded
by the National Highway Trafc Safety Administration to study the involvement in trafcvi-
olations of recent immigrants to the United States.He is currently the PI in a NIH-funded pro-
ject looking at estimating alcohol-related and drug-related relative risks, and on an Ofce of
Juvenile Justice and Delinquency Prevention project to study the impact of alcohol-related
laws and policies on teens' impaired driving. Dr. Romano holds a Ph.D. in Agricultural and Ap-
plied Economics from the Virginia Polytechnic Institute and State University.
Michael Scherer is an associate research scientist and statistician at PIRE in Calverton, MD.
His research has focused primarily on the adverse impact of substance use and misuse on
outcomes such as motor vehicle crashes or DUI/DWI convictions. He is also interested in
the role of social networks, cognitive abilities and the personality factors and the role they
play in risk-taking behavior. His previous research focused on developing, implementing
and evaluating innovative methods in addressing substance use and the adverse impact it
has on people's lives. He has an M.S. in Rehabilitation Counseling from the Medical College
of Virginia and a Ph.D. in Counseling Psychology from Virginia Commonwealth University.
James C. Fell is a senior research scientist with the Pacic Institute for Research and Evalua-
tion (PIRE) in Calverton, MD. He recently completed research on the effectiveness of gradu-
ated driver licensing laws under a grant from the National Institute of Child Health and
Human Development (NICHHD), on enforcement intensity measures and impaired driving
on the roads for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and studies
on responsible beverage service, alcohol ignition interlock laws, high visibility enforcement
and alcohol monitoring devices on impaired driving of fenders for the National Highway Traf-
c Safety Administration (NHTSA). He is currently working on three grants from the NIAAA
studying the effects of various underage drinking laws on underage drinking and driving fatal
crashes, the length of administrative license suspens ion on impaired driving recidivism, and a
meta-analysis of the effectiveness of lowering blood alcohol concentration (BAC) limits for
driving to .08 and to .05. In addition, he is co-principal investigator on a large demonstration
project on high visibility enforcement of impaired driving for NHTSA.
Mr. Fell formerly worked at NHTSA from 1969 to 1999 and has 47 years of trafcsafetyand
alcohol research experience. He has both a Bachelor's and Master's degree in Human Factors
Engineering from the State University of New York at Buffalo. Mr. Fell is a member and cur-
rently Secretary-Elect of the International Council on Alcohol, Drugs, and Trafc Safety
(ICADTS), and a member of the Association for the Advancement of Automotive Medicine
(AAAM), the Research Society on Alcoholism (RSA), the Society for Prevention Research
(SPR) and the Human Factors and Ergonomics Society (HFES). He received the Widmark
Award from ICADTS in 2013 for outstanding, sustained and meritorious contribution to the
eld of alcohol, drugs and trafcsafety.
Eileen Taylor is a program director at PIRE in Calverton, MD. A former probation/parole
ofcer, Ms. Taylor has managed trafc safety research, evaluation and eld projects for
PIRE since 1988.Ms. Taylor holds a Master of Science Degree in Criminal Justice Adminis-
tration from American University, as well as a Bachelor's degree from the University of
221E. Romano et al. / Journal of Safety Research 55 (2015) 213221
... No Brasil, a combinação "álcool e direção" é a quinta maior responsável por causar graves acidentes no trânsito (IPEA, 2015a). No entanto, a idade mínima para beber, as campanhas educativas e as leis de "tolerância zero", juntas, contribuem para a redução do envolvimento de condutores alcoolizados com os ATTs (ROMANO et al., 2015). Entre as políticas públicas adotadas para coibir a prática do consumo de álcool seguido da condução de veículos, destacam-se o Código de Trânsito Brasileiro (CTB) e suas alterações: Lei nº 11.705/2008; Lei nº 12.760/2012, popularmente conhecida como "Lei de Tolerância Zero"; Lei nº 13.281/2016 e Lei nº 13.546/2017, que agravam as ...
... Sandoval et al. (2020) comentam que os brasileiros são influenciados por preços acessíveis na compra de bebidas alcoólicas e por aspectos intrinsicamente culturais. Além disso, Romano et al. (2015) dizem que uma solução para tal problema seria aumentar os custos do álcool e/ou minimizar a sua disponibilidade no mercado. Em Botsuana, na África, sete meses após a implantação de impostos sobre consumo de álcool, as taxas de ATT diminuíram 12% (WHO, 2018a). ...
