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Concept: Remove Intoxicated Drivers


Insufficient sleep is common among high school students and has been associated with an increased risk for motor vehicle crashes (1), sports injuries (2), and occupational injuries (3). To evaluate the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among U.S. high school students, CDC analyzed data from 50,370 high school students (grades 9-12) who participated in the national Youth Risk Behavior Surveys (YRBSs) in 2007, 2009, 2011, or 2013. The likelihood of each of the five risk behaviors was significantly higher for students who reported sleeping ≤7 hours on an average school night; infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students who reported sleeping ≥10 hours compared with 9 hours on an average school night. Although insufficient sleep directly contributes to injury risk, some of the increased risk associated with insufficient sleep might be caused by engaging in injury-related risk behaviors. Intervention efforts aimed at these behaviors might help reduce injuries resulting from sleepiness, as well as provide opportunities for increasing awareness of the importance of sleep.

Concepts: Sleep, Injuries, High school, Somnolence, Driver's license, Automobile, Helmet, Remove Intoxicated Drivers


To examine the association between driving while alcohol/drug impaired (DWI) and the timing and amount of exposure to others' alcohol/drug-impaired driving (riding while impaired [RWI]) and driving licensure timing among teenage drivers.

Concepts: The Association, Driving under the influence, Drunk driving, Driver's license, Remove Intoxicated Drivers, Device driver


We tested the generalizability of a science-based community prevention design to reduce DUI crashes. Previous researcher-led studies have confirmed the effects of an intervention design of visible enforcement coupled with heightened public awareness of enforcement to increase driver perception of likely detection for drinking and driving. A community coalition based the project on a prevention intervention model that included two key intermediate variables: levels of visible enforcement and of public awareness of enforcement. We evaluated the project using community-specific monthly time-series measures of DUI crashes and state level trends in DUI crashes, indicators of enforcement, and public attention to enforcement. We devised the evaluation design to determine if an observed trend in DUI crashes declined and to verify if key intermediate variables increased, as stimulated by local efforts. DUI crash analysis documented an upward trend during a pre-trial period from July 2010-December 2011, which matched the upward trend in state DUI crashes. After the local intervention began in January 2012, local DUI crashes began a clear downward trend (average 2013 crashes were 23% lower than in 2012 and a 5-month post-intervention average from 2013 was lower than the equivalent 5-month pre-intervention average). This contrasted with the continued upward state DUI crash trend, with a 2-year increase of 16%. The downward trend in local crashes was associated with an increase in DUI enforcement as well as news stories concerning DUI enforcement that were stimulated by the efforts of the community prevention project. These results confirm the generalizability of two previous community research trials that were conducted with limited or no research resources or leadership. We discuss the importance of controlling for external factors in attributing causation in a local prevention evaluation by confirming both sufficient local prevention efforts and a decline in DUI crashes.

Concepts: Criminal law, Driving under the influence, Confirmation, Remove Intoxicated Drivers


In many jurisdictions, a risk assessment following a first driving while impaired (DWI) offence is used to guide administrative decision making regarding driver relicensing. Decision error in this process has important consequences for public security on one hand, and the social and economic well being of drivers on the other. Decision theory posits that consideration of the costs and benefits of decision error is needed, and in the public health context, this should include community attitudes. The objective of the present study was to clarify whether Canadians prefer decision error that: i) better protects the public (i.e., false positives); or ii) better protects the offender (i.e., false negatives).

Concepts: Decision making, Risk, Decision theory, Criminal law, Statistical hypothesis testing, Driving under the influence, Optimal decision, Remove Intoxicated Drivers


Addressing drinking and driving remains a challenge in the U.S. The present study aims to provide feedback on DUI in California by assessing if drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; if this is through perceptions that one can get arrested for this behavior; and if this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home).

Concepts: Crime, Criminal law, Alcoholic beverage, Arrest, Remove Intoxicated Drivers, Law enforcement agency powers


Objective In Sweden, a joint action method called SMADIT is in use, where the police quickly offer help from the social services or the dependency care and treatment service to suspected drink drivers. The objective of this paper is to analyse the experiences of suspected drink drivers who accepted the offer of help, and what it meant for them. The knowledge can be used to improve procedures and consultations. Furthermore, it can allow the basic premises of the method to be examined, for example the importance of offering help quickly. Methods To enable comparisons over time, in-depth interviews were conducted with twelve suspected drink drivers on two occasions with one year between. Results To varying degrees the informants knew about their alcohol problems, but were unsure if they would have sought help by themselves. Therefore, the original ideas of the method with an initial contact with the social services or the dependency care and treatment service within 24 hours, was found to be important. However, the results also showed that some of the informants needed some time before the first meeting as they were in shock from the drink driving incident or in need of sleep. Therefore, the drink driver’s situation and individual wishes always have to be considered. The paper also shows that an encouraging attitude among the police, the social services, and the dependency care and treatment service is important for the success of the SMADIT method. The informants are satisfied with the method, and in retrospect the incident and the SMADIT offer of help are described as a turning point in their lives. One year after being offered help the informants were no longer focused solely on the personal consequences of drink driving, as they were shortly after the incident. Instead they had gained insights into the harm they could have done to other road users when they drove while drunk. Conclusions One conclusion from this paper is that SMADIT, as an innovative method that can be deployed more rapidly than other alcohol-impaired driving countermeasures, should be considered as a good complement to conventional methods to deal with drink driving. Based on the results we recommend a trial of the joint action method against drink driving in other jurisdictions.

