Blood Alcohol Concentration Laws Research Articles

The relationship between alcohol availability and drink-driving policies and admissions to substance use disorder treatment during pregnancy.

Pregnancy-specific alcohol policies are widely adopted yet have limited effectiveness and established risks. It is unknown whether general population alcohol policies are effective during pregnancy. This study investigated associations between general population policies and alcohol treatment admission rates for pregnant people specifically. Data are from the Treatment Episodes Data Set: Admissions and state-level policy data for 1992-2019 (n=1,331 state-years). The primary outcome was treatment admissions where alcohol was the primary substance, and the secondary outcome included admissions where alcohol was any substance. There were five policy predictors: 1) Government spirits monopoly, 2) Ban on Sunday sales, 3) Grocery store sales, 4) Gas station sales, and 5) Blood alcohol concentration (BAC) laws. Covariates included poverty, unemployment, per capita cigarette consumption, state and year fixed effects, and state-specific time trends. In models with alcohol as the primary substance, prohibiting spirits sales in grocery stores (vs. allowing heavy beer and spirits) had lower treatment admission rates [IRR=0.88, 95% CI: 0.78-0.99, p=0.028]. States with BAC laws at 0.10% (vs. no law) had higher treatment admission rates [IRR=1.24, 95% CI: 1.08-1.43, p=0.003]. When alcohol was any substance, prohibiting spirits sales in grocery stores (vs. allowing heavy beer and spirits) was again associated with lower treatment admission rates [IRR=0.89, 95% CI: 0.80-0.98, p=0.021], but there was no association for BAC laws. Restrictions on grocery store spirits sales and BAC laws were associated with lower and higher alcohol treatment admission rates among pregnant people, respectively, suggesting general population alcohol policies are relevant for pregnant people's treatment utilization.

The impact of state laws on motor vehicle fatality rates, 1999-2015.

Motor vehicle crash (MVC) fatalities have been declining while states passed various legislation targeting driver behaviors. This study assesses the impact of state laws on MVC fatality rates to determine which laws were effective. Publically available data were collected on driver-related motor vehicle laws, law strengths, enactment years, and numbers of verified-trauma centers. Prospective data on crash characteristics and MVC fatalities 16 years or older from Fatality Analysis Reporting System 1999 to 2015 (n = 850) were obtained. Generalize Linear Autoregressive Modeling was used to assess the relative contribution of state laws to the crude MVC fatality rate while controlling for other factors. Lowering the minimum blood alcohol content (BAC) was associated with largest declines for all ages, especially the older cohorts: 16 years to 20 years (B = 0.23; p < 0.001), 21 years to 55 years (B = 1.7; p < 0.001); 56 years to 65 years (B = 3.2; p < 0.001); older than 65 years (B = 4.1; p < 0.001). Other driving under the influence laws were also significant. Per se BAC laws accompanying a reduced BAC further contributed to declines in crude fatality rates: 21 years to 55 years (B = -0.13; p < 0.001); older than 65 years (B = -0.17; p < 0.05). Driving under the influence laws enhancing the penalties, making revocation automatic, or targeting social hosts had mixed effects by age. Increased enforcement, mandatory education, vehicle impoundment, interlock devices, and underage alcohol laws showed no association with declining mortality rates. Red light camera and seatbelt laws were associated with declines in mortality rates for all ages except for older than 65 years cohort, but speed camera laws had no effect. Graduated Driver License laws were associated with declines for 16 years to 21 years (B = -0.06; p < 0.001) only. Laws targeting specific risks (elderly, motorcycles, marijuana) showed no effect on declining MVC mortality rates during the study period. States have passed a wide variety of laws with varying effectiveness. A few key laws, specifically laws lowering allowable BAC, implementing red light cameras, and mandating seatbelt use significantly reduced MVC mortality rates from 1999 to 2015. Simply adding more laws/penalties may not equate directly to lives saved. Continued research on state laws will better inform policy makers to meet evolving public health needs in the management of MVC fatalities. Epidemiological, Level III.

