research questions about drinking and driving

Click through the PLOS taxonomy to find articles in your field.

For more information about PLOS Subject Areas, click here .

Loading metrics

Open Access

Peer-reviewed

Research Article

Injury patients’ perceptions of drink-driving: A qualitative assessment of drink-driving behavior in Moshi, Tanzania

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing

Affiliation Duke Global Health Institute, Duke University, Durham, NC, United States of America

Roles Formal analysis, Writing – original draft, Writing – review & editing

Roles Conceptualization, Writing – review & editing

Affiliations Duke Global Health Institute, Duke University, Durham, NC, United States of America, Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America

Affiliation Kilimanjaro Christian Medical Center, Moshi, Tanzania

Affiliation Division of Neurosurgery and Neurology, Department of Neurosurgery, Duke University School of Medicine, Durham, NC, United States of America

Roles Conceptualization, Investigation, Methodology, Supervision, Writing – review & editing

* E-mail: [email protected]

Roles Conceptualization, Data curation, Funding acquisition, Investigation, Project administration, Resources, Supervision, Writing – review & editing

• Deena El-Gabri, 
• Loren K. Barcenas, 
• Brian Meier, 
• Mark Mvungi, 
• Michael Haglund, 
• Charles J. Gerardo, 
• Joao Ricardo N. Vissoci, 
• Catherine A. Staton

• Published: May 5, 2020
• https://doi.org/10.1371/journal.pone.0230662
• Reader Comments

Globally, 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.

The 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.

A 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’.

Conclusions

Normalization 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.

Citation: El-Gabri D, Barcenas LK, Meier B, Mvungi M, Haglund M, Gerardo CJ, et al. (2020) Injury patients’ perceptions of drink-driving: A qualitative assessment of drink-driving behavior in Moshi, Tanzania. PLoS ONE 15(5): e0230662. https://doi.org/10.1371/journal.pone.0230662

Editor: Neal Doran, University of California San Diego School of Medicine, UNITED STATES

Received: June 14, 2019; Accepted: March 5, 2020; Published: May 5, 2020

Copyright: © 2020 El-Gabri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper.

Funding: This research was supported by the Fogarty International Center of the National Institutes of Health under Award Number K01TW010000 (PI, Staton). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Globally, 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 ].

RTIs are particularly a problem in low- and middle-income countries (LMICs) with poor infrastructure and weakly enforced traffic laws [ 1 , 4 ]. In particular, 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 ]. With RTIs contributing to around 70% of all alcohol-related injuries, Tanzania falls into the second category [ 7 ]. Current policies in place include blood alcohol concentration limits of 0.08g/dl for the general population and 0g/dl for commercial drivers, which can be enforced through random breath testing or police check points [ 8 ]. However, the effectiveness of overall enforcement of national drink-driving laws is rated a 2 on a scale of 0–10 [ 8 ].

A total of 36 traffic crash hotspots have been identified in Moshi, Tanzania alone, with 40% of crash sites on local roads with increased motorcycle density [ 9 ]. One cross-sectional study done country-wide found that motorcycles caused 53.4% of road traffic crashes. The dangerous nature of motorcycles is troubling as many Tanzanians ride as passengers on motorcycle-taxis (called “boda bodas”) as a form of transport [ 10 ]. Another vehicle being used to meet the rising demand of public transportation in northern Tanzania is the minibus, locally known as dala-dala. Dala-dala drivers are incentivized to engage in unsafe driving habits such as ignoring road signs and speeding since they are paid on commission and do not depart until the minibus is full [ 11 ]. Studying RTIs in Tanzania is important to gain first-hand understanding of drink-driving behavior and ultimately reduce the burden.

Driver drunkenness is perceived as one of the leading causes of RTI in Tanzania [ 12 ], however not much is known about why people continue drink-driving regardless of the consequences, or what patients believe can prevent injuries like their own. Knowing the injury population’s views will allow policymakers to develop more effective ways to address drink-driving behavior, based on those who have experienced the consequences of drink-driving. The lack of cultural understanding makes grounded theory useful to investigate inductively [ 13 ]. This study aims to qualitatively determine what the injury population, their families, and community advisory board members of Tanzania believe about drink-driving to help inform policies to address this public health hazard.

Institutional review board

For the study, we obtained IRB approval from the Duke Institutional Review Board, Kilimanjaro Christian Medical Center Ethics Committee and National Institute of Medical Research. There was a minimal level of risk for this study. Patients completed a written informed consent prior to participation but to ensure privacy, names or identifying information of participants were not collected.

Study design

The semi-structured focus group was designed based on the grounded theory and assessed using thematic analysis. Grounded theory is a research method that generates theories grounded in data [ 14 ]. Constant comparative analysis, a process in grounded theory used for category development [ 15 ], led to focus group questions (appendix A) about community drinking behavior and what is appropriate and acceptable behavior when deciding to or seeing someone drink and drive. Focus groups were conducted between August 2016 and January 2017.

Focus groups were conducted by two trained female research nurses at Kilimanjaro Christian Medical Center (KCMC). The research nurses both have over ten years of experience conducting focus groups among similar patient populations. A relationship was established with the participants at the onset of the focus group sessions. Focus group participants were informed of the aims of the study as well as the qualifications of the research team and focus group facilitators. They were informed that the focus group is a component of a greater research collaboration aimed at reducing alcohol related injury in northern Tanzania. Facilitators reported their interest in the research as based on an investment in the livelihood and betterment of the community.

Study setting

This project took place in Moshi, a city in the Kilimanjaro region of Northern Tanzania with a population of 143,799. Moshi is home to Kilimanjaro Christian Medical Center (KCMC), the third largest hospital in the country and the referral hospital for northwestern Tanzania [ 16 ]. KCMC serves the urban and rural population of Moshi and was therefore selected as a central location to assess general perceptions of the region. Assessing the qualities and factors that lead to drink-driving is important for this region as road traffic crash rates are climbing and current data from the KCMC Casualty (Emergency) Department suggests that 28% of all the patients who arrive to the Casualty Department for treatment of an injury consumed alcohol prior to their injury and therefore are ‘Hazardous drinkers’ [ 17 ].

Although Tanzania does have a national blood alcohol limit of 0.08g/dl for the general population and 0g/dl for commercial drivers [ 8 ], policies including random breath testing, police checkpoints, and penalty point systems are currently not in place [ 8 ]. High alcohol consumption is more of a problem in Moshi than other regions of Tanzania because it is less religious than other Muslim predominated regions [ 18 ]. The strong Chagga culture of the region views alcohol as an integral part of traditional ceremonies, thus making it a more acceptable habit [ 19 ]. Another factor contributing to higher alcohol consumption is the large tourist population attracted by being situated at the base of Mount Kilimanjaro. Tourism brings in significant revenue that contributes to higher disposable income, which is associated with higher alcohol consumption rates [ 18 ]. Demand for bars created by tourists could contribute to the wide availability and exposure to advertisements of alcohol experienced by northern Tanzanians [ 18 ].

Study population

Focus groups participants were a convenience sample of injury patients, their families, and community advisory board members. Patients and their family members were identified face-to-face in the KCMC ED waiting or treatment areas, after treatment or stabilization, and were offered participation in the focus group. If patients or family members accepted, they were invited to return to the hospital for patient and family focus group days, respectively.

Injury patients (both patients and drivers) were included in the focus groups if they were ≥18 years of age, seeking care at KCMC for any acute (<6 hours) injury, clinically sober at the time of enrollment, medically stable, able to communicate in Swahili or English and consent to participate. Patients were excluded from enrollment if they were medically unstable or had a deteriorating condition, were too critically ill to participate, did not speak English or Swahili, were <18 years of age, presented for non-injury related complaints or follow-up care, or did not consent to be enrolled. Family member focus group participants were family members of a patient who was able to be enrolled in the study, who also agreed to participate, and speak English or Swahili.

Research nurse facilitators attended Community Advisory Board (CAB) meeting to conduct focus groups in order to utilize this group's perspective on drinking behavior within the community. The KCMC CAB is comprised of 30–40 adult community members who understand research, have advised investigators on pertinent research questions, cultural norms, and cultural acceptability of interventions, treatments and research protocols. All interested CAB participants enrolled were ≥18 years of age and were present at the monthly CAB meeting when we conducted the focus group discussion.

Data collection

Patient and family focus groups were scheduled once 5–10 eligible interested participants were recruited from the emergency department and provided informed consent. CAB focus groups took place prior to the monthly CAB meeting and consisted of 5 to 10 members who provided informed consent. No participants dropped out. Each focus group, led by trained research nurses, lasted between 45 and 60 minutes. They were audiotaped and transcribed for formal qualitative analysis utilizing thematic analyses. Transcriptions occurred within days following the focus group and research nurse notes were included in the transcriptions about the content.

Focus groups among each population group, patients, families, and CAB members, were conducted using an iterative process until thematic saturation was reached. This was done for four patient, four family member, and two CAB focus groups. The original focus group questions were designed to understand the general perceptions of drink-driving in Moshi Tanzania. These questions included “What is acceptable drinking behavior?” and “What is thought of a person who drinks and drives?”. These scripted questions were piloted by the research nurses conducting focus groups. After thematic saturation was reached, the focus group script was altered to expose reasons for preliminary data from patient surveys. Focus groups were conducted until thematic saturation was again reached.

After the focus groups were recorded and transcribed, each script was translated from Swahili to English. English scripts were then assessed for potential cultural misinterpretations, back translated and annotated for English, American comprehension. Transcripts were assessed by bilingual American and Tanzanian researchers and not returned to participants as they were difficult to contact after completion of the study. All transcripts, audio tapes, and related data will be kept for six years after study completion.

Data analysis

Analysis was iterative throughout the study, which allowed emerging themes, derived from the data to be explored in later focus groups. The focus groups among patients, family members, and CAB members were coded separately and then analyzed. Comparing and contrasting across and within these datasets highlighted emerging themes and divergence of perspectives. Thematic saturation occurred when no new themes developed from focus group analysis and marked the end of the qualitative study for individual population subsets.

All transcripts were coded by DE and BM, using a thematic narrative approach, reflecting the research questions and themes raised by the participants [ 20 ]. The researchers (DE and BM) separately completed coding with primary and secondary level coding classifications. DE and BM then compared coding with advisors specializing in qualitative research. The Tanzanian research group reviewed the evolving thematic codes and resulting narratives and gave input based on their experience with the focus group populations and cultural knowledge. Representative quotes for each theme were then selected based on comparative analysis of DE and BM coding with input from research team members.

Demographics and characteristics of participants

A 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). Demographic information is not presented here in the interest of maintaining respondent confidentiality. While the study was not intended to focus on commercial drivers, most participants spoke about boda boda or dala dala drivers. 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’.

Emerging themes and related quotes

1. ‘drinking is ingrained in boda boda driver culture’ theme..

Among all three focus group types, a prominent theme was that drinking is so common among boda boda drivers that it is seen as normal. The normalization of drinking among boda boda drivers has allowed this behavior to become ingrained in the culture, so “reporting those drivers is very rare” (Family, 4) making it difficult to change. Along with the perception that drink-driving is normal comes the normalization of its consequences. One focus group member admits that, “Although accidents still happen and people cut their leg or break their head [due to alcohol attributable road traffic injuries] , our society sees it as normal” (Family, 4).

A strong drinking culture may stem from occupational stressors. Boda boda driving is seen as a difficult job and therefore deserving of a drink. Society believes that alcohol gives drinkers more energy, so “boda boda drivers cannot work well until they drink something” (Family, 4). Additionally, drivers believe that because they are both experienced drinkers and drivers that they can do both successfully. One patient related that “I am experienced with alcohol . I can drink even four containers so that I have energy to work” (Patient, 4).

Drinking is so ingrained in the boda boda driver culture that fellow drivers have been known to “help one another buy alcohol by contributing money if one person cannot afford a drink” (Patient, 1). This implies that boda boda drivers find camaraderie through drinking, making it even more difficult to stop. Reverse stigma, or a negative attitude among heavy drinkers towards someone who stops drinking, may play a role in perpetuating drink-driving culture among boda boda drivers. For example, if one driver quit drinking, “his fellows will see him as a betrayer . They will want to pull him back to his previous ways so he cannot escape their company of drinking alcohol” (CAB, 1).

2. ‘Individuals have a personal responsibility to address drink-driving’ theme.

Throughout focus groups, participants expressed notions that passengers are responsible for their own safety, rather than drivers being responsible for their passengers. Generally, there were two responses showing different levels of commitment to personal safety. Some act passively, not taking any action against drunk driving because they feel that drink-driving is inevitable and changing this behavior is hopeless. Others look out for the personal safety of themselves and others by taking actions such as looking for a sober driver and stopping a drink driver.

Participants who act passively typically know the dangers of drink-driving, but feel that trying to change this behavior is useless. Because they feel that drink drivers “won’t listen to anyone or ask for any assistance” (Patient, 2) these participants reluctantly accept drink-driving. Most passengers maintain the idea that those drivers who drink are set in their ways because past confrontations with drivers have not made a difference and have become passive towards drink-driving as a result. One person from the CAB focus group recalls trying to positively influence a drink driver, but was unsuccessful, saying, “We have tried to advise him but he said he can’t stop drinking alcohol until he dies . ” The perception that changing drink-driving behavior is impossible discourages citizens from taking action or pushing for stronger law enforcement.

Rather than feeling hopeless and becoming passive, another sub-group of participants took personal safety into their own hands. One way of doing so is refusing to ride with a drink driver and finding another driver. Participants said, “If I find a dala-dala driver is drunk , I must go find another dala-dala driver” (Family, 2) and “It’s better not to enter the bus if you realize that the driver is drunk” (CAB, 2). Participants in this group believed that safety was important enough to intervene, using methods to stop drink drivers. If the passengers have not gotten into the vehicle yet, they will avoid riding with the driver and “tell fellow passengers that the driver is drunk” (CAB, 2) while “disagreeing [that the driver is ready] because he is drunk and then report him” (CAB, 2). Alternatively, “ If there is only one driver on whom we depend and he is drunk , he will have to rest until the drunkenness is over . Then we will ask him to drive” (CAB 2) . If the passengers are already in the vehicle, and see that “he is losing concentration , then we use force to stop him and tell him not to drive the vehicle” (Patient, 3). These passengers understand the danger of riding with a drink driver and believe taking responsibility for their own safety is necessary.

3. ‘Police enforcement on drink-driving is necessary’ theme.

The final contributing theme that emerged from the perceptions of drink-driving focus groups was ‘necessary police enforcement on drink-driving’. 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.

Those who thought citizens should be actively involved expressed that “passengers should be very careful with a drunk driver and inform the traffic police immediately” (Patient, 2). Reflecting the thought that police should be informed, one participant notes, “If you know he is drunk then you have to stop him driving a car or inform a policeman that he is drunk and can’t drive the vehicle” (Family, 2).

In practice, informing the police should be simple, “it’s just a matter of reporting the driver who is drunk . He will be stopped and you will be given another driver , therefore it’s very easy” (CAB, 2).

However, others feel that even if you do go to the law enforcement, not much can be done to resolve the situation. In reply to the previous quote, a CAB member explained that in his or her experience, getting a sober replacement driver can be difficult and very slow, pointing to the need for improved policies and police enforcement. Another issue is the reliability of the passengers’ report in the police’s eyes. If a law enforcement officer cannot confirm that a driver is drunk, he or she may not take any precautions, as this participant describes, “If three people from the same bus tell [the police] that the driver is drunk , he may not believe them . It would take the bus getting into an accident for him to believe” (CAB, 2). Because the police do not take the people’s word, many feel that the police are not doing enough to enforce drink-driving laws.

This innovative study is the first to examine the perceptions of drink-driving in the Moshi, Tanzania community as experienced by injury patients, their family members and a community advisory board. Focus group discussions demonstrated three specific themes: 1) that drinking is ingrained in boda boda driver culture, 2) if individuals take responsibility to address drink-driving it is at the personal level, and 3) police enforcement needs to be strengthened. These results highlight areas that potential interventions could focus on to be the most productive; For example, the normalization of drink-driving among boda boda drivers needs to be addressed, utilizing personal motivation to avoid drink-driving exposure could be increasing safe ride options, and there is a perception that strengthening enforcement would decrease drink-driving.

We found that drink-driving behavior is specifically ingrained in boda boda driver culture. While previous studies have shown that drinking alcohol is a regular part of social interactions throughout Tanzania, [ 21 , 22 ] we found that it was even more common place and expected part of this work culture. Some commercial drivers in Tanzania see alcohol as a means of fighting fatigue [ 21 ], and when workers perceive alcohol to enhance their performance or reduce stress, it is more likely to become widely accepted [ 21 , 22 ]. Dominant cultural practices can be addressed by health promotion initiatives at the community level. For example, the huge reduction in tobacco use that followed a cultural change from tobacco accomodation to intolerance is a great illustration of the effectiveness of health promotion initiatives [ 23 ]. Interventions targeted at communities shown to reduce alcohol use include group-based education programs, changing school policies, and emphasizing alcohol-related harms [ 24 ].

