Driving After Drinking Research Articles

Trajectories of Driving after Drinking among Marijuana-Using Youth in the Emergency Department: Substance Use, Mental Health, and Peer and Parental Influences

Background: The psychosocial correlates and longitudinal trajectories of driving after drinking (DAD) among youth remain understudied in at-risk populations. Objectives: We investigated the relationships of DAD trajectories and negative peer and parental influences, substance use, and mental health among predominantly marijuana-using youth seeking emergency department (ED) treatment. Methods: Data were from a 2-year prospective cohort study of drug-using patients (97.4% used marijuana) ages 14–24 seeking ED care for assault injury, or as part of a non-assaulted comparison group. Validated surveys measured DAD behaviors and correlates at baseline, 6, 12, 18, and 24 months. Latent class growth analysis identified characteristic DAD trajectory groups; baseline predictors were analyzed descriptively and using multinomial logistic regression. Results: Three DAD trajectory groups were identified among driving-age youth (n = 580): no DAD (NDAD; 55.2%), low-steady (LDAD; 29.0%), and high-declining (HDAD; 15.9%). In unadjusted analyses, HDAD youth were older, but otherwise similar to other groups demographically. Compared to NDAD, LDAD and HDAD group members had higher rates of drug and alcohol use disorders (p < .001). Further, HDAD group members had higher rates of anxiety symptoms and were more likely to be diagnosed with PTSD or depression than NDAD or LDAD youth (p < .05). Negative peer and parent influences were significantly higher in progressively more severe trajectory groups (p < .01). Adjusted effects from the multinomial model were analogous for peer and parental influences and substance use disorders, but not mental health. Conclusion: DAD is strongly associated with negative social influences and substance use disorders among marijuana-using youth, reinforcing their importance when developing interventions.

A Mobile Phone–Based Brief Intervention With Personalized Feedback and Text Messaging is Associated With Reductions in Driving After Drinking Among College Drinkers

Driving after drinking (DAD) among college students remains a significant public health concern and is perhaps the single riskiest drinking-related behavior. Counselor-delivered and web-based Brief Alcohol Interventions (BAIs) have been shown to reduce DAD among college students, but to date no study has evaluated the efficacy of a single-session mobile phone-based BAI specific to DAD. The present study examined whether a driving-specific BAI delivered via mobile phone would significantly decrease DAD among college students compared to an informational control. Participants were 84 college students (67.1% women; average age = 23; 52.4% White) who endorsed driving after drinking two or more drinks at least twice in the past 3 months. After completing baseline measures, participants were randomly assigned to receive either (a) DAD information or (b) DAD mobile BAI that included personalized feedback and interactive text messaging. Participants completed outcome measures at 3-month follow-up. Repeated-measures mixed modeling analyses revealed that students receiving the mobile phone-based BAI reported significantly greater reductions in likelihood of DAD (three or more drinks) and the number of drinks consumed before driving than students in the information condition at 3-month follow-up. These findings provide preliminary support for the short-term efficacy of a mobile phone-based BAI for reducing DAD among college students.

Marijuana and other substance use among male and female underage drinkers who drive after drinking and ride with those who drive after drinking

The study sought to describe the occurrence of adolescent driving after drinking (DD) and riding with a driver who had been drinking (RWDD) and associations with substance use for both males and females. As part of screening for a randomized controlled trial, we surveyed 16–20year olds (N=3418) recruited from an emergency department (ED) and analyzed data from those reporting past-year alcohol consumption (n=2150, 58% females). DD was reported by 22% of females and 28% of males and RWDD was reported by 39% of females and 38% of males, also in the past year. In regression models, risky alcohol use and past-year marijuana use were associated with increased odds of DD and RWDD for females and males. Marijuana use was a strong predictor, with odds increased by 2.3 and 1.7 times for DD among females and males respectively and 1.4 times for RWDD for females and males. Prescription drug misuse was also associated with RWDD for females and for both males' and females' reported DD. The findings highlight the alarming rate of DD and RWDD among both males and females and suggest ED-based injury prevention efforts consider such risky road behavior as well as consider their substance use. Future research might also further examine the effects of driving under influence of substances, particularly marijuana, and the negative synergistic effects of co-ingestion prior to driving.