Effectiveness of lowering the blood alcohol concentration (BAC) limit for driving from 0.10 to 0.08 grams per deciliter in the United States

Objective: The current study evaluates of the effects of lowering the blood alcohol concentration (BAC) limit from 0.10 to 0.08 g/dL across all 50 states in the United States. Our objectives were to (1) estimate the effects of the 0.08 g/dL BAC limit on drinking driver fatal crash rates; (2) compare the effects from early-adopting states to the effects of late-adopting states; (3) determine the effects on drivers with low BACs (0.01–0.07 g/dL) and high BACs (0.08+ g/dL); and (4) estimate the lives saved since 1983 due to the adoption of 0.08 g/dL BAC laws.Methods: Our study examined annual data from the Fatality Analysis Reporting System (FARS) for each jurisdiction from 1982 through 2014. Our basic outcome measure was the ratio of drinking drivers (BAC ≥0.01 g/dL) to nondrinking drivers (BAC = 0.00 g/dL). Covariates included 0.10 BAC laws, administrative license revocation (ALR) laws, seat belt laws, minimum legal drinking age (MLDA) laws, and unemployment rates. We utilized autoregressive integrated moving average (ARIMA) models for each state, where the implementation date of the law was modeled as a zero-order transfer function in the series, in addition to any extant trends that may have been occurring simultaneously. Before determining the specific impact of the implementation of 0.08 g/dL BAC laws, we conducted a time series analysis for each state. We tested for between-state mediating factors relating to our covariates.Results: A total of 38 of the 51 jurisdictions showed that lowering the BAC limit was associated with reduced drinking driver fatal crash ratios, with 20 of those reductions being significant. The total effects showed a 10.4% reduction in annual drinking driver fatal crash rates, which is estimated to have saved an average of 1,736 lives each year between 1983 and 2014 and 24,868 lives in total. Implementing a BAC limit of 0.08 g/dL had significant impacts on both high- and low-BAC fatal crash ratios. Though early-adopting jurisdictions (1983–1999) demonstrated a larger decrease in fatal drinking driver crash ratios than did late-adopting jurisdictions (2000–2005), the results were not statistically significant (P > .05).Conclusions: Our study of the effects of lowering the BAC from 0.10 to 0.08 g/dL in the United States from 1982 to 2014 showed an overall effect of 10.4% on annual drinking driver fatal crash rates, in line with other multistate studies. This research provides strong evidence of the relationship between lowering the BAC limit for driving and the general deterrent effect on impaired-driving fatal crash rates.

The Problem of “Driving while Stoned” Demands an Aggressive Public Policy Response

Abstract Mark A.R. Kleiman and his colleagues (hereafter Kleiman) have done the public a service by highlighting the problem of “driving while stoned.” Drug-impaired driving is a serious national problem. Numerous drugs other than alcohol, whether legal or illegal—such as opioids, cocaine, tranquilizers, sleep aids, hallucinogens, and marijuana—degrade driving performance and increase the risk of highway morbidity and mortality. Other than alcohol, marijuana is the biggest problem because it is the most commonly used drug, and its use is increasing, given marijuana legalization. Two facts aggravate that problem: (1) marijuana is often combined with alcohol and (2) a marijuana-alcohol cocktail has an enhanced debilitating effect on safe motor vehicle handling. As the U.S. Office of National Drug Control Policy has noted, driving while impaired is a major public health problem. Kleiman is correct that identifying impairment attributable to substances other than alcohol is a difficult problem. Two twentieth century developments helped society reduce the number of alcohol-related crashes, injuries, and deaths: the passage of 0.08 g/dL blood-alcohol content laws, and the development of reliable, easily operated, hand-held Breathalyzers for roadside use. Unfortunately, we cannot successfully use that approach for impairing drugs other than alcohol. We do not know what amount of THC impairs a majority of drivers. In any event, we do not have a measurement device comparable to a Breathalyzer. Kleiman argues that, given those enforcement problems, we should use only administrative measures to penalize marijuana-impaired driving. I think that there is room for the criminal justice system. People who use marijuana and drive put others at risk of injury or death. Just as legislatures can force a factory to bear the risk of pollution-related injury, so too can a legislature force marijuana users to internalize any costs of their drug use. If you use marijuana, don’t drive for at least eight hours. Use public transportation. Take a cab. Call Uber. Walk. Ask a friend for a lift. Or just remain where you are. No one has a constitutional right to drink alcohol, to smoke marijuana, or to drive an automobile. Society hardly asks too much of its citizens to demand that they not do all three simultaneously or to delay driving for eight hours after either of the first two activities. That is not all. States should test every driver involved in a crash, particularly one involving a fatality, not only for alcohol but also for legal and illegal impairing drugs. Moreover, all 50 states fix 21 as the minimum drinking age and the minimum age for recreational marijuana use. Whatever administrative penalty the states impose for underage drinking and driving—such as license suspension—should apply as well to everyone under that age who tests positive for any illegal drug use. States should also report on a regular basis the data regarding motorists’ use of impairing drugs, including marijuana. There is also room for Congress to act. Because U.S. highways are arteries of interstate commerce, Congress can protect their use by commercial and non-commercial drivers alike by preventing interstate highways from being used by drivers who increase the morbidity and mortality risks of others. Congress can demand that the states use a portion of their federal highways funds to adopt safety or information-gathering measures like the ones suggested above. At a minimum, Congress should force states to fund the cost of learning what their marijuana legalization measures have wrought.