We also found that if individuals take responsibility to address drink-driving, it is at the personal level. We can leverage the personal responsibility most passengers feel for their own safety by providing more alternatives to drink-driving or riding with impaired drivers. Safe ride programs are the provision of free to low cost transportation, which have been implemented differently in various high-income settings with mixed effectiveness [ 25 ]. The United States National Highway Traffic Safety Administration reports that programs with the greatest likelihood of reducing crashes incorporate accessibility, availability, and ease of integration into activity [ 26 ]. However, these programs may function differently within Tanzania where most of our participants discussed riding with a commercial driver or taking public transport. Therefore, these programs would need to be evaluated to see if both intoxicated and sober individuals would choose to use a safe ride program than ride with an intoxicated driver, among other feasibility and acceptability challenges. An alternative transportation option is using ridesharing apps, such as Uber and Lyft [ 27 , 28 ]. Ridesharing apps allow passengers to order a safe ride from their phone at any time, as long as a driver is available. To remain a certified driver with the company, drivers would have to comply with the company’s zero tolerance drug and alcohol policy, and ride users can leave evaluations of the drivers which would reduce the use of those drivers with poor evaluations [ 29 , 30 ].

When taking into context the overwhelming cultural acceptance and the fact that many take personal responsibility for self-protection, one intervention that can address education and harness personal choice would be a brief intervention (BI). The BI has been used in emergency departments in high income countries to encourage the reduction of alcohol consumption among injury patients [ 31 , 32 ]. While there is no evidence to support its use in countering cultural practices on a large scale, patient level education can increase personal choice and capacity for change. Focusing on topics important to the individual, including perceived risks, moral convictions, or religious beliefs can help curb alcohol consumption [ 25 – 27 ]. Using the BI in medical facilities is highly effective at reducing self-reported drinking as well as alcohol-related road traffic injuries [ 25 ]. However, these interventions must be tested and adapted for culturally appropriate use in Tanzanian society.

Participants identified a perceived lack of police enforcement of legislation against drink-driving. Proper police enforcement of traffic laws is important as it is associated with decreased road traffic fatalities and injuries [ 16 ]. Using breathalyzers and police checkpoints to apprehend drink drivers can give officers agency to enforce consequences that impact behavior [ 33 , 34 ]. However, police officers in Tanzania are not empowered to enforce current legislation due to constraints on funding, human resources, equipment, and vehicles [ 35 ]. Additional barriers faced by the Tanzanian police force include inadequate training in road safety over the last few years, as well as lack of motivation in part due to criticisms of abuse of power [ 35 ]. A multi-level intervention focusing on improving policy, supporting education and availability of safe rides, as well as supportive police enforcement would be successful [ 16 ].

Limitations

One limitation of the study is the potential for social desirability bias, especially on a stigmatized topic such as drink-driving. To limit the effect of this potential bias, we used research personnel who were comfortable talking about stigmatizing topics and included questions to talk about the general society and not the participants individual actions or behaviors. As inclusion criteria required participants to be injury patients who were medically stable to enroll in the study, we lack the perspective of those who were critically ill or in deteriorating condition. The fact that we enrolled injury patients and their family allows us to understand the motivations for continued drink-driving to plan for interventions, but might not fully represent the Tanzanian general society’s perspective about drinking or drink-driving.

Normalization of drink-driving in commercial driver culture creates a dangerous environment for passengers. Interventions like education and health promotion can help mitigate drinking and spark change among commercial drivers. 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. Implementing the BI in emergency departments can encourage high risk drinkers to take personal responsibility for their drinking behaviors as well. While legislation is in place against drink-driving, police officers need to be empowered to enforce them. With training and funding, police officers can implement checkpoints for random breathalyzer tests, which has been shown to decrease drink-driving and save lives.

• 1. World Health Organization. GLOBAL STATUS REPORT ON ALCOHOL AND HEALTH 2018. S.l.: WORLD HEALTH ORGANIZATION; 2019.
• View Article
• PubMed/NCBI
• Google Scholar
• 8. World Health Organization. Global status report on road safety: time for action. World Health Organization; 2009.
• 17. Staton C. Addressing High Risk Alcohol Use among Injury Patients in an Emergency Department in Tanzania. Moshi, Tanzania: Fogarty International Center. 2015.
• 20. Riessman CK. Narrative analysis. Vol. 30. Sage; 1993.
• 25. Goodwin AH, Thomas L, Kirley B, Hall W, O’Brien NP, Hill K. Countermeasures That Work: A Highway Safety Countermeasure Guide for State Highway Safety Offices:: 2015. United States. National Highway Traffic Safety Administration; 2015.
• 26. Decina LE, Foss RD, Tucker ME, Goodwin A, Sohn J, TransAnalytics LLC. Alternative transportation programs: A countermeasure for reducing impaired driving. United States. National Highway Traffic Safety Administration; 2009.
• 27. Uber. Earn Money by Driving or Get a Ride Now | Uber United States [Internet]. Uber. [cited 2019 Dec 12]. Available from: https://www.uber.com/
• 28. Lyft. Become a Driver or Get a Ride Now [Internet]. Lyft. [cited 2019 Dec 12]. Available from: https://www.lyft.com
• 29. Legal | Uber [Internet]. [cited 2019 Dec 12]. Available from: https://www.uber.com/legal/policies/zero-tolerance-policy/en/
• 30. Lyft. Zero-tolerance drug and alcohol policy [Internet]. Lyft Help. [cited 2019 Dec 12]. Available from: http://help.lyft.com/hc/en-us/articles/115012926187-Zero-tolerance-drug-and-alcohol-policy
• 35. Ministry of Infrastructure Development Dar es Salaam. THE UNITED REPUBLIC OF TANZANIA: NATIONAL ROAD SAFETY POLICY. 2009.

Risky Driving

• Distracted Driving
• Drowsy Driving
• Drug-Impaired Driving

Drunk Driving

Every day, about 37 people in the United States die in drunk-driving crashes — that's one person every 39 minutes. In 2021, 13,384 people died in alcohol-impaired driving traffic deaths — a 14% increase from 2020. These deaths were all preventable.

Buzzed Driving Is Drunk Driving

• Alcohol Effects

Risk Factors

Consequences.

• Responsible Driving
• NHTSA In Action

How alcohol affects driving ability

Alcohol is a substance that reduces the function of the brain, impairing thinking, reasoning and muscle coordination. All these abilities are essential to operating a vehicle safely.

As alcohol levels rise in a person’s system, the negative effects on the central nervous system increase. Alcohol is absorbed directly through the walls of the stomach and small intestine. Then it passes into the bloodstream where it accumulates until it is metabolized by the liver. A person's alcohol level is measured by the weight of the alcohol in a certain volume of blood. This is called Blood Alcohol Concentration, or BAC. At a BAC of .08 grams of alcohol per deciliter (g/dL) of blood, crash risk increases exponentially. Because of this risk, it’s illegal in all 50 states, the District of Columbia and Puerto Rico to drive with a BAC of .08 or higher, except in Utah where the BAC limit is .05. 

However, even a small amount of alcohol can affect driving ability. In 2021, there were 2,266 people killed in alcohol-related crashes where a driver had a BAC of .01 to .07 g/dL.

BAC is measured with a breathalyzer, a device that measures the amount of alcohol in a driver’s breath, or by a blood test.

The Effects of Blood Alcohol Concentration

Frequently asked questions, does the type of alcohol i drink affect my bac.

No. A drink is a drink. 

A standard drink equals about half an ounce of alcohol (.54 ounces, to be exact). This is the approximate amount of alcohol found in: 

• one shot of distilled spirits, or 
• one 5-ounce glass of wine, or 
• one 12-ounce beer.   

What affects my BAC?

How fast a person’s BAC rises varies based on a number of factors: 

• The number of drinks. The more you drink, the higher your BAC. 
• How fast you drink. When alcohol is consumed quickly, you will reach a higher BAC than when it is consumed over a longer period of time. 
• Your gender. Women generally have less water and more body fat per pound of body weight than men. Alcohol does not go into fat cells as easily as other cells, so more alcohol remains in the blood of women. 
• Your weight. The more you weigh, the more water is present in your body. This water dilutes the alcohol and lowers the BAC.
• Food in your stomach. Absorption will be slowed if you’ve had something to eat.   

Can I determine my BAC?

Because of the number of factors that affect BAC, it is very difficult to assess your own BAC or impairment. Even small amounts of alcohol affect one’s brain and the ability to drive. People often think they are “fine” after several drinks – but in fact, the failure to recognize alcohol impairment is often a symptom of impairment. 

While the lower stages of alcohol impairment are undetectable to others, the drinker knows vaguely when the “buzz” begins. A person will likely be too impaired to drive before looking – or maybe even feeling “drunk.”   

What impact does BAC have on my driving?

Know that alcohol steadily decreases a person’s ability to drive a motor vehicle safely. The more you drink, the greater the effect. As with BAC, the signs of impairment differ with the individual. 

Drivers with a BAC of .08 are approximately 4 times more likely to crash than drivers with a BAC of zero. At a BAC of .15, drivers are at least 12 times more likely to crash than drivers with a BAC of zero. The risk of crashing is even greater for young males.  

Driving After Drinking

• Motorcyclists
• Alcohol Abuse and Cost

Driving after drinking is deadly. Yet it still continues to happen across the United States. If you drive while impaired, you could get arrested, or worse — be involved in a traffic crash that causes serious injury or death.

About 31% of all traffic crash fatalities in the United States involve drunk drivers (with BACs of .08 g/dL or higher). In 2021, there were 13,384 people killed in these preventable crashes. In fact, on average over the 10-year period from 2012-2021, about 10,850 people died every year in drunk-driving crashes.

In every state, it’s illegal to drive drunk, yet one person was killed in a drunk-driving crash every 39 minutes in the United States in 2021.

Car crashes are a leading cause of death for teens, and about a quarter of fatal crashes involve an underage drinking driver. In 2021, 27% of young drivers 15 to 20 years old who were killed in crashes had BACs of .01 g/dL or higher.

To reduce alcohol-related fatal crashes among youth, all states have adopted a minimum legal drinking age of 21. NHTSA estimates that minimum-drinking-age laws have saved 31,959 lives from 1975 to 2017.

In 2021, the highest percentage of drunk drivers (with BACs of .08 g/dL or higher) were the 21-to 24-year-old age group and 25-to-34-year old age groups. Men are most likely to be involved in this type of crash, with four male drunk drivers for every female drunk driver.

In 2021, 5,932 people operating a motorcycle were killed in traffic crashes. Of those motorcycle riders, 1,624 (29%) were drunk (BAC of .08 g/dL or higher). 

Motorcycle operators involved in fatal crashes were found to have the highest percentage (28%) of alcohol-impaired drivers than any other vehicle types. 

The 35-39 and 45-to-49 age groups had the highest percent, 35%, of drunk motorcycle riders killed in 2021.

Repeat offenders who drink and drive are a very real, very deadly problem. Drivers with BACs of .08 g/dL or higher involved in fatal crashes were 4 times more likely to have prior convictions for driving while impaired than were drivers with no alcohol (7% and 2%, respectively).

When it comes to drunk driving, it affects more than just the driver. In 2021, among children (14 and younger) killed in motor vehicle crashes, 25% were killed in drunk-driving crashes. Of those deaths, more than half the time (55%) the child killed was in the vehicle driven by the drunk driver.

In addition to the human toll drunk driving takes on our country, the financial impact is devastating: based on 2019 numbers, impaired-driving crashes cost the United States $68.9 billion annually.

Driving a vehicle while impaired is a dangerous crime. Tough enforcement of drunk-driving laws has been a major factor in reducing drunk-driving deaths since the 1980s. Charges range from misdemeanors to felony offenses, and penalties for impaired driving can include driver’s license revocation, fines, and jail time. It’s also extremely expensive. A first-time offense can cost the driver upwards of $10,000 in fines and legal fees.

Many states require offenders to install ignition interlock devices at the driver’s own expense. An ignition interlock device is a breath test device connected to a vehicle’s ignition. The vehicle cannot be operated unless the driver blows into the interlock and has a BAC below a pre-set low limit, usually .02 g/dL. NHTSA strongly supports the expansion of ignition interlocks as a proven technology that keeps drunk drivers from getting behind the wheel.

Responsible behavior

BEING A RESPONSIBLE DRIVER IS SIMPLE: IF YOU ARE DRINKING, DO NOT DRIVE.

• Plan your safe ride home before you start the party, choose a non-drinking friend as a designated driver.
• If someone you know has been drinking, do not let that person get behind the wheel. Take their keys and help them arrange a sober ride home. 
• If you drink, do not drive for any reason. Call a taxi, a ride-hailing service, or a sober friend. 
• If you’re hosting a party where alcohol will be served, make sure all guests leave with a sober driver.
• Always wear your seat belt — it’s your best defense against impaired drivers.

If you see an impaired driver on the road, contact local law enforcement. Your actions could help save someone’s life.

NHTSA is dedicated to eliminating risky behaviors on our nation's roads

NHTSA demonstrates its commitment to eliminating drunk driving through research, public awareness campaigns, and state safety grant programs. We will continue until there are zero drunk-driving crashes on our roadways.

Policy & Guidance

Search for more resources, explore other topics in risky driving.

• Open access
• Published: 12 March 2015

Driving under the influence of alcohol: frequency, reasons, perceived risk and punishment

• Francisco Alonso 1 ,
• Juan C Pastor 1 ,
• Luis Montoro 2 &
• Cristina Esteban 1  

Substance Abuse Treatment, Prevention, and Policy volume  10 , Article number:  11 ( 2015 ) Cite this article

70k Accesses

41 Citations

8 Altmetric

Metrics details

The aim of this study was to gain information useful to improve traffic safety, concerning the following aspects for DUI (Driving Under the Influence): frequency, reasons, perceived risk, drivers' knowledge of the related penalties, perceived likelihood of being punished, drivers’ perception of the harshness of punitive measures and drivers’ perception of the probability of behavioral change after punishment for DUI.

A sample of 1100 Spanish drivers, 678 men and 422 women aged from 14 to 65 years old, took part in a telephone survey using a questionnaire to gather sociodemographic and psychosocial information about drivers, as well as information on enforcement, clustered in five related categories: “Knowledge and perception of traffic norms”; “Opinions on sanctions”; “Opinions on policing”; “Opinions on laws” (in general and on traffic); and “Assessment of the effectiveness of various punitive measures”.

Results showed around 60% of respondents believe that driving under the influence of alcohol is maximum risk behavior. Nevertheless, 90.2% of the sample said they never or almost never drove under the influence of alcohol. In this case, the main reasons were to avoid accidents (28.3%) as opposed to avoiding sanctions (10.4%). On the contrary, the remaining 9.7% acknowledged they had driven after consuming alcohol. It is noted that the main reasons for doing so were “not having another way to return home” (24.5%) and alcohol consumption being associated with meals (17.3%).

Another important finding is that the risk perception of traffic accident as a result of DUI is influenced by variables such as sex and age. With regard to the type of sanctions, 90% think that DUI is punishable by a fine, 96.4% that it may result in temporary or permanent suspension of driving license, and 70% that it can be punished with imprisonment.

Conclusions

Knowing how alcohol consumption impairs safe driving and skills, being aware of the associated risks, knowing the traffic regulations concerning DUI, and penalizing it strongly are not enough. Additional efforts are needed to better manage a problem with such important social and practical consequences.

In Europe, traffic accidents are one of the main causes of mortality in people between 15 and 29 years old, and driving under the influence of alcohol (DUI) is a major risk factor in most crashes [ 1 , 2 ].

In the year 2001 in Spain, 40,174 people were treated in public hospitals for traffic injuries. Some 28% of these injuries were serious or very serious and drinking was involved in a high percentage of cases. According to the Spanish Directorate General of Traffic (DGT), alcohol is involved in 30-50% of fatal accidents and in 15 to 35% of crashes causing serious injury, constituting a major risk factor in traffic accidents. This problem is especially important among young people and worsens on weekend nights [ 3 , 4 ].

In more recent years, several studies have shown that more than a third of adults and half of teenagers admit they have driven drunk. We also know that most of them were not detected. Generally, the rate of arrests for driving under the influence is very low and even those drivers who were arrested were mostly “first-time” offenders [ 5 ].

Some studies show that many young people lack information or knowledge about the legislation regulating consumption of alcohol for drivers, as well as the effects of this drug on the user [ 6 - 8 ].

There are also some widespread beliefs and misconceptions regarding the actions the driver can take in order to neutralize the effects of alcohol before driving (for instance drinking coffee, having a cold shower or breathing fresh air). As suggested by Becker’s model of health beliefs [ 9 , 10 ], preventive behavior is unlikely to occur unless the subject considers the action necessary, hence the importance of providing adequate information and disproving false beliefs.