Evaluating the Powerful Prediction of Integrated Behavioral Model for Risky Road Behaviors

Risky behaviors lead to road traffic safety accidents in Vietnam. Some individual risky behaviors were studied through distinct models to understand road user behaviors and to propose measurements for traffic safety improvement. This paper generally aimed to evaluate powerful prediction of Integrated Behavioral Models (IBM) for three risky behaviors i.e., driving after drinking (DAD), illegal changing direction (IDC), and speeding. Potential countermeasures will be proposed based on results. Results indicate that IBM successfully explains risky behaviors, especially for DAD. Among explainable variables, perceived severity is the only factor affecting all three risky behaviors.

Patterns of Alcohol Consumption and Related Behaviors in Brazil: Evidence from the 2013 National Health Survey (PNS 2013).

This study uses data from a nationally representative household survey (the 2013 National Health Survey, n = 62,986) to describe patterns of alcohol consumption and related behaviors among Brazilian adults. Analyses include descriptive and multivariable Poisson regression for self-reports in the past 30 days of: drinking any alcohol, binge drinking, binge drinking 4 or more times, and driving after drinking (DD); as well as age of alcohol consumption initiation. Results show that current drinking prevalence was 26%, with an average age of initiation of 18.7 years. Binge drinking was reported by 51% of drinkers, 43% of whom reported binge drinking 4 or more times. Drinking and driving was reported by nearly one quarter of those who drive a car/motorcycle. Current drinking was more likely among males, ages 25–34, single, urban, and those with more education. Binge drinking was more likely among males, older age groups, and people who started drinking before 18. Drinking and driving was higher among males, those with more education, and rural residents. Those who binge-drink were nearly 70% more likely to report DD. All behaviors varied significantly among Brazilian states. Given their potential health consequences, the levels of injurious alcohol behaviors observed here warrant increased attention from Brazilian policymakers and civil society.

The behavioral economics of driving after drinking among college drinkers.

Driving after drinking (DAD) among college students is a significant public health concern, yet little is known about specific theoretical risk factors for DAD, beyond drinking level, among college student drinkers. This study had the following aims: (i) to examine the associations between elevated alcohol demand and DAD, (ii) to determine whether demand decreases in response to a hypothetical driving scenario, (iii) to determine whether drivers who report DAD in the past 3months would show less of a reduction in demand in response to the hypothetical driving scenario, and (iv) to determine whether delayed reward discounting (DRD) is associated with DAD. Participants were 419 college students who reported at least 1day of past-month alcohol use. Participants completed 2 alcohol purchase tasks (APTs) that assessed hypothetical alcohol consumption across 17 drink prices with and without a driving scenario, a delay-discounting task, and a series of questions regarding DAD. In logistic regression models that controlled for drinking level, demographics, and sensation seeking, participants reporting higher demand intensity (95% confidence interval [95% CI] [1.04, 2.34]), breakpoint (95% CI [1.23, 2.28]), Omax (95% CI [1.03, 1.53]), and lower elasticity (95% CI [0.15, 1.02]) were more likely to report DAD. Additionally, in analyses of covariance, DAD(+) participants exhibited significantly less of a reduction in demand between the standard and the driving APT (intensity, p<0.01, breakpoint, p=0.05, and Omax , p<0.01). A binary logistic regression model with identical covariates revealed that DRD is not associated with DAD. DAD is associated with elevated/inelastic demand and less sensitivity to a hypothetical driving scenario. Drinkers with elevated demand should be prioritized for DAD intervention efforts.

Injunctive Peer Misperceptions and the Mediation of Self-Approval on Risk for Driving After Drinking Among College Students

Of the alcohol-related risks faced by college students, it is arguable that none presents a greater public health hazard than driving after drinking (DAD). The present study examined the extent to which students' injunctive misperceptions toward DAD predicted the likelihood to engage in DAD and how this relation was mediated by self-approval of DAD. Participants were 2,848 college students (59.1% female, 64.6% Caucasian) from two U.S. West Coast universities who completed confidential web-based surveys assessing DAD beliefs and behaviors. Results revealed that respondents tended to overestimate their peers' approval toward DAD. Moreover, the subgroups likely to engage in DAD—men, 21 + years of age, Greek affiliated students, Caucasians, students with a family history of alcohol abuse—were also more likely to misperceive (i.e., overestimate) their peers' level of approval toward DAD. Using binary logistic regression analyses, self-approval of DAD emerged as an important statistical mediator in the relation between misperception of typical student approval toward DAD and engagement in DAD. Results point to the considerable role injunctive peer misperceptions may play in the pathways leading to drinking-driving risk. These findings provide preliminary support for DAD-specific social normative interventions, either complementing or supplementing existing alcohol interventions. By targeting high-risk student subgroups and communicating accurate drinking-driving norms, these proposed interventions have the potential to reduce self-approval and incidence of DAD.