Federal actions to incentivise state adoption of 0.08 g/dL blood alcohol concentration laws.

To model rates of 0.08 g/dL blood alcohol concentration (BAC) per se law implementation among the states associated with (1) a federal incentive grant programme and (2) a threat from the federal government to withhold highway transportation funds. An observational study of state-level 0.08 g/dL BAC per se law enactment among all 50 US states from 1982 to 2006 using a parametric survival analysis to assess the time-dependent risk of policy enactment. The federal government's threat to withhold transportation funds was associated with a 10.30 times greater hazard (HR: 10.30, 95% CI 3.88 to 27.36) of states adopting a 0.08 g/dL BAC law compared with periods of time when this threat was not in place. The incentive grant programme created by the federal government was associated with a non-significant 17% decrease in the hazard of states adopting a 0.08 g/dL BAC law (HR: 0.83, 95% CI 0.35 to 2.0). In the case of 0.08 g/dL BAC per se laws, the federal government's threat to withhold transportation funds was effective at accelerating policy adoption.

The Predictive Influence of Youth Assets on Drinking and Driving Behaviors in Adolescence and Young Adulthood.

Drinking and driving among adolescents and young adults remains a significant public health burden. Etiological research is needed to inform the development and selection of preventive interventions that might reduce alcohol-involved crashes and their tragic consequences. Youth assets-that is, skills, competencies, relationships, and opportunities-can help youth overcome challenges, successfully transition into adulthood, and reduce problem behavior. We examined the predictive influence of individual, relationship, and community assets on drinking and driving (DD) and riding with a drinking driver (RDD). We assessed prospective relationships through analysis of data from the Youth Assets Study, a community-based longitudinal study of socio-demographically diverse youth. Results from calculation of marginal models using a Generalized Estimating Equation approach revealed that parent and peer relationship and school connectedness assets reduced the likelihood of both drinking and driving and riding with a drinking driver approximately 1year later. The most important and consistent asset that influenced DD and RDD over time was parental monitoring, highlighting the role of parental influence extending beyond the immediate teen driving context into young adulthood. Parenting-focused interventions could influence factors that place youth at risk for injury from DD to RDD, complementing other evidence-based strategies such as school-based instructional programs and zero tolerance Blood Alcohol Concentration laws for young and inexperienced drivers.

Alcohol-Impaired Driving Among Adults - United States, 2012.