... Niederdeppe, Avery e Miller (2017) reforçam que a preocupação quanto aos efeitos nocivos do consumo excessivo de álcool e aos problemas sociais que eles podem ocasionar será sempre centro de atenção e debate para governadores e a sociedade. A questão levantada por Romano et al. (2015) é que, sem uma compreensão clara das políticas públicas que melhor se adequam àquela comunidade, torna-se difícil priorizar a alocação de recursos para garantir os melhores resultados. Acrescente-se a isso que fatores políticos, geográficos, culturais e econômicos podem afetar tanto o consumo de álcool quanto a saúde da população (CASTILLO-MANZANO et al., 2017). ...
Full-text available
p class="HOLOS-ResumoeAbstract">O objetivo desse estudo foi analisar os impactos da Lei n. 11.705/2008, e suas alterações, em indicadores de acidentes de trânsito no estado do Rio Grande do Norte (RN). Trata-se de pesquisa predominantemente descritiva, do tipo documental, com coleta de dados realizada no sítio eletrônico da Polícia Rodoviária Federal (PRF), para o período de 2007 a 2018. Foram empregados gráficos de linha para analisar a tendência dos dados ao longo da série temporal, bem como gráficos de setores e de barras para situações e ajustes mais convenientes aos propósitos desse trabalho. Os resultados mostraram que tanto a Lei n. 11.705 (Lei Seca), quanto suas alterações, ao longo do período analisado, não foram suficientes para diminuir o número de vítimas de acidentes por embriaguez ao volante. Enquanto para os anos de vigência da Lei Seca ocorreu redução no número de Acidentes de Transporte Terrestre (ATT) envolvendo vítimas do álcool, os números de autuações foram sempre altos. Acredita-se que um trânsito mais seguro seria composto por uma relação indissociável de quatro elementos: leis, fiscalização, educação e punição.</p
... Regarding the impact of student traffic safety behavior and subjective norms, evidence shows that seat belt laws are effective in reducing RTIs in 15-20-year-old drivers (Romano et al., 2015). Adolescents whose parents monitor their behaviors are less likely to engage in dangerous traffic behaviors, such as not fastening a seat belt, using a cell phone, and drunk driving compared to their peers with lower parental monitoring (Ginsburg et al., 2009). ...
Full-text available
Road traffic injuries are public health challenges with heavy economic and social burdens. Road traffic injuries are common in developing countries and occur disproportionately with adolescents. This study aimed to elicit beliefs about traffic behaviors based on the theory of planned behavior among male high school students in Hamadan, Iran. We used a constructivist-interpretive qualitative design with directional content analysis. Interviews were conducted with 19 adolescent males in Hamadan, Iran. Analysis revealed that theory of planned behavior fit well to explain how perceptions, attitudes, and beliefs influenced traffic behaviors. Perceived subjective norms in the forms of parental encouragement, traffic rules and policies, and media advertising influenced the pursuit of safe traffic behaviors. Control belief factors that impeded safe behaviors included aggressive and/or drunk driving and bad road conditions, distance to bridge crossings, and improper seat belt position. Our results provided a deeper understanding of attitudes, experiences, and intentions that precede adolescents’ traffic behaviors. Understanding precursors to behaviors is necessary for effective intervention. Further exploration of factors that lead youth to engage in unsafe behaviors despite education, knowledge, and presence of influential people that promote safe traffic behaviors is needed.
... Voor jonge bestuurders (met andere woorden, zij die minder dan twee jaar over een rijbewijs beschikken) is er wetenschappelijke consensus dat het voor hen aangewezen is om de wettelijke limiet te verlagen tot 0,2 g/l (Macaluso, Theofilatos, Botteghi, & Ziakopoulos, 2017;Romano, Scherer, Fell, & Taylor, 2015). De rationale voor deze verlaging is gebaseerd op de kennis dat zij minder ervaring hebben in het verkeer en alcohol een groter effect heeft op hun rijgedrag (Keall, Frith, & Patterson, 2004;Peck, Gebers, Voas, & Romano, 2008). ...