Predicting Driving After Drinking Over Time Among College Students: The Emerging Role of Injunctive Normative Perceptions

Despite prevention efforts, driving after drinking (DAD) is a prevalent high-risk behavior among college students and is a leading cause of death and injury. Examination of factors predicting future DAD behavior is necessary to develop efficacious targeted interventions to reduce this behavior among college students. The current study evaluated demographic, social cognitive, and behavioral predictors of DAD using longitudinal data. Participants were 655 nonabstaining college students (67.2% female; 60.3% White; Mage = 19.3 years) who completed online surveys at two time points 12 months apart. Results revealed that participants consistently overestimated their peers' approval (injunctive norms) of DAD. In a three-step hierarchical logistic regression model, injunctive norms, age, and past DAD behavior uniquely contributed to the prediction of this behavior 12 months later. Neither sex nor membership in a sorority or fraternity emerged as significant predictors. The findings provide important new insights into the longitudinal predictors of DAD among college students and highlight the need for DAD interventions, particularly among older students.

Identifying factors that increase the likelihood of driving after drinking among college students

Driving after drinking (DAD) is a serious public health concern found to be more common among college students than those of other age groups or same-aged non-college peers. The current study examined potential predictors of DAD among a dual-site sample of 3753 (65% female, 58% Caucasian) college students. Results showed that 19.1% of respondents had driven after 3 or more drinks and 8.6% had driven after 5 or more drinks in the past 3 months. A logistic regression model showed that male status, fraternity or sorority affiliation, family history of alcohol abuse, medium or heavy drinking (as compared to light drinking), more approving self-attitudes toward DAD, and alcohol expectancies for sexual enhancement and risk/aggression were independently associated with driving after drinking over and above covariates. These results extend the current understanding of this high risk drinking behavior in collegiate populations and provide implications for preventive strategies. Findings indicate that in addition to targeting at-risk subgroups, valuable directions for DAD-related interventions may include focusing on lowering both self-approval of DAD and alcohol-related expectancies, particularly those associated with risk/aggression and sexuality.

Predicting DUI recidivism: Personality, attitudinal, and behavioral risk factors

Aims To predict DUI recidivism using personality, attitudinal, and behavioral factors. Design We conducted cross-sectional analyses of survey data. Covariance structure modeling was used to identify unique predictors of driving after drinking (DAD), alcohol consumption, and high-risk driving. Participants Two hundred and eighty individuals with multiple DUI convictions, predominately male and Hispanic. Participants were surveyed in the Rio Hondo Courthouse, Los Angeles County, California. Measurements The survey included measures of past year frequency of DAD, socially desirable response bias, sensation seeking, trait hostility, high-risk driving style, alcohol expectancies, and alcohol consumption. Findings DAD was positively related with frequency of drinking and with positive alcohol expectancies. It was negatively associated with socially desirable response bias. Measures of high-risk driving and the personality variables were highly negatively associated with socially desirable response bias. Conclusions Individuals who believe that they are affected positively by alcohol intoxication are not responding to the standard penalties for DUI and persist in driving after drinking. These beliefs may serve as an important point of intervention for programs designed to reduce drunk driving. The current research also suggests that self-report measures of DAD, as well as many hypothesized risk factors, are highly correlated with socially desirable response biases. Failure to control for such biases may be a significant threat to the validity of research in this field.

Young People Driving After Drinking and Riding with Drinking Drivers: Drinking Locations—What Do They Tell Us?

Objective. The present study investigated the extent to which drinking in specific locations and heavy drinking mediated the effects of overall alcohol use on driving after drinking (DD) and riding with drinking drivers (RWDD) among young people. Additionally, this study examined the relationships among ethnicity, gender, drinking in specific locations, and DD and RWDD. Method. Using random-digit dialing procedures, participants were recruited to take part in a telephone survey in California, United States of America. Participants were 1,534 youth, ages 15–20 years (mean age = 17.6). Latinos, African Americans, and Asian Americans were over-sampled to allow cross-group comparisons. Along with background characteristics, overall alcohol use, heavy drinking, drinking in specific locations, DD, and RWDD were measured. Results. Latent variable structural equation modeling showed that European Americans, males, older adolescents, those who have a driver license, and those who drive more often were more likely to report drinking alcohol in the past year. Heavy episodic drinking and drinking in cars increased both DD and RWDD. Drinking in restaurants also increased DD. The effects of overall alcohol consumption on DD were entirely mediated through heavy episodic drinking and drinking in restaurants and cars. Alcohol consumption had both direct and indirect effects on RWDD. With the exception of being Latino and frequency of driving, the effects of the background variables on RWDD were all entirely mediated through alcohol consumption. Conclusions. Heavy drinking and drinking in specific locations appeared to be important unique predictors of both DD and RWDD. In light of the relationship between drinking in restaurants and in cars, and DD, prevention programs and policies aimed at underage drinking should focus on developing more effective responsible beverage service programs, increasing compliance with laws limiting alcohol sales to youth, and enforcing graduated driver licensing and zero tolerance laws.