Alcohol-impaired driving crashes account for approximately one third of all crash fatalities in the United States. In 2013, 10,076 persons died in crashes in which at least one driver had a blood alcohol concentration (BAC) ≥0.08 grams per deciliter (g/dL), the legal limit for adult drivers in the United States. To estimate the prevalence, number of episodes, and annual rate of alcohol-impaired driving, CDC analyzed self-reported data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) survey. An estimated 4.2 million adults reported at least one alcohol-impaired driving episode in the preceding 30 days, resulting in an estimated 121 million episodes and a national rate of 505 episodes per 1,000 population annually. Alcohol-impaired driving rates varied by more than fourfold among states, and were highest in the Midwest U.S. Census region. Men accounted for 80% of episodes, with young men aged 21-34 years accounting for 32% of all episodes. Additionally, 85% of alcohol-impaired driving episodes were reported by persons who also reported binge drinking, and the 4% of the adult population who reported binge drinking at least four times per month accounted for 61% of all alcohol-impaired driving episodes. Effective strategies to reduce alcohol-impaired driving include publicized sobriety checkpoints, enforcement of 0.08 g/dL BAC laws, requiring alcohol ignition interlocks for everyone convicted of driving while intoxicated, and increasing alcohol taxes.

Effects of introducing an administrative .05% blood alcohol concentration limit on law enforcement patterns and alcohol-related collisions in Canada

Except for Quebec, all Canadian provinces have introduced administrative laws to lower the permitted blood alcohol concentration (BAC) to .05% or .04% for driving—or having the care of—a motor vehicle. Using linear mixed effects models for longitudinal data, this study evaluates the effect of administrative BAC laws on fatal alcohol related crashes and law enforcement patterns in Canada from 1987 to 2010. Results reveal a significant decrease of 3.7% (95% C.I.: 0.9–6.5%) in fatally injured drivers with a BAC level equal or greater than .05% following the introduction of these laws. Reductions were also observed for fatally injured drivers with BAC levels greater that .08% and .15%. The introduction of administrative BAC laws led neither to significant changes in the rate of driving while impaired (DWI) incidents reported by police officers nor in the probability of being charged for DWI under the Criminal Code.

Response to commentaries on 0.05 blood alcohol concentration (BAC) limit.

Response to commentaries on 0.05 blood alcohol concentration (BAC) limit.

Translating Evidence into Policy: Lessons Learned from the Case of Lowering the Legal Blood Alcohol Limit for Drivers

This case study examines the translation of evidence on the effectiveness of laws to reduce the blood alcohol concentration (BAC) of drivers into policy. It was reconstructed through discussions among individuals involved in the processes as well as a review of documentation and feedback on oral presentations. The Centers for Disease Control and Prevention collaborated extensively with federal and non-federal partners and stakeholders in conducting a rigorous systematic review, using the processes of the Guide to Community Preventive Services to evaluate the body of empirical evidence on 0.08% BAC laws. The timely dissemination of the findings and related policy recommendations-made by the independent Task Force on Community Preventive Services-to Congress very likely contributed to the inclusion of strong incentives to States to adopt 0.08 BAC laws by October 2003. Subsequent dissemination to partners and stakeholders informed decision-making about support for state legislative and policy action. This case study suggests the value of: clearly outlining the relationships between health problems, interventions and outcomes; systematically assessing and synthesizing the evidence; using a credible group and rigorous process to assess the evidence; having an impartial body make specific policy recommendations on the basis of the evidence; being ready to capitalize in briefly opening policy windows; engaging key partners and stakeholders throughout the production and dissemination of the evidence and recommendations; undertaking personalized, targeted and compelling dissemination of the evidence and recommendations; involving multiple stakeholders in encouraging uptake and adherence of policy recommendations; and addressing sustainability. These lessons learned may help others working to translate evidence into policy.