Technical Report
Full-text available
Het rijden onder invloed van alcohol vormt een groot gevaar voor de verkeersveiligheid wereldwijd en dus ook in België (Meesmann, Vanhoe, & Opdenakker, 2017; SWOV, 2018). Een belangrijke vraag is hoe bestuurders die zich hieraan schuldig hebben gemaakt, kunnen ontraden dit gedrag opnieuw te vertonen. Naar straffen toe, kan er een onderscheid gemaakt worden tussen klassieke en alternatieve straffen. Beide methodes van straffen hebben als doel om toekomstig recidive tot een minimum te beperken. Een klassieke straf bestaat meestal uit het betalen van een geldboete en het opleggen van een rijverbod. Onder alternatieve straffen wordt, in dit rapport, een educatieve maatregel bedoeld. Bij zo een leermaatregel wordt, door een intense vorming, de bestuurder bewust gemaakt van de gevaren van zijn gedrag en krijgt handvaten aangereikt om dit gedrag in de toekomst niet meer te vertonen. Uit de resultaten van internationaal onderzoek blijkt dat het opleggen van een leermaatregel als alternatieve straf tot minder recidive leidt dan een klassieke straf. Hoewel er eveneens studies zijn met geen eenduidige resultaten of resultaten die in de tegenovergestelde richting wijzen. Uit een recente meta-analyse (Slootmans, Martensen, Kluppels, & Meesmann, 2017) blijkt het volgen van een dergelijke vorming de kans op recidive te verlagen. In België heeft Vias institute – het voormalige Belgische Instituut Voor de Verkeersveiligheid – een lange traditie bij het verzorgen van deze vormingen. In 2003 werd er voor de eerste keer een effectiviteitsstudie uitgevoerd waarbij recidive als uitkomstmaat gold. In deze studie werden bestuurders die een klassieke straf kregen opgelegd vergeleken met de bestuurders die een vorming hebben gevolgd (Vanlaar, Kluppels, Wiseur, & Goossens, 2003). Hoewel de resultaten niet significant van elkaar verschilden, was er een tendens zichtbaar dat de bestuurders die de vorming hebben gevolgd minder recidive kenden dan de andere bestuurders. Dit beeld komt ook naar voor in meer recente studies (Waeyaert, 2017). In de periode van 2003 tot 2019 is het aantal bestuurders die worden doorverwezen naar een vorming vervijfvoudigd en zijn de vormingen eveneens verder ontwikkeld. Om deze reden is het opportuun om anno 2019 de effectiviteit van deze vormingen opnieuw na te gaan, waarbij recidive de belangrijkste uitkomstmaat is. In de huidige studie zijn 606 bestuurders opgenomen die ofwel een klassieke of alternatieve straf kregen opgelegd tussen 2010 en 2014. Er werd voor alle bestuurders nagegaan of zij opnieuw zijn hervallen tot en met december 2017. Wanneer het percentage recidivisten in beide groepen vergeleken wordt aan het einde van de opvolgingsperiode, blijkt dat de bestuurders die de vorming gevolgd hebben 41% minder recidive vertonen in vergelijking met de klassiek gestraften. Voorts, is de tijd tot een volgend recidivefeit langer voor de bestuurders die de vorming hebben gevolgd. Aan de hand van een Cox regressieanalyse is gebleken dat de kans op recidive 2.63 kleiner is voor bestuurders die de vorming volgden in vergelijking met bestuurders die klassiek gestraft werden. De effecten van de vorming zijn meer uitgesproken voor vrouwen en bestuurders zonder strafblad (i.e., de zogenaamde first – offenders). Hierbij dient opgemerkt te worden dat in het geval dat bestuurders die de vorming hebben gevolgd hervallen, hun promillage hoger is dan het promillage van de bestuurders die een klassieke straf kregen opgelegd. De resultaten van deze studie liggen in lijn met internationale onderzoeksbevindingen. In verschillende internationale studies wordt aanbevolen om in de Driver Improvement vormingen de first offenders van de recidivisten te scheiden. In de huidige studie vinden we hier steun voor en om deze reden kan het opportuun zijn om hiermee rekening te houden bij de samenstelling van de groepen. Een beperking van deze studie is dat het geen experimentele opzet kent, hiermee wordt bedoeld dat er is gewerkt met reeds bestaande groepen bestuurders (naargelang welke straf is uitgesproken). De politierechter maakt een inschatting in iedere zaak of het opportuun kan zijn om de bestuurder een vorming te laten volgen of niet. Het kan dus zijn dat bestuurders met een bepaald profiel eerder naar de vorming worden doorverwezen (i.e., een zogenaamde selectiebias) en dat hierdoor de vorming bij uitstek al meer succesvol is. Om deze redenen zijn alle bestuurders in de controlegroep (i.e., zij die een klassieke straf kregen opgelegd) gematcht met de bestuurders uit de vorming op de belangrijkste criteria om voor de selectiebias te compenseren. Er is in deze studie eveneens getracht om profielen te destilleren teneinde na te gaan welke bestuurders het meest gebaat zijn bij welke straf. Hiervoor hebben we ons gebaseerd op de beschikbare informatie in het dossier. Helaas moeten we op basis van deze informatie vaststellen dat we geen eenduidige profielen hebben kunnen opstellen. Het geldt echter wel dat de effecten van de vorming meer uitgesproken zijn voor vrouwelijke bestuurders in vergelijking met mannelijke bestuurders. Eveneens geldt dat bestuurders zonder strafblad meer gebaat zijn bij het volgen van de vorming in vergelijking met bestuurders met strafblad. Wellicht kan de ontwikkeling van een instrument om beter in te schatten welke straf voor welke bestuurder het meest effectief is de doelstelling vormen van toekomstig onderzoek. Tot die tijd is het raadzaam bestuurders naar de vormingen te blijven doorverwijzen, in het bijzonder voor first offenders en vrouwen.