Drivers are not usually aware of the risk they assume when they drive under the influence of alcohol, as they do not suffer a traffic accident every time they drink and drive. Hence they tend to think there is no danger in driving under the influence of alcohol, incurring the same risk behavior once and again.

But the reality is quite different. Alcohol causes very obvious alterations in behavior, as it affects almost all the physical skills we need for safe driving. It can interfere with attention, perceptual functioning and motor skills, as well as in decision making while driving.

Drinking impairs the ability to drive and increases the risk of causing an accident. The effects of alcohol consumption on driving-related functions are modulated by some factors, such as form of consumption (regular or infrequent), expectations about their consumption, expertise in driving and driver’s age. The increased risk of accident starts at a lower blood alcohol level when drivers are inexperienced or they are occasional drinkers, and begins at a higher blood alcohol level when these are more experienced drivers or regular drinkers [ 11 , 12 ].

The BAC represents the volume of alcohol in the blood and is measured in grams of alcohol per liter of blood (g / l) or its equivalent in exhaled air.

Any amount of alcohol in blood, however small, can impair driving, increasing the risk of accident. Therefore, the trend internationally is to lower the maximum rates allowed.

After drinking, the rate of alcohol in blood that a driver is showing can vary widely due to numerous modulating variables. Among them, some important factors are the speed of drinking, the type of alcohol (fermented drinks such as beer or wine, or distilled beverages like rum or whisky) or the fact of having previously ingested some food, as well as the age, sex or body weight. Ideally, if everyone drank alcohol responsibly and never drove after drinking many deaths would be avoided. Accurate information about how driving under the influence effects traffic safety would be a positive step towards this goal.

Study framework

Research on enforcement of traffic safety norms has a long tradition. In 1979, a classic work [ 13 ] showed that increasing enforcement and toughening sanctions can reduce accidents as an initial effect, although the number of accidents tends to normalize later.

Justice in traffic is needed insofar as many innocent people die on the roads unjustly. This is our starting point and our central principle. In order to prevent traffic accidents, a better understanding is needed of the driver’s knowledge, perceptions and actions concerning traffic regulations. Drivers have to be aware of how important rules are for safety. The present study comes from a broader body of research on traffic enforcement, designed to develop a more efficient sanctions system [ 5 , 14 ].

Our research used a questionnaire to gain sociodemographic and psychosocial information about drivers, as well as additional information on enforcement clustered in five related categories: “Knowledge and perception of traffic norms”; “Opinions on sanctions”; “Opinions on policing”; “Opinions on laws” (general ones and traffic laws in particular); and “Assessment of the effectiveness of various punitive measures”.

A number of additional factors were also explored, including: driving too fast or at an improper speed for the traffic conditions, not keeping a safe distance while driving, screaming or verbal abuse while driving, driving under the influence, smoking while driving, driving without a seat belt and driving without insurance. For a more complete review, see the original study [ 14 ].

The aim of this study was to gain useful information to improve traffic safety, concerning the following aspects:

Frequency of driving under the influence of alcohol (DUI).

Reasons for either driving or not driving under the influence (DUI).

Perceived risk of DUI.

Drivers’ knowledge of DUI-related penalties.

The perceived likelihood of being punished for DUI.

Drivers’ perception of the harshness of punitive measures for DUI.

Drivers’ knowledge of the penalties for DUI.

Drivers’ perception concerning the probability of behavior change after punishment for DUI.

Sociodemographic and psychosocial factors related with alcohol consumption and driving.

Participants

The sample consisted of 1100 Spanish drivers: 678 men (61.64%) and 422 women (38.36%), between 14 and 65 years of age. The initial sample size was proportional by quota to segments of Spanish population by gender and age. The number of participants represents a margin of error for the general data of ± 3 with a confidence interval of 95% in the worst case of p = q = 50%; with a significance level of 0.05.

Drivers completed a telephone survey. 1100 drivers answered interviews, and the response rate was 98.5%; as it was a survey on social issues, most people consented to collaborate.

Procedure and design

The survey was conducted by telephone. A telephone sample using random digit dialing was selected. Every phone call was screened to determine the number of drivers (aged 14 or older) in the household. The selection criteria were possession of any type of driving license for vehicles other than motorcycles and driving frequently. Interviewers systematically selected one valid driver per home. The survey was carried out using computer assisted telephone interview (CATI) in order to reduce interview length and minimize recording errors, ensuring the anonymity of the participants at all times and emphasizing the fact that the data would be used only for statistical and research purposes. The importance of answering all the questions truthfully was also stressed.

In this article, we present the data on driving under the influence of alcohol. The first question raised was: How often do you currently drive after drinking any alcoholic beverage? Possible responses were: Almost always, Often, Sometimes, Rarely or Never.

If they answered either Almost always, Often or Sometimes, they were asked: What is the reason that leads you to drive under the influence? If they answered Rarely or Never, they were asked: What is the reason you rarely or never drive under the influence? In both cases, respondents had the option of an open answer.

Later they were asked to rate from 0 to 10 the risk that driving under the influence of alcohol can cause a traffic accident in their opinion (0 being the minimum risk and 10 the maximum risk of crash).

Then they were asked to rate from 0 to 10 the harshness with which they thought DUI sanctions should be administered.

They were also asked: Is driving exceeding alcohol limits punishable? In this case, participants had the chance of answering Yes or No . We would then compare the correct answers with the standard to determine the knowledge.

Drivers who were unaware that DUI is punishable were asked about the probability of being sanctioned for this reason using the following question: When driving exceeding the limits of alcohol, out of 10 times, how many times is it usually sanctioned?

Another question dealt with the type of penalties. The participants were asked if the penalties for DUI consisted of economic fines, imprisonment or license suspension, either temporary or permanent. The question raised was: Have you ever received any penalty for driving under the influence? Possible answers were Yes or No . Those drivers who answered affirmatively were then asked about the harshness of punishment: How do you consider the punishment for DUI? The response options were Hard enough, Insufficient or Excessive. Furthermore, they were asked whether or not they changed their behavior after the punishment.

The questionnaire was used to ascribe drivers to different groups according to demographic and psychosocial characteristics, as well as to identify driving habits and risk factors.

Demographic variables

Gender: male or female.

Age: 14-17, 18-24, 25-29, 30-44, 45-65 and over 65 years old.

Educational level.

Type of driver: professional or non-professional.

Employment status: currently employed, retired, unemployed, unemployed looking for the first job, homemaker or student.

Driving habits

Frequency: the frequency with which the participant drive, the possible choices being Every day, Nearly every day, Just weekends, A few days a week, or A few days per month.

Mileage: the total distance in number of kilometers driven or travelled weekly, monthly or annually.

Route: type of road used regularly, including street, road, highway or motorway, and tollway.

Car use: motives for car use, for instance, to work, to go to work and return home from work or study centre, personal, family, recreational, leisure and others.

Experience/risk

Experience: number of years the participant has held a driver license, grouping them as 2 years or less, 3-6, 7-10, 11-15, 16-20, 21-25, 26-30 and over 30 years.

Traffic offenses. Number of sanctions in the past three years (none, one, two, three or more).

Accidents. Number of accidents as driver throughout life (none, one or more than one), and their consequences (casualties or deaths, or minor damages).

Once data were collected, a number of statistical analyses were performed, using the Statistical Package for the Social Sciences (SPSS), in order to obtain relevant information according to the aims of the study.

74.7% of the sample said that they had never driven under the influence. 15.5% of drivers said they did it almost never, and only the remaining 9.7% (sometimes 9,1%, often 0,2% or always 0,5%) acknowledged that they had driven after consuming alcohol (Figure  1 ).

Frequency of DUI.

Regarding the main reasons that led the drivers to act this way, expressed among drivers who admitted to having driven under the influence of alcoholic beverages, 24.5% of them indicated that it was unavoidable, as “I had to go home and couldn’t do anything else”, while 17.3% claimed that the act of drink-driving was an unintentional consequence or “something associated with meals”, and only 16.4% admitted having done it “intentionally”. In addition, 12.7% considered that “alcohol doesn’t impair driving” anyway (Figure  2 ).

Reasons for DUI.

“In any case, 60% of the interviewees perceived driving under the influence of alcohol as the highest risk factor for traffic accidents.”

Among them, the perception of this risk (or dangerousness of driving under the influence) is greater in women [F (1, 1081) = 41.777 p <0.05], adults aged between 18 and 44 [F (5, 1075) = 4.140 p <0.05], drivers who have never been fined for this infraction [F (2, 1080) = 29.650 p <0.05], drivers who had never committed the offense [F (4, 1077) = 40.489 p <0.05], and drivers who have never been involved in an accident [F (1, 1081) = 12.296 p <0.05]. Table  1 shows the values for this perception by gender and age.

There appears to be no significant relationship between the perceived risk attributed to DUI and other variables such as educational level, type of driver, driving frequency, vehicle use and years of experience.

The main reasons put forward for not drinking and driving included not drinking in any circumstances (50,5%), to avoid accidents (28,3%) as opposed to avoiding sanctions (10,4%) - such as financial penalties (8,4%), withdrawal of driving license (1,8%) or jail (0,2%) - or other reasons related to attitudes to road safety (16,6%).

On a scale of 0-10, participants rated the risk of economic penalties when driving under the influence of the alcohol with an average of 5.2, in other words they estimate the probability of being fined as roughly half of the times one drives drunk.

The perception of this risk (penalty or financial punishment for driving under the influence) is also greater in women [F (1, 1095) = 30,966 p <0.05], drivers who have never been involved in an accident [F (1, 1095) = 8.479 p <0.05], and drivers who had never been fined for this infraction [F (2 1094) = 12.515 p <0.05].

There appears to be no significant relationship between the perceived risk of financial penalty and other variables such as educational level, employment, type of driver, driving frequency, vehicle use and years of experience.

Almost everyone (99.1%) thinks that DUI is punishable and only 0.9% of drivers think it is not.

On a scale of 0-10, participants assigned an average of 9.1 to the need to punish this traffic breach severely. The score is higher in women [F (1, 1086) = 29.474 p <0.05], adults aged 18 to 24 years [F (5, 1089) = 2.699 p <0.05], drivers who have never been involved in an accident [F (1, 1095) = 8.479 p <0.05], and people who had never been fined for this reason [F (2, 1085) = 26,745 p <0.05], which means that these groups are less tolerant of this kind of behavior. By age, college students are the least tolerant and retirees are the most tolerant.

There was no significant relationship between the perceived need to punish this behavior harshly and variables such as type of driver, driving frequency and vehicle use.

Regarding the type of sanctions, 89.5% of drivers think that driving under the influence is subject to an economic fine, almost 70% say it could even be punished by imprisonment, while 96.4% believe it can lead to a temporary or permanent suspension of the license (Figure  3 ).

Type of sanction the driver think DUI is subject to.

Among the drivers who had been fined for DUI, nearly 75% considered that the imposed punishment was adequate, while the remaining 25% saw it as excessive (Figure  4 ). Finally, 91.7% of this group found they had changed their behavior after punishment (Figure  5 ).

Perception of punishment harshness imposed for DUI.

Perception concerning behavior change after punishment for DUI.

Alcohol is a major risk factor in traffic accidents. From the objective standpoint, alcohol interferes with the skills needed to drive safely, as evidenced by numerous studies on driving under the influence of alcohol conducted to date. From the subjective point of view, drivers also perceive it as dangerous, as our study shows.

Around 60% of respondents believe that driving under the influence of alcohol is maximum risk behavior. A smaller percentage compared to those reported by other studies in which the percentage of people that saw drink-driving as a major threat to safety reached 81% [ 15 ].

First, we note a clear correlation between perceived risk and avoidance behavior. In general the higher the perceived risk, the lower the probability of committing the offense, and vice versa: the lower the perceived risk, the greater the likelihood of driving after consuming alcohol.

Thus, drivers who do not commit this offense perceive that the risk of accidents associated with DUI is very high. When it comes to drivers who commit the offense occasionally, the perceived risk is lower, and when it comes to drivers who often drive under the influence of the alcohol, the perception of risk is clearly inferior. Thus, the frequency of DUI and risk perception seem to be inversely related.

These results are related to the hypothesis of optimistic bias, which states that drinkers are overly optimistic about probabilities of adverse consequences from drink. In a study [ 16 ] about overconfidence about consequences of high levels of alcohol consumption, the authors established an alternative to the optimism bias hypothesis that could explain our findings, affirming that persons who drink frequently and consume large amounts of alcohol daily could be more familiar with the risks of such behaviors.

Another important finding is that the risk perception of traffic accident as a result of DUI is influenced by variables such as sex and age. In relation to gender, the perception of risk seems to be higher in women than in men. In relation to age, risk perception is higher in adults between 18 and 44 years old.

The finding about the reason for not drinking and driving supports the already evident need for an integrative approach to developing sustainable interventions, combining a range of measures that can be implemented together. In this way, sustainable measures against alcohol and impaired driving should continue to include a mix of approaches, such as legislation, enforcement, risk reduction and education, but focus efforts more closely on strategies aimed at raising awareness and changing behavior and cultural views on alcohol and impaired driving.

Almost all the drivers surveyed are well aware that driving after drinking any alcoholic beverage is a criminal offense. They also consider that this is a type of infraction that should be punished harshly. In this respect, they assign nine points on a scale of ten possible.

Finally, with regard to the type of sanctions, 90% of drivers think that driving drunk is punishable by a fine. 96.4% consider that it may result in temporary or permanent suspension of driving license, and 70% believe that it can be punished with imprisonment.

In any case, there are several limitations of this study. This was a population-based study of Spanish drivers; there is possibly a lack of generalizability of this population to other settings.

Another possible limitation of this study is the use of self-report questionnaires to derive information rather than using structured interviews. Similarly, self-reported instruments may be less accurate than objective measures of adherence as a result of social desirability bias.

In Spain, various traffic accident prevention programs have been implemented in recent years. Some of them were alcohol-focused, designed to prevent driving under the influence and to inform the Spanish population about the dangers associated with this kind of risk behavior.

As a result, many Spanish drivers seem to be sensitized to the risk of driving drunk. As revealed in our survey, many Spanish drivers never drive under the influence of alcohol, and many of them identify DUI as maximum risk behavior. This shows that a high percentage of the Spanish population know and avoid the risks of DUI.

In any case, the reality is far from ideal, and one out of four drivers has committed this offense at least once. When asked why they did it, the two major risk factors of DUI we identified were the lack of an alternative means of transport and the influence of meals on alcohol consumption. Both situations, especially the latter, occur frequently, almost daily, while it is true that the amount of alcohol consumed in the former is considerably higher and therefore more dangerous.

In addition, most drivers are aware of the dangers of driving under the influence, and they tend to avoid the risk of accident or penalty for this reason. Some drivers never drive under the influence, to avoid a possible accident. To a lesser extent, some do not drive under the influence to avoid a possible fine. They usually think that the possibility of sanction in the event of DUI is so high that they will be fined every two times they risk driving drunk.

Moreover, drivers know the legislation regulating DUI and they believe that the current penalty for DUI is strong enough. Nevertheless, even though almost all the drivers that were fined for this reason say they changed their behavior after the event, nine out of ten drivers would penalize this kind of offense even more strongly.

Knowing how alcohol consumption impairs safety and driving skills, being aware of the associated risks, knowing the traffic regulations concerning DUI and penalizing it strongly are not enough. Many drivers habitually drive after consuming alcohol and this type of traffic infraction is still far from being definitively eradicated.

Additional efforts are needed for better management of a problem with such important social and practical consequences. Efforts should be focused on measures which are complementary to legislation and enforcement, increasing their effectiveness, such as education, awareness and community mobilization; Alcolock™; accessibility to alcohol or brief interventions.

Abbreviations

• Driving under the influence

Racioppi F, Eriksson L, Tingvall C, Villaveces A. Preventing Road Traffic Injury: a public health perspective for Europe. Copenhagen: World Health Organization Regional Office for Europe; 2004. Download from: http://www.euro.who.int/document/E82659.pdf . Accessed March 2009.

Google Scholar  

Fell JC. Repeat DWI, offenders involvement in fatal crashes in 2010. Traffic Inj Prev. 2014;15(5):431–3.

Article   PubMed   Google Scholar  

Pedragosa JL. Analisi dels accidents de transit a Catalunya i causes més rellevants. Anuario de Psicologia/Facultat de Psicologia, Universidad de Barcelona. 1995;65:205–13.

Summala H, Mikkola T. Fatal accidents among car and truck drivers: Effect of fatigue, age, and alcohol consumption. Ergonomics. 1994;36:315–26.

CAS   Google Scholar  

Alonso F, Esteban C, Calatayud C, Medina JE, Alamar B. La justicia en el tráfico: análisis del ciclo legislativo-ejecutivo a nivel internacional. Barcelona: Attitudes; 2005.