Impact of lowering the legal blood alcohol concentration limit to 0.03 on male, female and teenage drivers involved alcohol-related crashes in Japan

In June of 2002, a revision to part of the Road Traffic Act drastically increased the penalties for drinking and driving offences in Japan. Most notably, the legal blood alcohol concentration (BAC) limit for driving was lowered from 0.05 mg/ml to 0.03 mg/ml. The rationale for the new lower BAC limit was predicated on the assumption that drinking drivers will comply with the new, lower limit by reducing the amount of alcohol they consume prior to driving, thereby lowering their risk of crash involvement. This, in turn, would lead to fewer alcohol-related crashes. A key limitation of previous lower BAC evaluation research in determining the effectiveness of lower legal BAC limit policies is the assumption of population homogeneity in responding to the laws. The present analysis is unique in this perspective and focuses on the evaluation of the impact of BAC limit reduction on different segments of the population. The chief objective of this research is to quantify the extent to which lowering the legal limit of BAC has reduced male, female and teenager involvement in motor vehicle crashes in Japan since 2002. Most notably, the introduction of reduced BAC limit legislation resulted in a statistically significant decrease in the number of alcohol-impaired drivers on the road in Japan, indicating responsiveness to the legal change among adults and teenagers. In addition, this preliminary assessment appears to indicate that the implementation of 0.03 BAC laws and other associated activities are associated with statistically significant reductions in alcohol-involved motor vehicle crashes. In comparison, the rates of total crashes showed no statistically significant decline nor increase in the period following the introduction of the BAC law, indicating that the lower BAC limit only had an effect on alcohol-related crashes in Japan. The evidence suggests that the lower BAC legal limit and perceived risk of detection are the two most important factors resulting in a sustained change in drinking and driving behaviour in Japan. It is recommended that future research and resources in other countries be focused on these factors as determinants to reduced alcohol-related crashes.

Impact of BAC limit reduction on different population segments: A Poisson fixed effect analysis

Over the past few decades, several countries enacted the reduction of the legal blood alcohol concentration (BAC) limit, often alongside the administrative license revocation or suspension, to battle drinking-and-driving behavior. Several researchers investigated the effectiveness of these policies by applying different analysis procedures, while assuming population homogeneity in responding to these laws. The present analysis focuses on the evaluation of the impact of BAC limit reduction on different population segments. Poisson regression models, adapted to account for possible observation dependence over time and state specific effects, are estimated to measure the reduction of the number of alcohol-related accidents and fatalities for single-vehicle accidents in 22 U.S. jurisdictions over a period of 15 years starting in 1990. Model estimates demonstrate that, for alcohol-related single-vehicle crashes, (i) BAC laws are more effective in terms of reduction of number of casualties rather than number of accidents, (ii) women and elderly population exhibit higher law compliance with respect to men and to young adult and adult population, respectively, and (iii) the presence of passengers in the vehicle enhances the sense of responsibility of the driver.

MODERATE ALCOHOL INTAKE AND MOTOR VEHICLE CRASHES: THE CONFLICT BETWEEN HEALTH ADVANTAGE AND AT-RISK USE

To review the evidence on moderate alcohol intake and motor vehicle crash (MVC) risk, and discuss the possible public health tension in balancing risk reduction and increment with respect to moderate alcohol intake. A Medline review was conducted on moderate alcohol intake, MVC, and cardiovascular disease (CVD) risks. Moderate alcohol intake (24 g ethanol, two US standard drinks, or less a day) is associated with 20% reduction in risk of CVD. Public awareness of this may contribute to why rates of driving with blood alcohol content (BAC) <0.08 g/dl in the United States are static. Studies show 3- to 17-fold increased risk of a fatal MVC with BAC < 0.08 g/dl compared to sober drivers. The United States has 0.08 g/dl BAC laws, higher than that reached by a driver drinking two drinks per day or less. The public should be educated that although moderate alcohol drinking may not violate BAC laws, it still carries significant risk of MVC. Current BAC laws in some countries needs re-evaluation.