Full-text available
Introduction: The presence of passengers can affect the driving behavior of motor-vehicle operators. Child passengers present unique motivations to drive more safely, as well as opportunities to distract drivers. Because motor-vehicle crashes are an important cause of premature childhood mortality, this study assesses whether adult drivers with child passengers are more or less likely to cause a fatal crash. Method: Data include fatal crashes involving one or two vehicles from 2007 to 2017 in the U.S. Fatality Analysis Reporting System. We apply methods developed by Levitt and Porter (2001) and Dunn and Tefft (2020) -the LPDT approach- to estimate the risk that adult drivers (21 years or older) with at least one child passenger (15 year or younger) cause a fatal crash relative to adults without child passengers. Results: Childhood crash exposure when traveling with an adult driver is low: 0.78% of vehicle miles traveled by adults included a child passenger. Nevertheless, adult drivers with child passengers were significantly more likely to cause a fatal crash than adult drivers without child passengers. The estimated risk of causing a single-vehicle crash was 6.2 times higher among the full sample of adults, 7.2 times higher among female drivers, and 5.0 times higher among drivers 25-44 years old. Conclusions: Despite their relatively low crash exposure, child passengers are associated with much greater risk of causing a fatal crash. Practical applications: This study not only informs about the need to develop interventions to remind parents and adult drivers of the risks associated with driving children, but also reminds researchers about the enormous potential of the LPDT approach when applied to traffic safety issues.
Introduction: Time series models play an important role in monitoring and understanding the serial dynamics of road crash exposures, risks, outcomes, and safety performance indicators. The time-series methods applied in previous studies on crash time series analysis assume that the serial dependency decays rapidly or even exponentially. However, this assumption is violated in most cases because of the existence of long-memory properties in the crash time series data. Ignoring the long-memory dependency could result in biased understanding of the dynamics of road traffic crashes. Method: To fill this research gap, this study proposes an autoregressive fractionally integrated moving average model with generalized autoregressive conditional heteroscedasticity (ARFIMA-GARCH) to capture and accommodate the long-memory decencies in the road fatality rate time series. To further investigate how the factors influencing the fatality risks play a role in the long-memory dependence, the effects of exogenous variables are examined in this study. The analysis is conducted based on the road crash fatality data in Florida, USA over 44 years. Results' Conclusions: The case analysis confirmed the existence of long-memory property in the crash fatality time series data by both the joint tests of Augmented Dickey-Fuller and the Phillips-Perron, and the integer order of differencing (≤0.5) in the proposed models. The model results reveal that gasoline price and alcohol consumption per capita is positively associated with road fatality risks, whereas unemployment rate and rural/urban road mileage are negatively related to the road fatality risks. Practical applications: The significant influential factors are also found to account for the long-memory serial correlations between road traffic fatalities to some extent.