Concepts: English-language films, Criminal law, Alcoholic beverage, Driving under the influence, American films, Remove Intoxicated Drivers


Issue addressed: Alcohol-related road crashes are a leading cause of the injury burden experienced by Indigenous Australians. Existing drink driving programs are primarily designed for the mainstream population. The ‘Hero to Healing’ program was specifically developed with Indigenous communities and is underpinned by the Community Reinforcement Approach (CRA). This paper reports on the formative evaluation of the program from delivery in two Far North Queensland communities.Methods: Focus groups and semistructured interviews were conducted with drink driver participants (n = 17) and other Elders and community members (n = 8) after each program. Qualitative content analysis was used to categorise the transcripts.Results: The CRA appealed to participants because of its flexible nature and encouragement of rearranging lifestyle factors, without specific focus on alcohol use. Participants readily identified with the social and peer-related risk and protective factors discussed. Cofacilitation of the program with Elders was identified as a key aspect of the program. More in-depth discussion about cannabis and driving, anger management skills and relationship issues are recommended.Conclusions: Participants' recognition of content reinforced earlier project results, particularly the use of kinship pressure to motivate younger family members to drink drive. Study findings suggest that the principles of the CRA are useful; however, some amendments to the CRA components and program content were necessary.So what?: Treating drink driving in regional and remote Indigenous Australian communities as a community and social issue, rather than an individual phenomenon, is likely to lead to a reduction in the number of road-related injuries Indigenous people experience.

Concepts: Australia, Alcoholic beverage, Driving under the influence, Indigenous Australians, Queensland, Indigenous peoples, Torres Strait Islanders, Remove Intoxicated Drivers


Driving while intoxicated (DWI) is a significant public health issue. The likelihood someone will intervene to prevent DWI is affected by the characteristics of the individuals and the context of the potential driving scenario. Understanding such contexts may help tailor public health messages to promote intervening from those who are nearby to an intoxicated driver.

Concepts: Public health, Driving under the influence, Drunk driving, Remove Intoxicated Drivers


Objective Outcomes from previous studies report the driving under the influence (DUI) conviction rates for trauma patients in several cities within Canada and the United States over the last two decades. This study reports charge, conviction, and prosecution rates for trauma patients at two level-1 trauma centers servicing a large metropolitan city. Methods A retrospective review of the trauma databases were completed to identify patients meeting inclusion criteria. Four hundred sixty patients were identified and their records were compared with the District Attorney’s records for DUI charges and convictions.Results The conviction rate for this study was 8.7%, demonstrating continued low rates of conviction despite growing interest and public awareness of drinking and driving. Conclusions We discuss legal considerations that providers should consider when treating patients who have been drinking and driving.

Concepts: Hospital, United States, City, Driving under the influence, Physical trauma, Trauma center, Metropolitan area, Remove Intoxicated Drivers


In recent years, increasing attention has been paid to the issue of driving under the influence of alcohol (DUI), especially among young people. The aims of the present study were (1) to analyse the trends of DUI, riding with a driver under influence of alcohol (RWDUI) and alcohol-related road crashes (A-rC) in a nationally representative sample of students in the period 2007-2013, (2) to assess how different drinking patterns were associated with DUI and RWDUI, (3) to evaluate other influential factors (such as gender, older siblings' and friends' behaviour with alcohol) on DUI and RWDUI. Data were drawn from the cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) carried out annually in Italy. The sample size ranged from 25,555 to 40,390 students (15-19 years old). Results were stratified for students <18 years and ≥18 years old. Although a significant decreasing trend for alcohol consumption was observed only in the younger group, a significant decrease in DUI [APC (annual percent change) -9.7 in the younger and -6.4 in the older group] and in RWDUI (APC -6.7 in the younger and -4.8 in the older group) was detected. A significant decreasing trend of A-rC was observed only in the older group (APC -3.4). Three specific drinking patterns were identified: "Drinking to Excess" (DE), "Drinking with Intoxication" (DI) and "Drinking but Not to Excess" (DNE). In both age groups, the DE pattern significantly increased the likelihood of DUI, whereas the DI pattern was negatively associated, and the DNE pattern was not associated. Different results were found for RWDUI: the DE and DI patterns where significantly associated with RWDUI, whereas the DNE pattern was negatively associated. Overall, illegal substance use, parental monitoring, peers' and siblings' influence were associated with DUI and RWDUI. The change in behaviour towards DUI and RWDUI suggests a cumulative effectiveness of current alcohol policies, although further actions (greater attention to social context, law enforcement, and promotion of good practice) are needed to substantially reduce alcohol-related crashes.

Concepts: Sample, Sample size, Sampling, Alcoholic beverage, Driving under the influence, Drinking culture, Illegal drug trade, Remove Intoxicated Drivers