Drinking and driving: a prospective assessment of the relation between risk cognitions and risk behavior

This study examined the relations between risk cognitions and risk behavior. Adolescents’ perceptions of the risks associated with driving after drinking (DAD) and their perceptions of the prevalence of this behavior among their peers were assessed, and these perceptions were used to predict their DAD behavior. Results provided evidence of a type of cognitive social influence: the more common adolescents thought the behavior was, the less risk, both personal and general, they attributed to it. As expected, however, this relation was significant only for those who were high in a tendency to engage in social comparison. Perceptions of risk, in turn, were prospectively related to risk behavior for all participants. Specifically, low perceived risk, especially personal risk, was associated with an increase in DAD behavior. Implications of the results for DAD interventions are discussed.

Outlets, drinking and driving: a multilevel analysis of availability.

This study examines the degree to which the physical availability of alcohol as measured by outlet densities is related to self-reported individual drinking patterns, preferred drinking location, as well as both driving after drinking (DAD) and driving while intoxicated (DWI). Data from 7,826 drinkers were obtained from a general-population telephone survey of 1,353 zip code areas in California. Measures of individual alcohol consumption included drinking frequency, drinks per occasion and variance in quantities consumed per occasion. Preferred drinking locations included bars, restaurants and the homes of drinkers and of their friends. DAD was defined as driving a motor vehicle within 4 hours of having one or more alcoholic drinks, and DWI was defined as driving after having too much to drink and drive safely. Geographic measures of outlet densities were obtained for bars, restaurants and off-premises establishments, using zip codes as geographic units of analysis. Hierarchical linear modeling was used to relate outlet densities within and surrounding respondents' area of residence to respondents' drinking and to respondents' drinking and driving. Whereas restaurant densities were directly related to greater drinking frequencies and DAD, bar densities were inversely related to DAD. There were no direct effects of drinking patterns on drinking and driving. Drinking and driving was strongly related to drinking location preference (e.g., bars and restaurants) only when considered simultaneously with individual drinking patterns, particularly drinking frequency. Increased restaurant density is strongly related to higher rates of both self-reported driving after drinking and drinking frequency. The strongest influence on both driving after drinking and driving while intoxicated is preferred drinking location considered together with individual drinking patterns. Outlet density and preferred drinking location when considered together with individual drinking patterns support driving after drinking and thereby increase the potential for alcohol-related accidents.

Brief prevention for adolescent risk‐taking behavior

Despite widespread prevention efforts to decrease adolescent risk-taking, substance use and driving after drinking (DD) are prevalent in the United States. The current study compared the efficacy of an abbreviated version of Drug Abuse and Resistance Education (DARE-A) to a new Risk Skills Training Program (RSTP). Adolescent participation in drinking, drug use, DD and riding with a drunk driver was examined longitudinally. After baseline assessments, adolescents were randomly assigned to the RSTP. DARE-A or a no intervention control group and then completed 2-month post-test and 6-month follow-up assessments. Adolescents attended a mid-sized suburban high school. The sample (N = 300) was comprised of 58% females and the age range was 14-19 years. The RSTP was developed to target several risk behaviors and to examine the feasibility of conducting a brief personalized prevention program in a group setting. DARE-A focused on increasing knowledge and understanding the deleterious effects of substance use. Risk-taking behavior, perception of peer risk-taking and positive and negative alcohol expectancies were assessed. RSTP participants decreased participation in several risk behaviors at post-test, but reductions were not maintained at 6-month follow-up. The control and DARE-A groups increased their positive and decreased their negative alcohol expectancies. The control group increased their alcohol consumption. Results suggest that a brief, personalized, group prevention program is a feasible approach to reducing adolescent risk-taking. Strategies must be developed to solidify these positive changes so that they are longer-lasting.