Reppetto E, Senra MP. Incidencia de algunos factores educativos, sociales y afectivos en el consumo de alcohol de los adolescentes. Rev Electron Investig Psicoeduc Psigopedag. 1997;15(1):31–42.

Turrisi R, Jaccard J, Kelly SQ, O’Mally CM. Social psychological factors involved in adolescents’ efforts to prevent their friends from driving while intoxicated. J Youth Adolesc. 1993;22(2):147–69.

Article   Google Scholar  

Weiss J. What do Israeli Jewish and Arab adolescents know about drinking and driving? Accid Anal Prev. 1996;28(6):765–9.

Article   CAS   PubMed   Google Scholar  

Becker MH, Maiman LA. Sociobehavioural determinants of compliance with health and medical care recommendations. Med Care. 1975;13(1):10–24.

Rodriguez-Marin J. Evaluación en prevención y promoción de la salud. In: Fernández R, editor. Evaluación conductural hoy. Madrid: Pirámide; 1994. p. 652–712.

Wall IF, Karch SB. Traffic Medicine. In: Stark MM, editor. Clinical Forensic Medicine. A Physician’s Guide. London: Humana Press; 2011. p. 423–58.

Peck RC, Gebers MA, Voas RB, Romano E. The relationship between blood alcohol concentration (BAC), age, and crash risk. J Safety Res. 2008;39(3):311–9.

Kaiser G. Delincuencia de tráfico y prevención general: Investigaciones sobre la criminología y el derecho penal del tráfico. Madrid: Espasa-Calpe; 1979.

Alonso F, Sanmartín J, Calatayud C, Esteban C, Alamar B, Ballestar ML. La justicia en el tráfico. Conocimiento y valoración de la población española. Barcelona: Attitudes; 2005.

Drew L, Royal D, Moulton B, Peterson A, Haddix D. National Survey of Drinking and Driving Attitudes and Behaviors. DOT HS 811-342. Washington, D.C: US Department of Transportation; 2010.

Sloan FA, Eldred LM, Guo T, Yu Y. Are people overoptimistic about the effects of heaving drinking? J Risk Uncertain. 2013;47(1):93–127.

Article   PubMed Central   PubMed   Google Scholar  

Download references

Acknowledgements

The authors wish to thank the Audi Corporate Social Responsibility program, Attitudes, for sponsoring the basic research. Also thanks to Mayte Duce for the revisions.

Author information

Authors and affiliations.

DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (University Research Institute on Traffic and Road Safety), University of Valencia, Serpis 29, 46022, Valencia, Spain

Francisco Alonso, Juan C Pastor & Cristina Esteban

FACTHUM.lab (Human Factor and Road Safety), INTRAS (University Research Institute on Traffic and Road Safety), University of Valencia, Serpis 29, 46022, Valencia, Spain

Luis Montoro

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Francisco Alonso .

Additional information

Competing interests.

The authors declare that they have no competing interests.

Authors’ contributions

All authors contributed to the design of the study and also wrote and approved the final manuscript. FA drew up the design of the study with the help of CE; the rest of the authors also contributed. JCP and LM were in charge of the data revision. JCP and CE also drafted the manuscript. FA performed the statistical analysis. All authors read and approved the final manuscript.

Rights and permissions

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Cite this article.

Alonso, F., Pastor, J.C., Montoro, L. et al. Driving under the influence of alcohol: frequency, reasons, perceived risk and punishment. Subst Abuse Treat Prev Policy 10 , 11 (2015). https://doi.org/10.1186/s13011-015-0007-4

Download citation

Received : 07 November 2014

Accepted : 02 March 2015

Published : 12 March 2015

DOI : https://doi.org/10.1186/s13011-015-0007-4

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Road safety
• Driving while intoxicated

Substance Abuse Treatment, Prevention, and Policy

ISSN: 1747-597X

• General enquiries: [email protected]

Drinking and driving among college students: The influence of alcohol-control policies

• Epidemiology & Community Health
• Healthy Weight Research Center

Research output : Contribution to journal › Article › peer-review

Background: Studies have reported high rates of heavy episodic drinking and alcohol-related problems, including drinking and driving, among college students. However, most studies have been conducted in single colleges or states. This study used a national sample to examine policy factors associated with alcohol-involved driving. Methods: A random sample of full-time students (N=10,904) attending a nationally representative sample of 4-year colleges in 39 states (n=119) completed self-administered questionnaires. The questionnaire examined driving after consuming any alcohol, driving after ≥5 drinks, and riding with a high or drunk driver. Individual-level data about driving after ≥5 drinks were linked to information on the policy environment at both local and state levels and to ratings of enforcements for drunk driving laws. Results: Drinking and driving behaviors are prevalent among a minority of college students and differ significantly among student subgroups. Students who attend colleges in states that have more restrictions on underaged drinking, high volume consumption, and sales of alcoholic beverages, and devote more resources to enforcing drunk driving laws, report less drinking and driving. Conclusion: The occurrence of drinking and driving among college students differs significantly according to the policy environment at local and state levels and the enforcement of those policies. Comprehensive policies and their strong enforcement are promising interventions to reduce drinking and driving among college students.

Bibliographical note

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

• 10.1016/S0749-3797(03)00199-5

Other files and links

• Link to publication in Scopus
• Link to the citations in Scopus

Fingerprint

• Policy Social Sciences 100%
• University Students Social Sciences 100%
• Influence Social Sciences 100%
• State Social Sciences 100%
• Control Social Sciences 100%
• Alcohol Social Sciences 100%
• College Students Psychology 100%
• Alcoholic Beverage Food Science 100%

T1 - Drinking and driving among college students

T2 - The influence of alcohol-control policies

AU - Wechsler, Henry

AU - Lee, Jae Eun

AU - Nelson, Toben F.

AU - Lee, Hang

N1 - Funding Information: This study was supported by a grant from the Robert Wood Johnson Foundation. We gratefully acknowledge the assistance of Anthony Roman and the University of Massachusetts–Boston Survey Research Center for collecting the data; Jeana Gledhill-Hoyt, Diana DerKoorkanian, and Meichun Kuo for producing the policy database used in this report; Jeff Hansen and Mark Seibring for preparation of the data; and Karen Powers for helping in the preparation of this report.

N2 - Background: Studies have reported high rates of heavy episodic drinking and alcohol-related problems, including drinking and driving, among college students. However, most studies have been conducted in single colleges or states. This study used a national sample to examine policy factors associated with alcohol-involved driving. Methods: A random sample of full-time students (N=10,904) attending a nationally representative sample of 4-year colleges in 39 states (n=119) completed self-administered questionnaires. The questionnaire examined driving after consuming any alcohol, driving after ≥5 drinks, and riding with a high or drunk driver. Individual-level data about driving after ≥5 drinks were linked to information on the policy environment at both local and state levels and to ratings of enforcements for drunk driving laws. Results: Drinking and driving behaviors are prevalent among a minority of college students and differ significantly among student subgroups. Students who attend colleges in states that have more restrictions on underaged drinking, high volume consumption, and sales of alcoholic beverages, and devote more resources to enforcing drunk driving laws, report less drinking and driving. Conclusion: The occurrence of drinking and driving among college students differs significantly according to the policy environment at local and state levels and the enforcement of those policies. Comprehensive policies and their strong enforcement are promising interventions to reduce drinking and driving among college students.

AB - Background: Studies have reported high rates of heavy episodic drinking and alcohol-related problems, including drinking and driving, among college students. However, most studies have been conducted in single colleges or states. This study used a national sample to examine policy factors associated with alcohol-involved driving. Methods: A random sample of full-time students (N=10,904) attending a nationally representative sample of 4-year colleges in 39 states (n=119) completed self-administered questionnaires. The questionnaire examined driving after consuming any alcohol, driving after ≥5 drinks, and riding with a high or drunk driver. Individual-level data about driving after ≥5 drinks were linked to information on the policy environment at both local and state levels and to ratings of enforcements for drunk driving laws. Results: Drinking and driving behaviors are prevalent among a minority of college students and differ significantly among student subgroups. Students who attend colleges in states that have more restrictions on underaged drinking, high volume consumption, and sales of alcoholic beverages, and devote more resources to enforcing drunk driving laws, report less drinking and driving. Conclusion: The occurrence of drinking and driving among college students differs significantly according to the policy environment at local and state levels and the enforcement of those policies. Comprehensive policies and their strong enforcement are promising interventions to reduce drinking and driving among college students.

UR - http://www.scopus.com/inward/record.url?scp=1542779694&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1542779694&partnerID=8YFLogxK

U2 - 10.1016/S0749-3797(03)00199-5

DO - 10.1016/S0749-3797(03)00199-5

M3 - Article

C2 - 14507527

AN - SCOPUS:1542779694

SN - 0749-3797

JO - American journal of preventive medicine

JF - American journal of preventive medicine

The Edvocate

• Lynch Educational Consulting
• Dr. Lynch’s Personal Website
• Write For Us
• The Tech Edvocate Product Guide
• The Edvocate Podcast
• Terms and Conditions
• Privacy Policy
• Assistive Technology
• Best PreK-12 Schools in America
• Child Development
• Classroom Management
• Early Childhood
• EdTech & Innovation
• Education Leadership
• First Year Teachers
• Gifted and Talented Education
• Special Education
• Parental Involvement
• Policy & Reform
• Best Colleges and Universities
• Best College and University Programs
• HBCU’s
• Higher Education EdTech
• Higher Education
• International Education
• The Awards Process
• Finalists and Winners of The 2022 Tech Edvocate Awards
• Finalists and Winners of The 2021 Tech Edvocate Awards
• Finalists and Winners of The 2020 Tech Edvocate Awards
• Finalists and Winners of The 2019 Tech Edvocate Awards
• Finalists and Winners of The 2018 Tech Edvocate Awards
• Finalists and Winners of The 2017 Tech Edvocate Awards
• Award Seals
• GPA Calculator for College
• GPA Calculator for High School
• Cumulative GPA Calculator
• Grade Calculator
• Weighted Grade Calculator
• Final Grade Calculator
• The Tech Edvocate
• AI Powered Personal Tutor

College Minor: Everything You Need to Know

14 fascinating teacher interview questions for principals, tips for success if you have a master’s degree and can’t find a job, 14 ways young teachers can get that professional look, which teacher supplies are worth the splurge, 8 business books every teacher should read, conditional admission: everything you need to know, college majors: everything you need to know, 7 things principals can do to make a teacher observation valuable, 3 easy teacher outfits to tackle parent-teacher conferences.

Research Topics About Drunk Driving

• Penalties for Drunk Driving: Criminal Charges for Causing Death While Driving Under the Influence
• Campaigns to Combat Drunk Driving
• Alcohol-Impaired Driving: Cause, Effect, and Control
• The Relationship between Breath Testing and Drunk Driving Demand
• Evidence on Punishment and Deterrence from Drunk Driving
• Seatbelt Use Following More Stringent Drunk Driving Laws
• Managing the Problem of Teenage Drinking and Driving
• The Intentional and Unintentional Consequences of Drunk Driving Policies
• Increase Penalties for Repeated Drunk Driving Offenders
• Preferred Drunk Driving Punishment Structure
• Alcohol and Drunk Driving Are Among the Leading Causes of Death.
• Technology Against Drunk Driving for U.S. Automakers
• Death Penalty for Drunk Driving: Should Drunk Drivers Who Kill Someone Get the Death Penalty?
• Repeat Offenders Can Be Prevented from Drunk Driving
• The Suffering and Pain That Drunk Driving Causes.
• State-Specific Drunk Driving Laws and Penalties in the United States
• The Necessity for More Stringent Drunk Driving Laws
• A View from the Economics of Crime on Preventing Drunk Driving Fatalities
• Evidence from Underage Drunk Driving Laws Concerning Youth Alcohol Use and Risky Sexual Behavior
• The Problem of Teenage Drinking and Driving in the United States: Causes and Solutions

Drunk Driving Essay Titles

• Relationships between Drunk Driving and Traffic Crashes
• Aggressive Strategies to Prevent Drunk Driving
• Impaired Driving Laws and Traffic Fatalities
• The Consequences of Drunk Driving on Society
• Drunk Driving and Drug Use Pose A Substantial Danger to Public Safety
• Deaths from Irresponsible Drinking and Drunk Driving
• Effects and Causes of Drunk Driving
• The Terrible Tragedy That Drunk Driving Has Caused in the United States
• The Reality of Drunk Driving: Why Drunk Driving Laws Should Be Stricter
• Dangers and Need for Preventing Drunk Driving
• Drunk Driving Following the Implementation of Smoking Bans in Bars
• Government and Society Should Collaborate to Eliminate Drunk Driving
• America Needs Better Drunk Driving Laws
• Mothers Against Drunk Driving: from the Ground Up to Policy
• Evidence from Underage Drunk Driving Laws Regarding Heavy Alcohol Use and the Commitment of Nuisance Crime
• Psychological Foundations of Drunk Driving
• Comparison of Mothers Against Drunk Driving and the National Urban League
• Preventing Teen Drinking and Driving
• License Revocation and Impaired Driving
• Drunk Driving Fatalities: Exigent Solution
• What Is Teenage Drunk Driving, and What Happens When the Phrase “Drunk Driving” Is Heard?
• Why Does Drunk Driving Occur?
• Why Should Drunk Driving Laws Be Made Stricter?
• How Has Drinking and Driving Affected A Student?
• Did Ontario’s Zero Tolerance and Graduated Licensing Laws Reduce Drunk Driving Among Teenagers?
• Can Police Deter Drunk Driving?
• What Are the Effects and Cause Essays on Drunk Driving?
• What Is the Issue with Drinking and Driving?
• What Are the Five Telltale Signs of An Impaired Driver?
• What Is the Definition of Drunk Driving?
• Is It A Drunk Driver or A Drunken Driver?
• Why Do Drunk Drivers Manage to Survive?
• Why Are Drunk Drivers Treated So Lightly?
• What Is the Remedy for Drunk Driving?
• How Can You Stop Drinking and Driving?
• What Do Drivers Need Three Seconds to Accomplish?
• How Long After Drinking Is It Safe to Drive?
• What Are the Penalties for A First Offense of Driving Under the Influence?
• Do You Accumulate Points for Drunk Driving?
• What Are Some Common Driving Distractions?
• What Are the Consequences of Drunk Driving?
• How Might One Best Defend Against A Drunk Driving Charge?
• What Do Police Frequently Look for in Drunk Drivers on the Road?
• Why Does America Need to Improve Its Drunk Driving Laws?
• How Do We Tackle the Problem of Teenage Drunk Driving?
• What Are Deterring Drunk Driving Fatalities?
• Did Ontario’s Zero Tolerance and Graduated Licensing Laws Reduce Drunk Driving Among Teens?
• What Are the Psychological Roots of Driving Under the Influence?
• What Are the Argumentative Effects of Free Drunk Driving on Society?
• What Are Effective Punishments for Drunk Driving in Wisconsin?

Research Topics on Domestic Violence

E-learning authoring tools: everything you need to ....

Matthew Lynch

Related articles more from author, aztec essay topics, simple & easy insanity defense essay topics, fascinating criticism essay topics to write about, essay topics on downsizing, research topics about alexander hamilton, conscience essay topics.

86 Drunk Driving Essay Topic Ideas & Examples

🏆 best drunk driving topic ideas & essay examples, ⭐ good research topics about drunk driving, 👍 simple & easy drunk driving essay titles, ❓ research questions about drunk driving.

