Abstract
BackgroundGlobally, about 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder. Alcohol use while driving is a major contributor to road traffic injuries (RTI). We need to understand the culture and perception of drink-driving in this setting to understand why people continue to drink drive and allow policymakers to develop more effective ways to address drink-driving behavior. This study aims to qualitatively determine what injury patients, their families, and community advisory board members in Tanzania believe about drink-driving to help inform policies to address this problem.MethodsThe semi-structured focus group was designed based on the grounded theory and assessed using thematic analysis. Focus groups participants were a convenience sample of injury patients, their families, and community advisory board (CAB) members. Analysis was iterative throughout the study. All transcripts were coded using a thematic narrative approach. Representative quotes for each theme were then selected based on comparative analysis of coding with input from research team members.ResultsA total of ten focus groups were conducted (4 patient, 4 family, and 2 CAB) with a total of 104 participants (37 females and 67 males). The normalization of drinking among drivers has allowed this behavior to become ingrained in the culture. Participants expressed notions that passengers are responsible for their own safety, rather than drivers being responsible for their passengers. Most participants believe it is a citizen’s duty to inform the police of suspected drink-driving, however there were differing opinions about how effective informed police officers can be in practice. Focus group discussions between all three population types highlighted major themes of ‘drinking is ingrained in boda boda driver culture’, ‘individuals have a personal responsibility to address drink-driving’, and a ‘police enforcement on drink-driving is necessary’.ConclusionsNormalization of drink-driving in commercial driver culture creates a dangerous environment for passengers which can be mitigated by education and health promotion. As most passengers already take personal responsibility for their own road traffic safety, they may be likely to make use of safe ride options, if available. While legislation is in place against drink-driving, police officers need to be empowered with appropriate training and funding to enforce them.
Highlights
About 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder [1]
Participants expressed notions that passengers are responsible for their own safety, rather than drivers being responsible for their passengers
Types highlighted major themes of ‘drinking is ingrained in boda boda driver culture’, ‘individuals have a personal responsibility to address drink-driving’, and a ‘police enforcement on drink-driving is necessary’
Summary
About 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder [1]. Alcohol use is the fifth leading risk factor for all disease and injury worldwide [2]. Road traffic injuries (RTIs) alone accounted for the most alcohol-attributable deaths in 2016 [1]. Those who drink while driving have 3.8 times greater risk of injury and fatality [3]. Laws related to alcohol use while driving must be firmly enforced in order to be effective at reducing alcohol-attributable RTIs [5,6]. High rates of alcohol attributable RTIs in many countries indicate that they either do not have proper policies in place, or they are not being implemented and enforced strongly enough [1]. The effectiveness of overall enforcement of national drink-driving laws is rated a 2 on a scale of 0–10 [8]
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