Introduction In 2007, the German legislature introduced a zero tolerance law (ZTL) for novice drivers to reduce the number of alcohol-related crashes. The purpose of our study was to evaluate the long-term effects of this law on current and former novice drivers. Method: Our approach was threefold: first, we used individual data of police records from 2003-2018 and conducted a cohort analysis to examine how the first cohort affected by the law responded in the long-term. Second, we analyzed the influence of the ZTL on alcohol-related traffic offenses by current novice drivers. Third, we conducted a survey to examine if the acceptance, knowledge, and behavior regarding the ZTL have changed compared to a decade ago. Results: The number of alcohol-related crashes was significantly lower in the first affected cohort than in earlier cohorts. Moreover, current novice drivers had lower levels of alcohol-related crashes and alcohol-related traffic offenses than did novice drivers before the ZTL became effective. The survey showed a high level of acceptance and knowledge in both current and first cohort and a decreased importance of drinking and driving. Conclusion: The ZTL is associated with a long-term increase of traffic safety in Germany. Former novice drivers appear to have retained learned behavior toward drinking and driving. Thus, the ZTL might have an impact on perceived norms resulting in less acceptance of drinking and driving. Changes in society, like lower alcohol consumption and decreased importance of passenger cars among young people, further accelerated these effects. Practical applications: ZTL for novice drivers are an effective way to improve traffic safety. It is associated with a positive effect on traffic safety even when drivers were no longer directly affected by the measure. These findings suggest that policies are an effective tool to improve traffic safety and help towards achieving Vision Zero.
Introduction Teen motor vehicle crash fatality rates differ by geographic location. Studies assessing teen transportation risk behaviors by location are inconclusive. Therefore, we explored the role of census region and metropolitan status for driving prevalence and four transportation risk behaviors among U.S. public high school students. Methods Data from 2015 and 2017 national Youth Risk Behavior Surveys were combined and analyzed. Multivariable models controlled for sex, age, race/ethnicity, grades in school, and school socioeconomic status. Results Overall, 41% of students did not always wear a seat belt. Students attending schools in the Northeast were 40% more likely than those in the Midwest to not always wear a seat belt. Among the 75% of students aged ≥16 years who had driven during the past 30 days, 47% texted/e-mailed while driving. Students in the Northeast were 20% less likely than those in the Midwest to text/e-mail while driving, and students attending suburban or town schools were more likely to text/e-mail while driving (20% and 30%, respectively) than students attending urban schools. Nineteen percent of students rode with a driver who had been drinking alcohol, and 7% of drivers aged ≥16 years drove when they had been drinking alcohol, with no significant differences by location for either alcohol-related behavior. Conclusions We found few differences in teen transportation risk behaviors by census region or metropolitan status. Age at licensure, time since licensure, driving experience, and the policy and physical driving environment might contribute more to variation in teen fatal crashes by location than differences in transportation risk behaviors. Regardless of location, teen transportation risk behaviors remain high. Future research could address developing effective strategies to reduce teen cell phone use while driving and enhancing community implementation of existing, effective strategies to improve seat belt use and reduce alcohol consumption and driving after drinking alcohol.
Background Teens who delay driving licensure may not be subject to graduated driver licensing restrictions that are known to reduce crash risk. We explored the association of delay in licensure with driving while impaired (DWI) and riding with an impaired driver (RWI) among emerging adults. Methods Data from the NEXT Generation Health Study, starting with 10th grade (2009‐2010), were analyzed using logistic regression. The outcome was Wave 7 (W7) self‐reported DWI and RWI as dichotomous variables. The independent variable was delay in licensure. Covariates included sex, urbanicity, race/ethnicity, family structure, parent education, family affluence, teen’s highest education, minimum legal drinking age laws, and onset age of alcohol use. Descriptive analysis and logistic regressions were conducted. Results Of 2525 participants eligible for licensure, 887 reported delay in licensure by 1‐2 years (38.9%, weighted) and 1078 by >2 years (30.3% weighted) across 7 waves. In W7, 23.5% (weighted and hereafter, 5.6% once, 17.8% ≥twice) of participants reported DWI and 32.42% (5.6% once, 25.4% ≥twice) reported RWI. Logistic regressions showed no overall significant association of delay in licensure with either W7 RWI or W7 DWI. However, in stratified analyses, among African American youth, delay in licensure was positively associated with DWI (OR=2.41, p=.03) and RWI (OR=2.72, p=.05). Among those with ≤ high school or lower education by W7, delayed licensure was positively associated with RWI (OR = 2.51, p < .01). Conclusions While in the overall sample, delayed licensure did not appear to be associated with DWI or RWI, our findings suggest that delayed licensure may be of concern to teen risk of DWI and RWI among African Americans and among those with lower educational attainment. Furthermore, as two‐thirds of youth delayed licensure, more research is needed to determine if this is more of a positive (i.e., protective) factor by reducing their exposure to crash risk or a negative (i.e., risk) factor due to missing important driver‐safety stages of graduated driver licensing.