• Drunk Driving vs. Texting While Driving Specifically, it presents the issue of drunk driving and texting while driving to investigate which of the two distracters causes more accidents on the roads.
• On the Issue of Drunk Driving The concentration of alcohol in a driver’s blood is directly proportional to the driver’s ability to judge distances as well react appropriately to sudden happenings in the road. We will write a custom essay specifically for you by our professional experts 808 writers online Learn More
• Driving Under the Influence of Alcohol One of the implications of the adolescent and adult driving while intoxicated is enduring the life after the occurrence of breaking the law.
• Drunk Drivers Should Be Imprisoned on the First Offense Drunk driving has been reported to be the leading cause of traffic accidents around the globe that has led to many deaths and loss of property.
• Drunk Driving Problem in the Modern Society I strongly believe that drunk driving is the problem which must be solved, however, the solutions to the problem which have already existed could not eliminate the problem.
• Drunk Driving and Its Consequences In all states of the United States, it is illegal to drive under the influence of alcohol beyond the set limit per state, according the countries legal definition, drunk driving is driving when one has […]
• Mothers Against Drunk Driving and National Public Radio’s Cultural Modes In Mothers Against Drunk Driving and National Public Radio, and National Public Radio, a proactive society is created in terms of norms and values, thanks to the organization’s beneficial system benefits the contributors’ financiers alike.
• Deterring the Drunk Driver: An Investigation of the Effectiveness of DUI Legislation Despites various legalizations in the prevention of repeat DUI offenses, research shows that the do little in the prevention of first time DUI offenses.
• Public Service Ads Against Drunk Driving The PSA includes the imagery of glasses filled with alcoholic drinks crashing against each other with the sound of a car accident in the background.
• Drunk Driving and Traffic Violations Issues A person who exceeded the norms of alcohol, and was driving home, is a violation that does not correspond to the punishment of spending a certain time in jail.
• Drunk Driving Issue Analysis One finds that the deep changes in the body composition of drinkers after drinking; one would anticipate alcohol to have as a minimum various straight outcomes on behavior.
• Teenage Drunk Driving Issue Analysis Therefore there is a need to analyze the relationship between drinking and driving and when it comes to teenagers, injuries take the form of fatal accidents.
• Tougher Laws Against Drunk Driving It must begin with laws that lower the limit so that drivers with a BAC of 0. 05 must not be allowed to operate a motor vehicle.
• Public Policy: The Issue of Drunk Driving The Government puts a great amount of effort into the DUI policy to minimize the number of impaired drivers getting behind the wheel and mitigating the consequences of such conduct.
• Alcohol and Drugs in Fatally Injured Drivers The researchers targeted to examine the prevalence of drugs in a sample of drivers. The other variables included the time of the crash, and fatalities reported after the accident.
• Mothers Against Drunk Driving It is useful to victims of drunken driving and to the families of the deceased victims as a result of drunk driving.
• Penalties for Drunk Driving: Criminal Charges for Killing Someone When Drunk Driving
• Campaigns Against Drunk Driving
• Drunk Driving Cause, Effect, and Control
• Breath Testing and the Demand for Drunk Driving
• Punishment and Deterrence: Evidence From Drunk Driving
• Seatbelt Use Following Stricter Drunk Driving Regulations
• Dealing With the Problem of Teenage Drunk Driving
• The Intended and Unintended Effects of Drunk Driving Policies
• Increasing Penalties for Drunk Driving Repeat Offenders
• Optimal Drunk Driving Penalty Structure
• Alcohol and Drunk Driving Is One of the Most Frequent Causes of Death
• Anti-drunk Driving Tech for U.S. Carmakers
• Death Penalty for Drunk Driving: Should Drunk Drivers Get the Death Penalty if They Kill Someone?
• Drunk Driving Stopping Repeat Offenders
• The Pain and Suffering Caused by Drunk Driving
• Drunk Driving Laws and Penalties by State in the USA
• The Need for Stricter Drunk Driving Laws
• Deterring Drunk Driving Fatalities: An Economics of Crime Perspective
• Youth Alcohol Use and Risky Sexual Behavior: Evidence From Underage Drunk Driving Laws
• The Causes and Solutions to the Problem of Teenage Drunk Driving in the U.S.
• Links Between Drunk Driving and Road Accidents
• Aggressive Methods of Preventing Drunk Driving
• Drunk Driving Legislation and Traffic Fatalities
• Drunk Driving: Its Effects on the Society
• Drunk Driving and Drugs Are a Significant Threat to Public Safety
• Irresponsible Drinking and Drunk Driving Deaths
• Cause and Effect of Drunk Driving
• The Terrible Tragedies Caused by Drunk Driving in the United States
• The Truth About Drunk Driving: Why the Drunk Driving Laws Should Be Worse
• Dangers and Need for Preventing Drunk Driving
• Drunk Driving After the Passage of Smoking Bans in Bars
• Society and the Government Should Work Together to Eliminate Drunk Driving
• America Needs Better Drunk Driving Laws
• Mothers Against Drunk Driving: Grassroots Movement to Policy
• Heavy Alcohol Use and the Commission of Nuisance Crime: Evidence From Underage Drunk Driving Laws
• The Psychological Roots of Drunk Driving
• Comparing Mothers Against Drunk Driving and National Urban Leagues
• Preventing Adolescent Drunk Driving
• License Suspension and Drunk Driving
• Drunk Driving Fatalities: Exigent Solution
• What’s Drunk Driving Among Teens, and What Happens When Hearing the Phrase “Drunk Driving”?
• Why Drunk Driving Happens?
• Why Should the Drunk Driving Laws Be Worse?
• How Drunk Has Driving Impacted a Student?
• Did Ontario’s Zero Tolerance & Graduated Licensing Law Reduce Youth Drunk Driving?
• Can Police Deter Drunk Driving?
• What Are Cause and Effect Essay on Drunk Driving?
• What Is the Problem With Drunk Driving?
• What Are the Five Signs of a Drunk Driver?
• What Is Meant by Drunken Driving?
• Is It a Drunk Driver or a Drunken Driver?
• Why Do Drunk Drivers Survive?
• Why Do Drunk Drivers Get off Easy?
• What Is the Solution to Drunk Driving?
• How Do You Stop Drunk Driving?
• What Does It Take Drivers Three Seconds to Do?
• How Long After Drinking Can You Drive?
• What Is the Penalty in Case of Drunken Driving for the First Offense?
• Do You Get Points for Drunk Driving?
• What Are Some Distractions While Driving?
• What Is the Punishment for Drunk Driving?
• What Is the Best Way to Beat a Drunk Driving Charge?
• What Do Cops Often Look For From Drunk Drivers on the Road?
• Why Does America Need Better Drunk Driving Laws?
• What Is Dealing With the Problem of Teenage Drunk Driving?
• What Are Deterring Drunk Driving Fatalities?
• Did Ontario’s Zero Tolerance and Graduated Licensing Law Reduce Youth Drunk Driving?
• What Are the Psychological Roots of Drunk Driving?
• What Are the Effects to the Society Argumentative of Free Drunk Driving?
• What Are Good Drunk Driving Punishments in Wisconsin?
• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2023, October 26). 86 Drunk Driving Essay Topic Ideas & Examples. https://ivypanda.com/essays/topic/drunk-driving-essay-topics/

"86 Drunk Driving Essay Topic Ideas & Examples." IvyPanda , 26 Oct. 2023, ivypanda.com/essays/topic/drunk-driving-essay-topics/.

IvyPanda . (2023) '86 Drunk Driving Essay Topic Ideas & Examples'. 26 October.

IvyPanda . 2023. "86 Drunk Driving Essay Topic Ideas & Examples." October 26, 2023. https://ivypanda.com/essays/topic/drunk-driving-essay-topics/.

1. IvyPanda . "86 Drunk Driving Essay Topic Ideas & Examples." October 26, 2023. https://ivypanda.com/essays/topic/drunk-driving-essay-topics/.

Bibliography

IvyPanda . "86 Drunk Driving Essay Topic Ideas & Examples." October 26, 2023. https://ivypanda.com/essays/topic/drunk-driving-essay-topics/.

• Texting and Driving Research Ideas
• Driving Research Ideas
• Cell Phone Ideas
• Distracted Driving Essay Ideas
• Crime and Punishment Titles
• Electric Vehicle Paper Topics
• Alcohol Essay Titles
• Gasoline Prices Ideas
• Uber Topics
• Drugs Titles
• Vehicles Essay Topics
• Criminal Behavior Essay Topics
• First Aid Research Topics
• Death Penalty Questions
• Social Security Paper Topics

• school Campus Bookshelves
• menu_book Bookshelves
• perm_media Learning Objects
• login Login
• how_to_reg Request Instructor Account
• hub Instructor Commons
• Download Page (PDF)
• Download Full Book (PDF)
• Periodic Table
• Physics Constants
• Scientific Calculator
• Reference & Cite
• Tools expand_more
• Readability

selected template will load here

This action is not available.

6.7: A Student Example- “Preventing Drunk Driving by Enforcement” by Daniel Marvins

• Last updated
• Save as PDF
• Page ID 6641

• Steven D. Krause
• Eastern Michigan University

The assignment that was the basis for this essay asked students to write a “first person narrative” about the research project they would be working on for the semester. “It was really important to me think about a lot of different ideas and topics because I was worried that I might not be able to find enough research or stick with it,” Marvins said. “This project helped me think this through.”

Preventing Drunk Driving by Enforcement

Despite the fact that Americans are more aware of the problems of drunk driving than we were in the past, it is still a serious problem in the U.S. While educating everyone about the dangers of drunk driving is certainly important, I am interested in researching and writing about different ways to more strictly enforce drunk driving laws.

My working thesis for my research project is “While stronger enforcement measures to control drunk driving might be controversial and a violation of individual rights, they have to be enacted to stop drunk driving deaths.” By “stronger enforcement measures,” I mean things like police check points, lower legal levels of blood-alcohol, required breatholizer tests, less control on police searching cars, and stronger jail sentences.

I got the idea to focus on this topic by working on some of the different brainstorming techniques we talked about in class. I tried several different brainstorming techniques including freewriting and clustering. For me, the most useful technique was making a list of ideas and then talking it over with the other students in my group.

We all agreed that drunk driving would be a good topic, but I thought about writing about other topics too. For example, I think it would also be interesting to write about gun control laws, especially how they might effect deaths with kids and guns. I also thought it might be interesting to do research on the tobacco business and the lawsuits different states are conducting against them.

But I am more interested in exploring issues about drunk driving for a couple of different reasons. First, I think drunk driving is an issue that a lot of people can relate to because most people know that it is dangerous and it is a bad idea. For example, we hear and read messages about not driving drunk in a lot of different advertisements. Still, even though everyone knows it is a bad idea, there are still a lot of deaths and injuries that result from drunk driving.

Second, I’m interested in doing research on stronger enforcement of drunk driving laws because I am not sure I have made my own mind up about it. Like everyone else, I of course think drunk driving is bad and police and society should do everything they can do to prevent people from driving drunk. On the other hand, I also think it’s bad for police to pull over everyone they think might be drunk even when they don’t know for sure. Strong enforcement might stop a lot of drunk driving, but it also gives police more chances to violate individual liberties and rights.

I have done a little bit of research already and I don’t think I’m going to have any problem finding evidence to support my topic. Drunk driving seems to be a pretty common topic with a lot of different things written about it. I did a quick search of the library’s databases and the World Wide Web and I found thousands of different articles. I skimmed the titles and it seemed like a lot of them would be very relevant and useful for my subject.

Drunk driving is a serious problem and everyone agrees that we should do something about it. The question is what should “it” be? My hope is that through my research, I will learn more about how stronger enforcement of drunk driving laws can curtail drunk driving, and I hope to be able to convince my readers of this, too.

Drinking and Driving Research Paper

View sample crime research paper on drinking and driving. Browse other research paper examples for more inspiration. If you need a thorough research paper written according to all the academic standards, you can always turn to our experienced writers for help. This is how your paper can get an A! Feel free to contact our writing service for professional assistance. We offer high-quality assignments for reasonable rates.

The automobile age brought with it unprecedented prosperity and freedom of movement, but motor vehicles have also caused the deaths and injuries of millions of people. From the beginning the abuse of alcohol has been universally viewed as one of the major causes of vehicular carnage, with severe punishments being deemed the best way of dealing with the self-indulgent reprobates responsible.

Academic Writing, Editing, Proofreading, And Problem Solving Services

Get 10% off with 24start discount code.

According to the sociologist Joseph Gusfield, noted for his work on alcohol in American society, behind all legislation aimed at curtailing drinking and driving is the image of ‘‘the killer drunk,’’ the morally flawed character who has committed more than an ordinary traffic violation. Unlike the social drinker, who knows his limits and respects the law, the drinking driver is a villain who threatens the lives of the innocent through indulgence in his own pleasure. In this legislation, unlike other kinds of traffic law, it is the behavior itself, the hostile, antisocial menace, which is singled out for special disapproval. From this perspective, the enforcement of drinking-driving legislation is as much a matter of public morality as it is of public convenience and safety (Gusfield).

The specter of the killer drunk is the key image that animates ‘‘the dominant paradigm,’’ to use the term coined by H. Laurence Ross, another American sociologist who has done more than any other scholar to elucidate, from an international perspective, the causes and prevention of drinking and driving (Ross, 1982, 1992). The dominant paradigm understands that there is a safe drinking level for the great mass of responsible drivers, differentiated from the levels regularly achieved by the small minority of reckless ‘‘drunken drivers.’’ The problem, in fact, is not ‘‘drinking and driving’’ at all, but ‘‘drunken driving.’’ The dominance of this paradigm in the United States is one reason why the term drunken driving is used so often there, in contrast to most European nations and Australia, where ‘‘drinking and driving’’ or ‘‘drink-driving’’ are the more popular terms.

How one defines the problem is fundamentally important in determining how one thinks about responses. The dominant paradigm calls for severe punishments administered through the criminal justice system. Not only are such punishments fitting, they are capable of deterring further offending, especially if they are backed by rigorous police enforcement. To the extent that the problem is construed in terms of the pathetic drunk rather than the cold-blooded killer, proponents of the dominant paradigm are also comfortable with offering treatment to offenders, provided such programs are not used to evade punishment.

Another way of viewing the problem is through what Laurence Ross calls ‘‘the challenging paradigm.’’ Those who think within this framework are uncomfortable about drawing a rigid line between dangerous drunks and social drinkers, although they recognize that heavy drinkers are a critical part of the problem. Their inspiration is the public health perspective, which is not primarily concerned with righting the moral balance of the world but with minimizing alcohol-related harms. Adherents of the challenging paradigm view alcohol-related accidents as the product of the conjunction of the social institutions of transportation and recreation, rather than as a manifestation of moral dereliction. All developed societies rely, to an increasing extent, on private vehicles for all daily functions including recreation, while the consumption of alcohol is accorded an honored place in afterwork camaraderie, weekend leisure, and business lunches. Large taverns with even larger car parks are built in the suburbs, and drinking to intoxication remains a core recreational activity for large numbers of people.

If the problem is institutions, perhaps the solutions lie in modifying the way these institutions operate. The challenging paradigm has a place for the criminal justice system, especially if the emphasis is on the general deterrence of the whole driving population. However, they also look beyond the criminal justice system to alcohol and transportation policy, exploring the utility of such measures as reducing alcohol availability or making vehicles or roadside hazards more ‘‘forgiving’’ of the errors of the drinking driver.

In the remainder of this discussion we explore many of the issues raised by the dominant and challenging paradigms, and assess the scientific evidence for the claims made.

The Role of Alcohol in Road Accidents

Around the middle of the twentieth century the technical means became available to measure the quantity of alcohol in a person’s blood (the blood alcohol concentration, or BAC, usually measured in terms of grams of alcohol per milliliter of blood). Laboratory research using this technology showed that at BAC levels much lower than those normally associated with intoxication, tasks related to driving performance (such as divided attention tasks) were noticeably affected. Although the effects of BAC depend on such factors as an individual’s weight, rate of drinking, and presence of food in the stomach, deterioration in performance becomes quite marked between BACs of .05 and .08. As a guide, the average man would attain a BAC of .05 or higher if he drank three ‘‘standard drinks’’ (e.g., three mid-size glasses of mid-strength beer) within one hour, without eating.

The alcohol-crash link was confirmed in a series of case-control studies that compared the BACs of drivers experiencing crashes with those of matched non-crash-involved drivers. These studies found that relative crash risks increase exponentially with BAC: at .05 the risk is double that for a zero-BAC driver, at .08 the risk is multiplied by ten, while at .15 or higher (the levels typically attained by drivers arrested for drinking and driving) the relative risk is in the hundreds. The curve is even steeper for serious and fatal crashes, for single-vehicle crashes, and for young people.

While it is likely that factors other than alcohol, such as a propensity to take risks, contribute both to the levels of drinking and to crash involvement, there is a near universal consensus that there is a direct and causal link between alcohol consumption and crashes, especially serious crashes. For example, eliminating alcohol would probably have prevented about 47 percent of fatal crashes in the United States in 1987 (Evans).

Prevalence and Patterns of Drinking and Driving

The most direct way of measuring the prevalence of drinking and driving is to take breath tests from a random sample of motorists. A number of countries carry out these surveys periodically, usually at nights and at weekends when drinking drivers are more numerous. Two groups of nations emerge in these studies. One group includes Scandinavia and Australia, where there are relatively few drinking drivers on the roads. Moderate to high BACs are found among less than 1 percent of drivers in these countries, even at peak leisure times. The second group includes the United States, Canada, France, and the Netherlands, where between 5 and 10 percent of drivers during nighttime leisure hours have moderate to high BACs. These patterns are broadly consistent with overall road fatality rates for different countries, and also with analyses of the BACs of drivers killed. However, in these latter studies even the Scandinavian countries have found that more than a quarter of drivers have positive BACs, despite the low numbers overall of drinking drivers on the road.