EVALUATION OF THE TEXAS 0.08 BAC LAW

The purpose of the present study was to assess the effects on alcohol-involved traffic crashes and fatalities of the 0.08 blood alcohol concentration (BAC) per se law introduced in the state of Texas in 1999. Data pertaining to alcohol-involved traffic crashes and fatalities were extracted from two datasets: the Fatality Analysis Reporting System (FARS) compiled by the National Highway Traffic Safety Administration (for the period January 1995-September 2002), and the Texas Department of Public Safety (DPS) reports of Alcohol Related Motor Vehicle Traffic Accidents and Casualties (for the period January 1995-December 2000). The data were analysed using time-series methods (ARIMA routines). The effects of the law on all drivers were assessed, along with the effects among gender, racial, and age subgroups and crash location (urban vs rural). Separate time-series analyses were conducted with all alcohol-involved and fatal alcohol-involved crashes from the DPS dataset and fatal alcohol-involved crashes from the FARS dataset as the outcome variables. None of the effects for either the total sample or any of the subgroups analysed was statistically significant (this was true of both the FARS and DPS datasets). While there is a growing body of evidence that indicates that 0.08 BAC laws can be effective in reducing alcohol-involved traffic accidents and fatalities, the present study shows that this was not the case in Texas. Future research should move beyond the simple question of whether or not 0.08 BAC laws 'work' and instead explore in more detail the conditions, such as publicity and enforcement, under which the law does or does not contribute to a decline in alcohol-involved accidents and fatalities.

How Do "Point Oh-Eight" (.08) BAC Laws Work?

Abstract Over the past two decades, states have toughened their adult drunk driving laws by setting the legal blood alcohol content (BAC) threshold at .08, down from .10. Although several studies have shown that these laws have been effective at reducing alcohol-related traffic fatalities, there is very little evidence on the underlying behavioral mechanisms through which .08 BAC laws achieve the fatality reductions. We estimate reduced form models of the effects of .08 BAC laws on a wide range of self-reported alcohol-related risk behaviors using large samples from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Surveys on Drug Use and Health (NSDUH) from 1999-2003 – a period when 32 states’ .08 BAC laws went into effect. Models with state and year fixed effects provide no evidence that .08 BAC laws reduced alcohol-involved driving, and we similarly find no effects on drinking participation or the likelihood of binge drinking. We do find robust evidence, however, that .08 BAC laws reduced past month alcohol consumption among moderate drinking males by about five percent. These reductions are larger for older, college educated, and married men. Taken together with results from previous research on other drunk driving interventions, our findings confirm a general deterrence effect and suggest that tougher drunk driving laws work primarily by reducing alcohol consumption.

How Do "Point Oh-Eight" (.08) BAC Laws Work?

Over the past two decades, states have toughened their adult drunk driving laws by setting the legal blood alcohol content (BAC) threshold at .08, down from .10. Although several studies have shown that these laws have been effective at reducing alcohol-related traffic fatalities, there is very little evidence on the underlying behavioral mechanisms through which .08 BAC laws achieve the fatality reductions. We estimate reduced form models of the effects of .08 BAC laws on a wide range of self-reported alcohol-related risk behaviors using large samples from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Surveys on Drug Use and Health (NSDUH) from 1999-2003 – a period when 32 states’ .08 BAC laws went into effect. Models with state and year fixed effects provide no evidence that .08 BAC laws reduced alcohol-involved driving, and we similarly find no effects on drinking participation or the likelihood of binge drinking. We do find robust evidence, however, that .08 BAC laws reduced past month alcohol consumption among moderate drinking males by about five percent. These reductions are larger for older, college educated, and married men. Taken together with results from previous research on other drunk driving interventions, our findings confirm a general deterrence effect and suggest that tougher drunk driving laws work primarily by reducing alcohol consumption.