Full-text available
The effectiveness of the zero tolerance law for novice drivers in Germany, which has been in force since 01/08/2007, was evaluated for the first time shortly after its introduction (HOLTE, ASSING, PÖPPEL-DECKER & SCHÖNEBECK, 2010). The results showed a significant decrease of alcohol-related accidents and alco-hol-related traffic offences as well as a high acceptance of the law in the target group of novice drivers. The present re-evaluation sought to investigate the long-term effects of the zero tolerance law to assess whether the law - besides a direct impact of reducing DUI of novice drivers – had a socialising effect to such degree that novice drivers who are accustomed to separate drinking and driving maintain this be-haviour in their further driving career even though they are not subject to the zero tolerance law any-more. For this purpose, long-term effects on alcohol-related accidents and alcohol-related traffic offences were analysed using data of the official road accident statistics and the Register of Driver Fitness. Additionally, a representative survey was conducted to determine knowledge, attitudes and behavioural intentions to-wards the zero tolerance law. According to the analysis of the accident data, (former) novice drivers of the first cohort affected by the zero tolerance law were also in the long-term less frequently involved in alcohol-related accidents than comparison groups. Thus, alcohol-related accidents did not only decrease during the period drivers were subject to the regulation, but they also developed better than comparison groups afterwards. Further-more, the share of DUI has decreased significantly more in the group of novice drivers than in the group of experienced drivers during the past eleven years since the introduction of the law. This result was con-firmed by the analysis of alcohol-related traffic offences: The number of offences for novice drivers de-clined disproportionately compared to older and more experienced drivers in the considered period. Acceptance of the zero tolerance law was very high in the group of novice drivers and even increased compared to the first evaluation. For former novice drivers who belonged to the first cohort subject to the zero tolerance law, the acceptance rate was even higher than in the evaluation in 2010 indicating that the zero tolerance law is still deemed to be important in the long term also by those who are not affected by this regulation anymore. Compared to the first evaluation, alcohol consumption and car driving both appeared to be less important for the present novice drivers than it was in 2008. The same held true for the respondents belonging to the first cohort of drivers under the zero tolerance law who are now experienced drivers. These two de-velopments seem to display long-term societal trends that might support effectiveness and acceptance of the zero tolerance law for novice drivers. Conclusively, the results of the present re-evaluation proved a lasting effectiveness of the zero tolerance law for novice drivers. The positive development of alcohol-related accidents and alcohol-related traffic offences as well as further increased acceptance provided clear evidence that the zero tolerance law for novice drivers contributed to traffic safety in a long-term perspective. The law had effects not only on the primary „target group“ of novice drivers, but also on drivers in the subsequent years when the law does not apply to them anymore. Therefore, acceptance and compliance to this effective measure should be kept up and riskiness and non-tolerance of DUI should be further addressed in driver training, road safety education and awareness and information campaigns.
Full-text available
Objective: The goal of this article is to review critically the extant minimum legal drinking age (MLDA) research literature and summarize the current state of knowledge regarding the effectiveness of this policy. Method: Comprehensive searches of four databases were conducted to identify empirical studies of the MLDA published from 1960 to 1999. Three variables were coded for each study regarding methodological quality: (1) sampling design, (2) study design and (3) presence or absence of comparison group. Results: We identified 241 empirical analyses of the MLDA. Fifty-six percent of the analyses met our criteria for high methodological quality. Of the 33 higher quality studies of MLDA and alcohol consumption, 11 (33%) found an inverse relationship; only 1 found the opposite. Similarly, of the 79 higher quality analyses of MLDA and traffic crashes, 46 (58%) found a higher MLDA related to decreased traffic crashes; none found the opposite. Eight of the 23 analyses of other problems found a higher MLDA associated with reduced problems; none found the opposite. Only 6 of the 64 college-specific studies (9%) were of high quality; none found a significant relationship between the MLDA and outcome measures. Conclusions: The preponderance of evidence indicates there is an inverse relationship between the MLDA and two outcome measures: alcohol consumption and traffic crashes. The quality of the studies of specific populations such as college students is poor, preventing any conclusions that the effects of MLDA might differ for such special populations.