A second main way of estimating the prevalence of drinking and driving is to ask random samples of drivers about their behaviors in the recent past. For example, a 1988 study comparing Norwegian, Australian, and American drivers found that 28 percent of Australians, 24 percent of Americans, but only 2 percent of Norwegians admitted to driving in the past year after four or more drinks (Berger et al.). Despite their poor behaviors, 78 percent of the Australians agreed that it was morally wrong to drive after so many drinks, a higher figure than in the United States, but (again) lower than for the Norwegians, who scored a very high 98 percent. Overall, ‘‘general prevention,’’ defined as the influence of moral inhibitions and of social pressures, had taken greater hold in Norway than in the English-speaking countries, but general deterrence (behavior change in response to fear of the threat of legal sanctions) was a more potent force in Australia than in the other countries.

Using intoxication among drivers in fatal crashes as an indicator, dramatic reductions in drinking and driving were experienced in most developed countries in the 1980s. However, the indicators reversed direction in the early 1990s, but then continued in modest decline in the second half of the decade. Formal and informal controls on drinking and driving differ markedly from country to country, but nevertheless there appear to be some common influences. Levels of police enforcement (not the severity of penalties) stand out in all countries as an influence, together with a reduction in per capita alcohol consumption. Attention paid to the problem by political leaders, and the visibility of drinking and driving in the press, appear to be critical factors.

The deterrence of drinking and driving depends primarily on increasing the perceived probability of apprehension in the target population. One way of accomplishing this is to introduce laws that replace the vague offense of ‘‘driving under the influence’’ with the offence of driving with a BAC above a prescribed level (usually .08 or .05). Another way is to initiate a police crackdown on drinking and driving for a period of time. The experience of the United Kingdom in 1967, when it introduced for the first time a .08 BAC limit, illustrates well the usual impact of such interventions. The law was extremely controversial at the time, with the result that most drivers were aware of it and believed they would be caught if they drove after drinking. There was a marked decline in serious accidents at nights and weekends, but not at times when drinking and driving would not be expected. However, the deterrent impact wore off within a few years as drivers gradually became used to the new law, and realized that their chances of detection were in fact not very high.

This pattern of a sharp decline in drinking and driving coincident with a new law or with intensified police enforcement, followed by a gradual decline to pre-intervention levels, is commonly found. Deterrence is an unstable psychological process dependent on continuous publicity and on the perception of a credible police threat. However, random breath testing (RBT) is a major exception to the rule that enforcement effects are invariably temporary.

Under RBT as it is practiced in Australia and some Scandinavian countries, large numbers of motorists are pulled over at random by police and required to take a preliminary breath test, even if they are in no way suspected of having committed an offense or been involved in an accident. Thus RBT should be sharply distinguished from the U.S. practice of sobriety checkpoints, in which police must have reasonable suspicion of alcohol consumption before they can require a test. The RBT law has been very extensively advertised and vigorously enforced in Australia, with the result that 82 percent of motorists reported in 1999 having been stopped at some time (compared with 16 percent in the United Kingdom and 29 percent in the United States).

Time series analyses of accidents show that in Australia RBT had an immediate, substantial, and permanent impact, with every extra one thousand tests conducted each day by police resulting in a 6 percent decline in daily serious accidents (Henstridge et al.). The direct deterrent impact was enhanced by the fact that RBT gave heavy drinkers a legitimate excuse to drink less when drinking with friends. This is a good example of how formal sanctions can reinforce informal sanctions.

The same time series analyses show that a reduction in the legal BAC in some states from .08 to .05 resulted in an average 10 percent decline in serious accidents. This is consistent with experience in other countries where the BAC level has been reduced.

RBT and lower BAC levels concern certainty of detection. Administrative license revocation, the practice in some U.S. states where drivers who drink have their licenses revoked almost as soon as they fail a breath test, concerns swiftness of punishment. Research supports the potential of this procedure to reduce the recidivism of sanctioned drivers and to deter others. As a general rule, the only sanction applied to drivers who drink that reduces recidivism is loss of license. Although many drivers continue to drive while unlicensed, they tend to be more cautious and hence safer. Thus it seems that license loss has (to some extent) a physically incapacitating effect.

Other Countermeasures

License loss is effective for both alcoholrelated and non-alcohol-related accidents, but its impact on drinking and driving can be enhanced if combined with alcohol treatment. While treatment without license suspension is generally ineffective, suspension plus education, psychotherapy counseling, or follow-up contact probation (preferably in combination) produce an additional 7 to 9 percent reduction in recidivism and accidents (Wells-Parker et al.). Ignition interlock devices, which prevent a vehicle being started until the driver passes a breath test, have been shown to be very effective for many highrisk offenders. However, the effects tend to be limited to the period of the court order unless combined with treatment within a case management framework to deal with the underlying problems.

The problem with all countermeasures focused on apprehended offenders is that most serious alcohol-related crashes involve drivers with no prior drinking and driving convictions. Hardcore drivers who drink comprise about 1 percent of drivers on the road, but more than a quarter of drivers killed. Many of these drivers have a history of violence and serious antisocial behavior including crime, with alcohol abuse simply one facet of their deviant careers. It is likely that for this group a radically different approach is needed, involving early childhood interventions (Farrington).

Most accidents do not involve hard-core offenders, and there is therefore a continuing need for countermeasures directed at the general population. Promising measures include promotion of responsible beverage service for bar staff and managers of on-premise alcohol outlets combined with deterrence of drinking and driving through local enforcement; reduction in retail availability of alcohol to minors; and reductions in the number and density of alcohol outlets to limit general access to alcohol. Any measure that reduces per capita alcohol consumption, such as increases in price through taxation, will reduce alcohol-related accidents.

Reducing dependence on driving has similar promise. Successful measures include designated driver programs (someone in a group stays sober so that that person can drive home), safe rides programs, and increasing the age of driver licensing or restricting licenses to daytime use for young drivers. Promoting public transport would certainly be effective if it were ever evaluated for its impact on drinking and driving. Contrary to expectations, there is no evidence that driver education for young people reduces crash involvement. Indeed, the evidence suggests the reverse: by encouraging young people to gain their license at an earlier age, such training increases exposure to risk, and hence accidents.

Finally, making the vehicle and roadside environment more forgiving of the errors of drinking drivers will reduce deaths and injuries. Frangible poles that minimize damage to vehicles; improved response times and skills of emergency medical teams; more use of seatbelts and airbags; and brighter reflective road signs (so impaired drivers notice them) are but a few examples of effective environmental interventions.

Overall, the picture is one of steady progress, with some setbacks. The challenging paradigm, based on the principles of population health, continues to score successes through such strategies as reducing the legal blood alcohol concentration. General deterrence, especially utilizing random enforcement methods, has achieved permanent reductions in alcohol-related crashes, as has administrative license revocation. Treatment combined with license suspension and ignition interlocks reduce recidivism and accidents. Tougher penalties, the major emphasis of the dominant paradigm, show no promise at all.

The challenges include maintaining the deterrent impact of random enforcement; finding long-term ways of dealing with hard-core offenders; optimizing the use of alcohol and driving controls in politically acceptable ways; and maintaining political and media interest in the drinking and driving problem in the face of stiff competition from other social issues. The fact that drinking and driving declined in most countries in the latter part of the twentieth century, despite wide variations in prevention strategies, suggests that within the challenging paradigm there are many pathways to a safer motoring environment.

Bibliography:

• BERGER, DALE; SNORTUM, JOHN R.; HOMEL, ROSS J.; HAUGE, RAGNAR; and LOXLEY, WENDY. ‘‘Deterrence and Prevention of AlcoholImpaired Driving in Australia, the United States and Norway.’’ Justice Quarterly 7 (3) (1990): 453–465.
• EVANS, LEONARD. Traffic Safety and the Driver. New York: Van Nostrand Reinhold, 1991.
• FARRINGTON, DAVID. ‘‘Early Developmental Prevention of Juvenile Delinquency.’’ Criminal Behavior and Mental Health 4 (3) (1994): 209–227.
• GUSFIELD, JOSEPH The Culture of Public Problems: Drinking-Driving and the Symbolic Order. Chicago, Ill.: The University of Chicago Press, 1981.
• HAUGE, R., ed. Scandinavian Studies in Criminology. 6, Drinking and Driving in Scandinavia. Oslo, Norway: Universitetsforlaget, 1978.
• HENSTRIDGE, JOHN; HOMEL, ROSS; and MACKAY, PETA. The Long-Term Effects of Random Breath Testing in Four Australian States: A Time Series Analysis. Canberra, Australia: Federal Office of Road Safety, 1997.
• HINGSON, RALPH. ‘‘Prevention of Drinking and Driving.’’ Alcohol Health and Research World 20, no. 4 (1996): 219–226.
• HOMEL, ROSS. Policing and Punishing the Drinking Driver: A Study of General and Specific Deterrence. New York: Springer-Verlag, 1988.
• HOMEL, ROSS. ‘‘Drivers Who Drink and Rational Choice: Random Breath Testing and the Process of Deterrence.’’ In Routine Activity and Rational Choice. Edited by Ronald V. Clarke and Marcus Felson. Vol. 5 Advances in Criminological Theory. New Brunswick, N.J.: Transaction Publishers, 1993. Pages 59–84.
• LAURENCE, MICHAEL; SNORTUM, JOHN R.; and ZIMRING, FRANKLIN E., eds. Social Control of the Drinking Driver. Chicago, Ill.: The University of Chicago Press, 1988.
• MCCORD, JOAN. ‘‘Drunken Drivers in Longitudinal Perspective.’’ Journal of Studies on Alcohol 45 (1984): 316–320.
• ROSS, H. LAURENCE. Deterring the Drinking Driver: Legal Policy and Social Control. and updated ed. Lexington, Mass.: Lexington Books, 1984.
• ROSS, H. LAURENCE. Confronting Drunk Driving: Social Policy for Saving Lives. New Haven, Conn.: Yale University Press, 1992.
• ROSS, H. LAURENCE. ‘‘Prevalence of Alcohol-Impaired Driving: An International Comparison.’’ Accident Analysis and Prevention 25(6) (1993): 777–779.
• WELLS-PARKER, ELIZABETH; BANGERT-DROWNS, ROBERT; MCMILLEN, ROBERT; and WILLIAMS, MARSHA. ‘‘Research Report: Final Results From a Meta-Analysis of Remedial Interventions with Drink/Drive Offenders.’’ Addiction 90 (7) (1995) 907–926.
• WILSON, R. JEAN, and MANN, ROBERT, eds. Drinking and Driving: Advances in Research and Prevention. New York: The Guilford Press, 1990.

ORDER HIGH QUALITY CUSTOM PAPER

• Solutions Industry Gaming Automotive Sports and events Education Government Travel & Hospitality Financial Services Healthcare Cannabis Technology Use case NPS+ Communities Audience Contactless surveys Mobile LivePolls Member Experience GDPR Employee Experience Conjoint
• Resources Blog eBooks Survey Templates Case Studies Training Help center

Drunk Driving Survey Questions + Sample Questionnaire Template

Drunk Driving Survey Questions Template is designed to collect feedback from people regarding their opinions of drunk driving. This sample survey template consists of 15 questions that help an individual express their free opinion about the ones who risk others lives through this act. This questionnaire can be customized and more questions can be added to suit the needs of researchers. This survey template will help receive first-hand responses on what the common people think about law enforcement against drunk driving. People driving under the influence of alcohol are called drunk drivers. When charged with this crime the driver is charged under Driving Under the Influence (DUI). Studies have been performed in the past to understand the common attributes among drunk drivers to know what leads them to this behavior. In America alone, 17,000 lives are consumed every year due to drunk driving. This is a huge loss for the families of the victim. In some cases where the victim survives this might lead to trauma and other mental health disorders. Below are the questions related to drunk driving:

• Desktop Created with Sketch.
• Mobile Created with Sketch.

Related templates and questionnaires

Apparel shopping lifestyle survey template, general shopping demographics survey template, life attitudes survey template.

• Sample Questions
• Sample Reports
• Survey Logic
• Integrations
• Professional Services
• Survey Software
• Customer Experience
• Communities
• Polls Explore the QuestionPro Poll Software - The World's leading Online Poll Maker & Creator. Create online polls, distribute them using email and multiple other options and start analyzing poll results.
• Research Edition
• Survey Templates
• Case Studies
• Coronavirus Resources
• Qualtrics Explore the list of features that QuestionPro has compared to Qualtrics and learn how you can get more, for less.
• SurveyMonkey
• VisionCritical
• Market Research Survey Software Real-time, automated and advanced market research survey software & tool to create surveys, collect data and analyze results for actionable market insights.
• Employee Survey Software Employee survey software & tool to create, send and analyze employee surveys. Get real-time analysis for employee satisfaction, engagement, work culture and map your employee experience from onboarding to exit!
• Customer Survey Software Robust, automated and easy to use customer survey software & tool to create surveys, real-time data collection and robust analytics for valuable customer insights.
• Community Survey Software Use the community survey software & tool to create and manage a robust online community for market research. Collect community feedback and insights from real-time analytics!
• Web Survey Software Powerful web survey software & tool to conduct comprehensive survey research using automated and real-time survey data collection and advanced analytics to get actionable insights.
• Mobile Survey Software Leverage the mobile survey software & tool to collect online and offline data and analyze them on the go. Create and launch smart mobile surveys!
• Business Survey Software Powerful business survey software & tool to create, send and analyze business surveys. Get actionable insights with real-time and automated survey data collection and powerful analytics!
• Enterprise Survey Software Real time, automated and robust enterprise survey software & tool to create surveys. collect data and analyze responses to get quick actionable insights.
• Email Survey Software Robust email survey software & tool to create email surveys, collect automated and real-time data and analyze results to gain valuable feedback and actionable insights!
• SMS Survey Software Use the power of SMS to send surveys to your respondents at the click of a button. SMS survey software and tool offers robust features to create, manage and deploy survey with utmost ease.
• Offline Surveys
• Customer Satisfaction Surveys
• Net Promoter Score (NPS) Learn everything about Net Promoter Score (NPS) and the Net Promoter Question. Get a clear view on the universal Net Promoter Score Formula, how to undertake Net Promoter Score Calculation followed by a simple Net Promoter Score Example.
• Conjoint Analysis
• GDPR & EU Compliance
• Likert Scale Complete Likert Scale Questions, Examples and Surveys for 5, 7 and 9 point scales. Learn everything about Likert Scale with corresponding example for each question and survey demonstrations.
• Executive Team
• Advisory Board
• Testimonials
• In the news

QuestionPro in your language

• Encuestas Online
• Pesquisa Online
• Umfrage Software
• Сервис опросов
• برامج للمسح
• Logiciel d'enquête

Awards & certificates

The experience journal.

Find innovative ideas about Experience Management from the experts

• Privacy Statement
• Terms of Use
• Cookie Settings

Creating a survey with QuestionPro is optimized for use on larger screens -

Though you're welcome to continue on your mobile screen, we'd suggest a desktop or notebook experience for optimal results.

• Share full article

Advertisement

Supported by

Complications From Alcohol Use Are Rising Among Women

New research shows that alcohol-related liver disease and other health problems increased even more than expected among women ages 40 to 64 during the pandemic.

By Dani Blum

A new study adds to a mounting body of evidence showing that rising alcohol consumption among women is leading to higher rates of death and disease. The report, published Friday in the journal JAMA Health Forum , examined insurance claims data from 2017 to 2021 on more than 14 million Americans ages 15 and older. Researchers found that during the first year and a half of the coronavirus pandemic, women ages 40 to 64 were significantly more likely than expected to experience serious complications like alcohol-related cardiovascular and liver disease, as well as severe withdrawal.

The Background

Alcohol consumption in the United States has generally increased over the last 20 years , said Dr. Timothy Naimi, the director of the Canadian Institute for Substance Use Research at the University of Victoria. Dr. Naimi was a co-author on a recent paper that showed deaths from excessive alcohol use in the United States rose by nearly 30 percent between 2016 and 2021.

While men still die more often from drinking-related causes than women, deaths among women are climbing at a faster rate. “The gap is narrowing,” said Dr. Bryant Shuey, an assistant professor of medicine at the University of Pittsburgh and the lead author of the new study.

The Research

The study looked at serious health issues related to drinking, including alcohol-related liver and heart disease, inflammation of the stomach lining that led to bleeding, pancreatitis, alcohol-related mood disorders and withdrawal. Researchers compared insurance claims data for these complications with the rates they expected to see based on past prevalence of these conditions.

In nearly every month from April 2020 to September 2021, women ages 40 to 64 experienced complications from alcohol-related liver disease — a range of conditions that can develop when fat begins to accumulate in the liver — at higher rates than researchers predicted. If damage from drinking continues, scar tissue builds up in the liver and leads to a later stage of the disease, called cirrhosis. Some people with alcohol-related liver disease also develop severe liver inflammation, known as alcohol-associated hepatitis.

Rates of alcohol-related complications during the pandemic were also higher than predicted among men ages 40 to 64, but those increases were not statistically significant. But “men are not out of the woods” and still face health risks, Dr. Shuey said.