A meta-analysis of .08 BAC laws in 19 jurisdictions in the United States

More than a dozen studies on the effectiveness of the .08 blood alcohol concentration (BAC) laws have been published; however, those studies have varied both in the statistical methods and the type of outcome measure used, so it is difficult to integrate the findings into an overall estimate of the effectiveness of the law. This study used a consistent outcome measure, drinking drivers in fatal crashes and an identical methodology time-series analysis, to analyze the introduction of the .08 law in 18 states and the District of Columbia from 1982 to 2000. Each analysis accounted for other key safety laws (administrative license suspension/revocation and safety belt laws), as well as economic conditions that might influence the effectiveness of the .08 law. This provided 19 independent evaluations in which the effectiveness (treatment effect) of the law could be measured in the same quantitative terms. The number of drinking drivers in fatal crashes declined in 16 of the 19 jurisdictions after the .08 law was adopted. Nine of the 16 reductions were statistically significant ( p < .05). The effect size combined across all 19 locations showed statistically significant decline ( p < .005) of 14.8% in the rate of drinking drivers in fatal crashes after the .08 laws were introduced. The reduction was greater in states that had an administrative license suspension/revocation law and implemented frequent sobriety checkpoints. This analysis suggests that 947 lives might have been saved, had all 50 states and the District of Columbia had the .08 law throughout the year 2000.

The Population Consumption Model, Alcohol Control Practices, and Alcohol-Related Traffic Fatalities

Background. More than 40% of urban traffic fatalities are alcohol related and the rate of such fatalities varies more than 10-fold across U.S. cities. These variations might be explained by differences in local alcohol control policies and practices.Methods. We conducted a cross-sectional survey of state Alcohol Beverage Control agencies and local city police departments in 107 cities that participate in the National Highway and Traffic Safety Administration's Fatality Analysis Reporting System. We examined the association of alcohol control practices in 1997 and alcohol-related traffic fatalities per daily vehicle miles traveled, 1995–1997.Results. Ninety-seven (91%) cities participated. Regulations related to alcohol accessibility, licensure of alcohol outlets, disciplinary procedures of alcohol outlets, and enforcement of blood alcohol concentration laws were associated with lower rates of fatalities. Cities with 9 or fewer of the 20 regulations had 1.46-fold greater alcohol-related traffic fatality rates than cities with 15 or more of these regulations, representing 392 excess deaths annually. Beer consumption was found to be a potential mediator of the effect of regulations on traffic fatalities.Conclusions. Alcohol beverage regulations are associated with alcohol-related traffic fatalities. Localities should consider greater restrictions on alcohol accessibility, stricter disciplinary measures for violations, and stricter licensure requirements as a potential means to reduce alcohol-related traffic fatalities.

Reviews of evidence regarding interventions to reduce alcohol-impaired driving

Background: Alcohol-related motor vehicle crashes are a major public health problem, resulting in 15,786 deaths and more than 300,000 injuries in 1999. This report presents the results of systematic reviews of the effectiveness and economic efficiency of selected population-based interventions to reduce alcohol-impaired driving. Methods: The Guide to Community Preventive Services’s methods for systematic reviews were used to evaluate the effectiveness of five interventions to decrease alcohol-impaired driving, using changes in alcohol-related crashes as the primary outcome measure. Results: Strong evidence was found for the effectiveness of .08 blood alcohol concentration laws, minimum legal drinking age laws, and sobriety checkpoints. Sufficient evidence was found for the effectiveness of lower blood alcohol concentration laws for young and inexperienced drivers and of intervention training programs for servers of alcoholic beverages. Additional information is provided about the applicability, other effects, and barriers to implementation of these interventions. Conclusion: These reviews form the basis of the recommendations by the Task Force on Community Preventive Services presented elsewhere in this supplement. They can help decision makers identify and implement effective interventions that fit within an overall strategy to prevent impaired driving.

Does setting limits save lives? The case of 0.08 BAC laws

Nineteen states have established laws that make it illegal per se to drive with a blood alcohol concentration (BAC) of 0.08. The controversy over extending this stricter definition throughout the nation has focused largely on whether the state laws have been effective at saving lives. Prior evidence on this question has been mixed as well as criticized on several methodological grounds. This study presents novel, panel-based evaluations of 0.08 BAC laws, which address the potential methodological limitations of previous studies. The results of this study indicate that 0.08 BAC laws have been effective in reducing the number of traffic fatalities, particularly among younger adults. These estimates suggest that the nationwide adoption of 0.08 BAC laws would generate substantial gains, reducing the annual count of traffic fatalities by at least 1200. © 2001 by the Association of Public Policy Analysis and Management.