Full-text available
Full-text available
Objective: The public generally assumes that the minimum legal drinking age of 21 (MLDA-21) legislation in the United States is embodied in a single law and therefore all states have the same law. Actually, the MLDA-21 state laws consist of multiple provisions that support the core MLDA-21 laws and include a family of policies directed at controlling underage drinking and underage drinking and driving. Because social host and fake identification laws have recently garnered interest by policy makers in the states, this study was designed to determine their effectiveness. Methods: The effective dates for 2 types of social host laws and 3 fake identification laws were documented using the Alcohol Policy Information System (APIS), the Substance Abuse and Mental Health Services Administration's (SAMHSA) 2011 Report to Congress on the Prevention and Reduction of Underage Drinking, and legal research tools. These laws include social host prohibitions (SHPs) and social host civil liability (SHCL), the use of fake identification (FID), retailer support for FID, and transfer/production of FID. We used a pre-post design to evaluate the influence on underage drinking-and-driving fatal crashes of these 5 laws using the Fatality Analysis Reporting System (FARS) data set for the years 1982 through 2010. The data were analyzed using structural equation modeling (SEM) controlling for as many variables as possible. Results: For those drivers younger than aged 21 years, FID supplier laws were associated with significant decreases in FARS ratios after states adopted these laws (-1.0%, P=.030). Conclusions: The 24 states that have adopted FID supplier laws are saving an estimated 14 lives per year in the United States. An additional 16 lives could be saved if the remaining states adopted this law. FID supplier laws prohibit the production of a FID or transfer of an ID or FID to another person. The more stringent the law (i.e., whether a state prohibits only one element [weaker law] compared to both transferring and manufacturing a FID [stronger]) the more effective a deterrent it becomes to supplying a minor with a FID. States without FID supplier laws should consider adopting them.
Minimum legal drinking age (MLDA) laws provide an example of how scientific research can support effective public policies. Between 1970 and 1975, 29 States lowered their MLDA's; subsequently, scientists found that traffic crashes increased significantly among teenagers. Alcohol use among youth is related to many problems, including traffic crashes, drownings, vandalism, assaults, homicides, suicides, teenage pregnancies, and sexually transmitted diseases. Research has demonstrated the effectiveness of a higher MLDA in preventing injuries and deaths among youth. Despite laws prohibiting the sale or provision of alcohol to people under age 21, minors can easily obtain alcohol from many sources. Increased MLDA enforcement levels and deterrents for adults who might sell or provide alcohol to minors can help prevent additional injuries and deaths among youth.
Several studies have examined the impact of a number of minimum legal drinking age 21 (MLDA-21) laws on underage alcohol consumption and alcohol-related crashes in the United States. These studies have contributed to our understanding of how alcohol control laws affect drinking and driving among those who are under age 21. However, much of the extant literature examining underage drinking laws uses a “Law/No law” coding, which may obscure the variability inherent in each law. Previous literature has demonstrated that inclusion of law strengths may affect outcomes and overall data fit when compared to “Law/No law” coding. In an effort to assess the relative strength of states' underage drinking legislation, a coding system was developed in 2006 and applied to 16 MLDA-21 laws. The current article updates the previous endeavor and outlines a detailed strength coding mechanism for the current 20 MLDA-21 laws.
Purpose: Although previous studies have suggested that greater community densities of alcohol sales outlets are associated with greater alcohol use and problems, the mechanisms are unclear. The present study examined whether density was associated with increased purchasing of alcohol by adolescents younger than the legal purchase age of 18 in Australia. Methods: The number of alcohol outlets per 10,000 population was identified within geographic regions in Victoria, Australia. A state-representative student survey (N = 10,143) identified adolescent reports of purchasing alcohol, and multilevel modeling was then used to predict the effects for different densities of outlet types (packaged, club, on-premise, general, and overall). Results: Each extra sales outlet per 10,000 population was associated with a significant increase in the risk of underage adolescent purchasing. The strongest effect was for club density (odds ratio = 1.22) and packaged (takeaway) outlet density (odds ratio = 1.12). Males, older children, smokers, and those with substance-using friends were more likely to purchase alcohol. Conclusions: One mechanism by which alcohol sales outlet density may influence population rates of alcohol use and related problems is through increasing the illegal underage purchasing of alcohol.