The Limitations

The study examined data only up until September 2021. Katherine Keyes, a professor of epidemiology at Columbia University who was not involved in the latest study, said she expected that alcohol use might keep rising among women — a pattern that could contribute to even more health issues.

And since the study relied on insurance claims, Dr. Shuey said it told an incomplete story. If someone is treated in the emergency room for an inflamed pancreas but doesn’t disclose a drinking history, for example, that instance may not be registered as an alcohol-related complication.

“The truth is, we’re probably underestimating this,” he said.

The Takeaways

These findings underscore how patterns of heavy drinking can translate into serious health consequences. Over the last 10 years, a growing number of American women — and particularly women in middle age — have reported binge-drinking, Dr. Keyes said.

“It used to be that 18- to 25-year-old males were the most likely to drink or the most likely to binge,” said Aaron White, a neuroscientist at the National Institute on Alcohol Abuse and Alcoholism. Now, binge drinking occurs more among people between the ages of 26 to 34, and is becoming more common among women. “Everything’s just getting pushed back later,” he said.

Demographic shifts can also help explain why women are drinking at higher rates, Dr. Keyes said. Women tend to marry and have children at later ages than in previous decades, so they spend more time in what Dr. Keyes calls a “high-risk period for heavy drinking.”

“People don’t realize the real health consequences these heavy drinking patterns can have,” she added.

These consequences take time to develop and often emerge between ages 40 and 60. Complications can occur after “years of heavy, persistent alcohol use,” Dr. Shuey said.

These longer-term increases in drinking predate the pandemic and might have increased the risk of health problems among women before Covid-19 hit. But higher levels of drinking during lockdowns may have exacerbated these issues or contributed to new complications, especially as women bore the brunt of family responsibilities, Dr. White said.

Even as research mounts on the harms of alcohol, many people might struggle to change their habits, Dr. White said.

“If you’ve been drinking wine with dinner every night for the last 20 years, just seeing a headline is not going to be enough to make you throw your wine away,” he said. “I think it’s going to be a slow cultural shift.”

Dani Blum is a health reporter for The Times. More about Dani Blum

Suggestions or feedback?

MIT News | Massachusetts Institute of Technology

• Machine learning
• Social justice
• Black holes
• Classes and programs

Departments

• Aeronautics and Astronautics
• Brain and Cognitive Sciences
• Architecture
• Political Science
• Mechanical Engineering

Centers, Labs, & Programs

• Abdul Latif Jameel Poverty Action Lab (J-PAL)
• Picower Institute for Learning and Memory
• Lincoln Laboratory
• School of Architecture + Planning
• School of Engineering
• School of Humanities, Arts, and Social Sciences
• Sloan School of Management
• School of Science
• MIT Schwarzman College of Computing

Desalination system could produce freshwater that is cheaper than tap water

Press contact :, media download.

*Terms of Use:

Images for download on the MIT News office website are made available to non-commercial entities, press and the general public under a Creative Commons Attribution Non-Commercial No Derivatives license . You may not alter the images provided, other than to crop them to size. A credit line must be used when reproducing images; if one is not provided below, credit the images to "MIT."

Previous image Next image

Engineers at MIT and in China are aiming to turn seawater into drinking water with a completely passive device that is inspired by the ocean, and powered by the sun.

In a paper appearing today in the journal Joule, the team outlines the design for a new solar desalination system that takes in saltwater and heats it with natural sunlight.

The configuration of the device allows water to circulate in swirling eddies, in a manner similar to the much larger “thermohaline” circulation of the ocean. This circulation, combined with the sun’s heat, drives water to evaporate, leaving salt behind. The resulting water vapor can then be condensed and collected as pure, drinkable water. In the meantime, the leftover salt continues to circulate through and out of the device, rather than accumulating and clogging the system.

The new system has a higher water-production rate and a higher salt-rejection rate than all other passive solar desalination concepts currently being tested.

The researchers estimate that if the system is scaled up to the size of a small suitcase, it could produce about 4 to 6 liters of drinking water per hour and last several years before requiring replacement parts. At this scale and performance, the system could produce drinking water at a rate and price that is cheaper than tap water.

“For the first time, it is possible for water, produced by sunlight, to be even cheaper than tap water,” says Lenan Zhang, a research scientist in MIT’s Device Research Laboratory.

The team envisions a scaled-up device could passively produce enough drinking water to meet the daily requirements of a small family. The system could also supply off-grid, coastal communities where seawater is easily accessible.

Zhang’s study co-authors include MIT graduate student Yang Zhong and Evelyn Wang, the Ford Professor of Engineering, along with Jintong Gao, Jinfang You, Zhanyu Ye, Ruzhu Wang, and Zhenyuan Xu of Shanghai Jiao Tong University in China.

A powerful convection

The team’s new system improves on their previous design — a similar concept of multiple layers, called stages. Each stage contained an evaporator and a condenser that used heat from the sun to passively separate salt from incoming water. That design, which the team tested on the roof of an MIT building, efficiently converted the sun’s energy to evaporate water, which was then condensed into drinkable water. But the salt that was left over quickly accumulated as crystals that clogged the system after a few days. In a real-world setting, a user would have to place stages on a frequent basis, which would significantly increase the system’s overall cost.

In a follow-up effort, they devised a solution with a similar layered configuration, this time with an added feature that helped to circulate the incoming water as well as any leftover salt. While this design prevented salt from settling and accumulating on the device, it desalinated water at a relatively low rate.

In the latest iteration, the team believes it has landed on a design that achieves both a high water-production rate, and high salt rejection, meaning that the system can quickly and reliably produce drinking water for an extended period. The key to their new design is a combination of their two previous concepts: a multistage system of evaporators and condensers, that is also configured to boost the circulation of water — and salt — within each stage.

“We introduce now an even more powerful convection, that is similar to what we typically see in the ocean, at kilometer-long scales,” Xu says.

The small circulations generated in the team’s new system is similar to the “thermohaline” convection in the ocean — a phenomenon that drives the movement of water around the world, based on differences in sea temperature (“thermo”) and salinity (“haline”).

“When seawater is exposed to air, sunlight drives water to evaporate. Once water leaves the surface, salt remains. And the higher the salt concentration, the denser the liquid, and this heavier water wants to flow downward,” Zhang explains. “By mimicking this kilometer-wide phenomena in small box, we can take advantage of this feature to reject salt.”

Tapping out

The heart of the team’s new design is a single stage that resembles a thin box, topped with a dark material that efficiently absorbs the heat of the sun. Inside, the box is separated into a top and bottom section. Water can flow through the top half, where the ceiling is lined with an evaporator layer that uses the sun’s heat to warm up and evaporate any water in direct contact. The water vapor is then funneled to the bottom half of the box, where a condensing layer air-cools the vapor into salt-free, drinkable liquid. The researchers set the entire box at a tilt within a larger, empty vessel, then attached a tube from the top half of the box down through the bottom of the vessel, and floated the vessel in saltwater.

In this configuration, water can naturally push up through the tube and into the box, where the tilt of the box, combined with the thermal energy from the sun, induces the water to swirl as it flows through. The small eddies help to bring water in contact with the upper evaporating layer while keeping salt circulating, rather than settling and clogging.

The team built several prototypes, with one, three, and 10 stages, and tested their performance in water of varying salinity, including natural seawater and water that was seven times saltier.

From these tests, the researchers calculated that if each stage were scaled up to a square meter, it would produce up to 5 liters of drinking water per hour, and that the system could desalinate water without accumulating salt for several years. Given this extended lifetime, and the fact that the system is entirely passive, requiring no electricity to run, the team estimates that the overall cost of running the system would be cheaper than what it costs to produce tap water in the United States.

“We show that this device is capable of achieving a long lifetime,” Zhong says. “That means that, for the first time, it is possible for drinking water produced by sunlight to be cheaper than tap water. This opens up the possibility for solar desalination to address real-world problems.”

“This is a very innovative approach that effectively mitigates key challenges in the field of desalination,” says Guihua Yu, who develops sustainable water and energy storage systems at the University of Texas at Austin, and was not involved in the research. “The design is particularly beneficial for regions struggling with high-salinity water. Its modular design makes it highly suitable for household water production, allowing for scalability and adaptability to meet individual needs.”

Funding for the research at Shanghai Jiao Tong University was supported by the Natural Science Foundation of China.

Share this news article on:

Press mentions, time magazine.

A number of MIT spinouts and research projects – including the MOXIE instrument that successfully generated oxygen on Mars, a new solar-powered desalination system and MIT spinout SurgiBox – were featured on TIME’s Best Inventions of 2023 list.

Insider reporter Katie Hawkinson explores how MIT researchers developed a new solar-powered desalination system that can remove the salt from seawater for less than the cost of U.S. tap water. Creating a device that relies on solar power, “eliminates a major financial barrier, especially for low-income countries experiencing water scarcity,” Hawkinson explains.

The Hill reporter Sharon Udasin writes that MIT researchers have developed a new solar-powered desalination device that “could last several years and generate water at a rate and price that is less expensive than tap water.” The researchers estimated that “if their model was scaled up to the size of a small suitcase, it could produce about 4 to 6 liters of drinking water per hour,” writes Udasin.

The Daily Beast

MIT researchers have developed a new desalination system that uses solar energy to convert seawater into drinkable water, reports Tony Ho Tran for the Daily Beast . The device could make it possible to, “make freshwater that’s even more affordable than the water coming from Americans’ kitchen faucets.”

Previous item Next item

Related Links

• Evelyn Wang
• Lenan Zhang
• Device Research Lab
• Department of Mechanical Engineering

Related Topics

• Desalination
• Mechanical engineering
• Sustainability

Related Articles

Passive cooling system could benefit off-grid locations

Solar-powered system offers a route to inexpensive desalination

Solar-powered system extracts drinkable water from “dry” air

Simple, solar-powered water desalination

More mit news.

A biomedical engineer pivots from human movement to women’s health

Read full story →

MIT tops among single-campus universities in US patents granted

A new way to detect radiation involving cheap ceramics

A crossroads for computing at MIT

Growing our donated organ supply

New AI method captures uncertainty in medical images

• More news on MIT News homepage →

Massachusetts Institute of Technology 77 Massachusetts Avenue, Cambridge, MA, USA

• Map (opens in new window)
• Events (opens in new window)
• People (opens in new window)
• Careers (opens in new window)
• Accessibility
• Social Media Hub
• MIT on Facebook
• MIT on YouTube
• MIT on Instagram

Research suggests that kombucha microbes may mimic the effects of fasting, without actually fasting

The tasty, fermented beverage was most recently found to be effective in reducing blood sugar levels, by joy saha.

Turns out, you may be able to reap the benefits of fasting without actually fasting. According to a recent study from the University of North Carolina at Chapel Hill, a simple bottle of kombucha has the potential to alter human fat metabolism, sans any strict dietary changes, and lower fat stores.  

The study, published in the journal PLOS Genetics , explored an alternate method by which people can reduce fat accumulation and lower triglyceride (lipid) levels in the body. High levels of triglycerides, a type of fat in the blood, are associated with several serious health conditions, including liver and pancreas problems and cardiovascular diseases such as atherosclerosis, stroke, and heart failure. Making healthy lifestyle choices — like exercising regularly, limiting alcohol intake and consuming a diet that’s high in fibers and healthy fats — can greatly reduce triglyceride levels. But researchers stressed that it’s imperative to find new supplemental solutions, especially as modern diseases continue to be among the leading causes of early death.

“Investigation of functional foods that may directly improve lipid homeostasis during metabolic disease, or that could serve as a supplement to traditional therapeutic approaches, is paramount to identifying new strategies to support long-term health in the modern age,” Rob Dowen, PhD, professor of cell biology and physiology at UNC’s School of Medicine and lead author of the study, told Medical News Today .

Researchers looked at kombucha tea in particular because there’s “a striking lack of mechanistic information about how its consumption impacts the consumer,” Dowen explained. Kombucha, which has roots in Eastern traditional medicine, remains a popular choice of beverage amongst consumers today. Per Grandview Research , the global kombucha market is expected to grow at a compound annual rate (CAGR) of 15.6% from 2022 to 2030.

Kombucha is a fermented drink made from black tea and a symbiotic culture of bacteria and yeast, better known as SCOBY. SCOBY is rich in probiotic microbes — including species of Acetobacter , Lactobacillus and Komagataeibacter genera — which have been associated with numerous health benefits like lowering blood pressure, supporting weight loss and decreasing inflammation.

The intestinal effects of kombucha’s microbes were studied in Caenorhabditis elegans , a nematode roundworm. These microscopic nematodes feed on a variety of bacteria, making them a model organism for studying different molecular, biochemical and microbial-related mechanisms.

Once the microbes colonized the nematode’s gut, they created metabolic changes akin to those that occur during fasting, researchers discovered. The microbes essentially increased the formation of proteins needed to break down fat, while also decreasing the formation of proteins that help build triglycerides.

Want more great food writing and recipes? Subscribe to Salon Food's newsletter , The Bite.

“We were surprised to find that animals consuming a diet consisting of the probiotic microbes found in kombucha tea displayed reduced fat accumulation, lower triglyceride levels, and smaller lipid droplets — an organelle that stores the cell's lipids — when compared to other diets,” researchers noted. “These findings suggest that the microbes in kombucha tea trigger a 'fasting-like' state in the host even in the presence of sufficient nutrients.”

Although the study was conducted on a microscopic nematode — which unlike mammals, stores fat in droplets in their intestinal cells — researchers believe similar effects will also be observed in humans. Dowen told Medical News Today that much of the evidence is “anecdotal,” adding that a similar study must be conducted on mammalian model systems “to further inform how kombucha consumption impacts human physiology.” 

Kombucha remains a prime subject within medical research. Most recently, kombucha was found to be effective in reducing blood sugar levels . Additional studies also suggested kombucha may be a powerful inflammation-reducing antioxidant and an antibacterial.

about fasting:

• Here's what experts say about the rewards — and risks — of intermittent fasting
• Intermittent fasting can boost your health, but how and when to restrict food consumption is crucial
• "The Wonder": Netflix’s story of "fasting girls" shows us starving bodies remain a public spectacle

Joy Saha is a staff writer at Salon. She writes about food news and trends and their intersection with culture. She holds a BA in journalism from the University of Maryland, College Park.

Related Topics ------------------------------------------

Related articles.

• SUGGESTED TOPICS
• The Magazine
• Newsletters
• Managing Yourself
• Managing Teams
• Work-life Balance
• The Big Idea
• Data & Visuals
• Reading Lists
• Case Selections
• HBR Learning
• Topic Feeds
• Account Settings
• Email Preferences

A Growth Strategy that Creates and Protects Value

• David A. Hofmann
• John J. Sumanth

Four steps to build a continuous value creation cycle.

For organizations to truly innovate and grow, leaders in every role and at every organizational level must be attuned to how they are creating new value while simultaneously protecting existing value. Just as a soccer coach must simultaneously pursue both scoring and defending, leaders must constantly focus their attention on opportunities to create value — through innovation, risk-taking, and experimentation — and to protect value — by preserving and defending key aspects of their responsibilities. Because both approaches are essential to success, organizational leaders must proactively and continually encourage their teams to adopt both a creating value and protecting value mindset when tackling their day-to-day responsibilities. But how can leaders do this? More specifically: Where and how do leaders deploy these two approaches, and how do these approaches change over time? In this article, the authors offer four steps leaders can take to ensure that they’re on the right path for growth.

Ask any leader what comes to mind when they hear the word “innovation” and you’ll quickly hear examples of a new, user-centric product design, or an R&D team pursuing a new mission, or their company’s exploration of a new market opportunity to drive additional revenue. But what if this relatively narrow view captures only a slice of the potential innovation that resides within your organization? What if your organization could unlock non-traditional avenues and areas for innovation, experimentation, and value creation?

• David A. Hofmann is the Hugh L. McColl, Jr. Distinguished Professor of Leadership and Organizational Behavior and Senior Associate Dean of UNC Executive Development at the Kenan-Flagler Business School at the University of North Carolina at Chapel Hill.
• John J. Sumanth is the James Farr Fellow & Associate Professor of Management at the Wake Forest University School of Business.

Partner Center

PFAS 'forever chemicals' above drinking water guidelines in global source water

We're likely underestimating the future impact of pfas in the environment.

Per-and poly-fluoroalkyl substances -- commonly known as PFAS -- are a group of over 14,000 human-made chemicals that have been popular since the 1950s for their diverse skills in resisting heat, water, grease and stains.

They've been commonly found in household products like non-stick frypans, clothing, cosmetics, insecticides, and food packaging, as well as specialty industry products, like firefighting foam.

But despite their broad skillset, the chemicals have a dark side: they're known as 'forever chemicals' as once they're in the environment -- or our bodies -- they don't degrade further.

PFAS have been linked to environmental and health issues, including some cancers, but a lot remains unknown about the true scale and potential impacts of the problem -- including how much is in our water supply.

A new UNSW-led international study, published today in Nature Geoscience , assessed the levels of PFAS contamination in surface and ground water around the globe.

It found that much of our global source water exceeds PFAS safe drinking limits.

"Many of our source waters are above PFAS regulatory limits," says senior author of the study, UNSW Engineering Professor Denis O'Carroll.

"We already knew that PFAS is pervasive in the environment, but I was surprised to find out the large fraction of source waters that are above drinking water advisory recommendations," he says. "We're talking above 5 per cent, and it goes over 50 per cent in some cases."

The research team pulled together PFAS measurements from sources around the world, including government reports, databases, and peer-reviewed literature. Altogether, they collated more than 45,000 data points, which span over roughly 20 years.

It's the first study to quantify the environmental burden of PFAS on a global scale.

The study also found high concentrations of PFAS in Australia, with many locations above recommended drinking water levels. This tended to be in areas where firefighting foams had been used in the past, like military institutions and fire training facilities.

Prof. O'Carroll stresses that these PFAS traces are found in source water, such as dams, and not drinking water itself -- drinking water goes through treatment plants, some of which are designed to reduce the amount of chemicals such as PFAS in our water before it comes out of the tap.

But some water providers -- for example, Sydney Water -- don't routinely measure the broad range of PFAS potentially in our drinking water, says Prof. O'Carroll.

"Drinking water is largely safe, and I don't hesitate drinking it," he says. "I also don't suggest that bottled water is better, because it doesn't mean that they've done anything differently than what comes out of the tap.

"But I certainly think that monitoring PFAS levels and making the data easily available is worthwhile."

A contentious debate: how much PFAS is too much?

Most people in Australia -- and in many places around the world -- are likely to have low levels of PFAS in their bodies.

But the potential health risks of PFAS chemicals are poorly understood and haven't been agreed on universally.

According to an Australian Government expert health panel, there is limited to no evidence that PFAS poses clinically significant harm to human health -- although further afield, peak bodies in the US and Europe suggest that PFAS is linked to adverse health outcomes, such as lower birth weight in babies, higher levels of cholesterol, reduced kidney function, thyroid disease, altered sex?hormone levels, reduced vaccine response, and liver, kidney, and testicular cancers.

In 2023, the World Health Organisation (WHO) declared PFOA, a type of PFAS, a category one human carcinogen.

While PFAS has been linked to many of these health outcomes, they haven't necessarily been shown to cause them -- but given the potential risks and 'forever' nature of these chemicals, many regulatory bodies have tightened PFAS use and introduced safe drinking water limits as a precaution.

"Two forms of PFAS initially raised of concerns about 20 years ago: PFOS and PFOA," says Prof. O'Carroll.

"These chemicals are regulated to different extents around the world. In the US, the proposed drinking water limits for PFOS and PFOA are four nanograms per litre."

A third PFAS is also regulated in Australia, called PFHxS. Here, the sum of PFOS and PFHxS is limited to 70 nanograms per litre -- well above the four nanograms per litre combined PFOS and PFOA limit in the US.

But our acceptable levels for PFOA in drinking water is even higher.

"PFOA, on the other hand, is regulated in Australia at 560 nanograms per litre, which is two orders of magnitude higher than in the US," says Prof. O'Carroll.

While Australia's limits seem relaxed compared to the US, both countries' recommended drinking water guidelines pale when compared to Canada's: here, rather than limiting only two or three forms of PFAS in drinking water, Canada tallies up the sum of all 14,000 PFAS and limits the overall number to 30 nanograms per litre.

The study found that 69 per cent of global groundwater samples with no known contamination source exceeded Health Canada's safe drinking water criteria, while 32 per cent of the same samples exceeded the US's proposed drinking water hazard index.

"There's debate about what level PFAS should be regulated to," says Prof. O'Carroll. "Australia has much higher limits than the US, but the question is why.

"Both health bodies would have different reasoning for that, and there's not a really strong consensus here."

An underestimated risk

The study suggests that actual PFAS pollution in global water resources could be higher than suspected.

This is, in part, due to us only monitoring and regulating a limited number of the 14,000 PFAS in existence, and also because the levels of PFAS in consumer products are higher than expected.

"There's a real unknown amount of PFAS that we're not measuring in the environment," says Prof. O'Carroll. "Commercial products like garments and food packaging have a lot more PFAS in them than we realise.

"This means we're likely underestimating the environmental burden posed by PFAS."

Prof. O'Carroll and his team are now trying to develop their research by quantifying these levels of PFAS from commercial products in the environment.

They're also working to develop technologies that can degrade PFAS in drinking water systems, and looking at developing predictive models that determine where PFAS will go in the environment.

"Part of this is figuring out how PFAS will associate with different parts of the environment and our bodies -- proteins, for example," says Prof. O'Carroll.

These studies will be in progress over the next two years and aim to be completed by 2026.

In the meantime, Prof. O'Carroll says manufacturers and consumers alike need to be careful and do our due diligence when using products containing PFAS.

"We manufacture and distribute a lot of chemicals without having a full assessment on their potential health impacts," he says.

" We should have judicious use of some of these chemicals. Just because they're available, doesn't mean that we should use them."

• Health Policy
• Medical Topics
• Diseases and Conditions
• Nature of Water
• Nuclear Energy
• Sports Science
• Drought Research
• Environmental Issues
• Water purification
• Environmental impact assessment
• Water resources
• Water scarcity
• Evaporation from plants

Story Source:

Materials provided by University of New South Wales . Original written by Sherry Landow. Note: Content may be edited for style and length.

Journal Reference :

• Diana Ackerman Grunfeld, Daniel Gilbert, Jennifer Hou, Adele M. Jones, Matthew J. Lee, Tohren C. G. Kibbey, Denis M. O’Carroll. Underestimated burden of per- and polyfluoroalkyl substances in global surface waters and groundwaters . Nature Geoscience , 2024; DOI: 10.1038/s41561-024-01402-8

Cite This Page :

Explore More

• Brightest Gamma-Ray Burst
• Stellar Winds of Three Sun-Like Stars Detected
• Fences Causing Genetic Problems for Mammals
• Ozone Removes Mating Barriers Between Fly ...
• Parkinson's: New Theory On Origins and Spread
• Clash of Stars Solves Stellar Mystery
• Secure Quantum Computing at Home
• Ocean Currents: Collapse of Antarctic Ice ...
• Pacific Cities Much Older Than Previously ...
• The Milky Way in Ancient Egyptian Mythology

Trending Topics

Strange & offbeat.

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities; Negussie Y, Geller A, Teutsch SM, editors. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington (DC): National Academies Press (US); 2018 Jan 17.

Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem.

• Hardcopy Version at National Academies Press

B Content Analysis of Alcohol-Impaired Driving Stories in the News

Deborah A. Fisher , Ph.D.

• INTRODUCTION

Throughout the 30-year period from 1980 to 2010, the United States made substantial gains in reducing alcohol-impaired driving fatalities, which fell from around 24,000 deaths annually in the early 1980s to just over 10,000 in 2010. Along with the number of fatalities, the rate of alcohol involvement in crash fatalities decreased from 60 percent in 1982 to 34 percent in 2010 ( Alcoholalert.com, n.d. ; NCSA, 2016 ). This progress came about through the efforts of grassroots community advocacy on alcohol and traffic safety, most notably with the advent of Mothers Against Drunk Driving and the legislative agendas supported at the state and federal levels, including raising the minimum legal drinking age and lowering the illegal per se blood alcohol concentration (BAC) limit for drivers.

Since 2010, however, fatalities and fatality rates associated with alcohol-impaired driving have remained stable. To provide guidance on how to resume progress on the issue, the Committee on Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities was established and tasked with identifying promising interventions for preventing impaired driving, barriers that exist and approaches to overcome them, and ways interventions may need to be changed or adapted to resume a downward trend.

One area for potentially refining or redirecting prevention approaches is the information environment around alcohol-impaired driving. The ways stories are told in the media (i.e., the slant, the frame, the lens used to view events and issues) have the potential to influence the ways people think about issues and, therefore, the solutions they believe will be effective and, thus, will support for alleviating problems. The framing of news stories around issues such as poverty, for example, has been shown to affect the way people think about them, with presentations that focus on general outcomes leading to attributions of responsibility to society at large, while those that focus on specific instances of low-income persons align with attributions of individual responsibility ( Iyengar, 1990 ).

Evidence suggests that the way impaired driving is covered in the news can affect individuals' support for alcohol enforcement and may affect behavior. In a study that manipulated the presence or absence of alcohol as a causative factor in news stories about violent crime, motor vehicle crashes, and other unintended injuries, investigators found that participants who read news stories with alcohol mentions reported greater support for enforcement of alcohol-control laws compared to those who read news stories lacking alcohol mentions ( Slater et al., 2012 ). Yanovitzky (2002) found in a longitudinal study using data from 1978 to 1995 that news coverage of alcohol-impaired driving significantly contributed to impaired-driving-related policy actions, which, in turn, were associated with a reduction in impaired driving among young and high-risk drivers.

The current content analysis of alcohol-impaired driving news stories was conducted to support the work of the committee by providing an assessment of the news environment around alcohol-impaired driving. Content analysis offers a rigorous methodology for qualitatively coding the content of media stories to gather insights into what topics are being presented to the public most often and how that information is being presented or framed (i.e., the context). The results help further our understanding of what messages viewers may be taking away from their interaction with media. Additionally, the results may suggest ways media messaging may need to be modified to support public health efforts.

As a first step in identifying the universe of news stories from which a sample could be drawn for coding purposes, four newspapers ( The Washington Post , The New York Times , USA Today , and The Wall Street Journal ) and three cable television news outlets (CNN, Fox News Network, and MSNBC) were selected as sources in an effort to obtain a balance of media outlets generally considered to represent the right, left, and center of the political spectrum. (Initially several other news outlets were targeted, including Politico, The Drudge Report, and Breitbart; however, the news stories of these outlets were not available as transcripts in LexisNexis and, therefore, they were dropped from the content analysis.)

After these sources were identified, a literature search was conducted in an attempt to gather as comprehensive a universe of stories as possible on alcohol-impaired driving spanning from 2010 through June 2017. The search strategy involved using a series of alcohol terms (e.g., blood alcohol ) and driving terms (e.g., drunk driving ) appearing in the headline, byline, or appearing at least four times in the story. The exact search strategy was as follows:

hlead (driving while impaired or driving while intoxicated or driving under the influence or crash or driving or driving fatalities or traffic accidents or traffic fatalities or traffic safety or automobile accidents or driving while intoxicated and blood alcohol or BAC or 0.05 or 0.05 blood alcohol content or alcohol impaired driver or drunk driving limit or drunk driving threshold or drink driving or drink! driving or drunk! driving or drunken driving or drunk driving or alcohol impaired driving or alcohol impaired fatalities or alcohol related deaths or alcohol related driving or alcohol intoxication or binge drinking or drinking behavior or drunken driving or alcohol involved driving) or atl4 ( driving while impaired or driving while intoxicated or driving under the influence or crash or driving or driving fatalities or traffic accidents or traffic fatalities or traffic safety or automobile accidents and blood alcohol or BAC or 0.05 or 0.05 blood alcohol content or alcohol impaired driver or drunk driving limit or drunk driving threshold or drink driving or drink! driving or drunk! driving or drunken driving or drunk driving or alcohol impaired driving or alcohol impaired fatalities or alcohol related deaths or alcohol related driving or alcohol intoxication or binge drinking or drinking behavior or drunken driving or alcohol involved driving).

This search strategy cast a wide net to ensure that the vast majority of relevant stories were captured and initially led to the identification of 774 articles published across the seven news outlets. Upon further investigation, 156 stories were dropped because on cursory inspection, they did not focus on impaired driving, or full-text access via hyperlinks or transcripts in LexisNexis was not available. The stories eliminated from the sample at this point came from The Wall Street Journal and the three cable television news outlets. This resulted in a sample of 618 news stories for coding. The distribution of news stories across the seven sources is shown in Table B-1 .

Number of News Stories by Media Outlet.

Coding Protocol

Guided by the work of Shanto Iyengar and other researchers who have conducted media content analyses focused on how issues such as tobacco are framed in the news media ( Clegg Smith et al., 2002 ), a coding scheme was developed and reviewed by the committee members. The coding scheme contained five sections: story descriptors, story frame and focus, voices represented, values and themes, and story topics. A copy of the final version of the coding scheme is presented after the references section of this paper.

Story Descriptors

Fields completed to provide descriptive information for each story included title, source, date of publication, date of coding, word count, and type of article (e.g., news, editorial, opinion, other).

Story Frame and Focus

A story frame refers to the techniques used to tell a news story that are posited to influence viewers' attributions of responsibility for social problems and suggest the solutions needed to solve them. As described by Benjamin (2007) , an episodic news frame focuses on individual case studies and discrete events; it is likened to taking a telephoto lens in that it gives a close-up picture. In contrast, a thematic frame focuses on trends over time, and highlights contexts and environment; it is likened to taking a wide-angle lens to the issue. Implications of news framing are that episodic frames tend to highlight solutions targeting the individual experiencing the problem; thematic frames, with their broader focus on the surrounding environment and public policies and institutions, highlight solutions aimed at fixing the underlying conditions that cause or contribute to the problem. Applied to alcohol-impaired driving news stories, those that focus on a specific incident of impaired driving (e.g., a crash, an arrest for driving under the influence of alcohol) represent the application of an episodic frame; those stories that focus on larger societal issues such as through historical and epidemiological pieces or calls for action by communities and officials to reduce the problem represent use of a thematic frame.

For each story about a specific incident of alcohol-impaired driving, several characteristics of the incident were coded, including the following:

• Type of incident: fatal crash, injury crash, property-damage-only crash, arrest without a crash, other;
• Time frame for reporting on the incident: less than 1 week, 1–4 weeks, more than 1 month later, unclear;
• Ramifications reported: physical injuries to victims and perpetrators, psychological impacts on victims and perpetrators, other impacts on victims and perpetrator (e.g., inability to work, financial), impacts on victims' families, various stages of the adjudication process, other;
• Whether the focus was on the victim versus the perpetrator;
• Whether the incident involved a celebrity or local person of prominence in the community; and
• What substances were reported as being involved in the incident.

For each story that included discussion of broader social or environmental issues, the technique(s) or approach(es) to presenting this wide-angle perspective, the focus, was coded. Coding categories for focus included historical/epidemiological, call for action, program/policy/legislation, alcohol/drinking culture, sales/marketing/promotion of alcohol, court challenges, and so forth. Stories that included discussion of an alcohol-impaired crash or arrest together with broader social issues related to alcohol-impaired driving were coded for both the specific incident (i.e., episodic frame) and the broader discussion (i.e., thematic frame).

Voices Represented

An extensive list of persons whose voices could be represented in stories by being directly quoted, cited, or referenced as sources of information for the story was developed. As with all variables, the list originally developed was expanded throughout the coding process. Voices included law enforcement and judicial officials, victims and their families, perpetrators and their families, attorneys (perpetrator's, victim's, and other/legal analyst), traffic safety advocates, government health and safety organizations, alcohol industry or trade association representatives, alcohol retailers, medical/health professionals, and others. Voices were coded for all stories.

Values or Themes

Values or themes represent the underlying message(s) embodied in the story. Examples of themes coded included victimization, injustice, punishment, individual problem/responsibility, collective problem/responsibility, liberty/personal freedom, and so forth. Values may be expressed directly by individuals represented in the story or implied by the type of information or way information is presented in the story. For example, one story reported on the advocacy efforts by the parents of one of two teenage passengers killed when their friend crashed the car they were all riding in after having been drinking at an underage party where the parent of the host joked with partygoers about the alcohol they were bringing into the home. The victim's parents were quoted calling for more severe penalties for the teen driver and the adult who knew about and permitted the teen drinking party in his home. In addition to the value/theme of punishment, this story was also coded based on the described actions of the adult social host for individual/problem responsibility as well as failure of family, the latter owing to the implied references to irresponsible parenting. Values were coded for all stories.

Story Topics

Story topics are the specific issues related to alcohol-impaired driving that were discussed explicitly in the story. In the coding scheme developed, these 41 topics fell into broad categories:

• Scope of the problem (e.g., societal toll, human toll);
• Responsibility for the problem (e.g., individual, enforcement of alcohol laws);
• Types of prevention or alcohol-impaired driving countermeasures discussed (e.g., prevention/general deterrence, intervention/specific deterrence, harm reduction);
• New tools or technology (e.g., for police, courts, retailers; for drinkers or drivers);
• Community mobilization;
• Impaired-driving system problems/failures (e.g., system overall, court system, alcohol retailers);
• Impaired-driving system successes (e.g., system overall, legislation/policy, alcohol industry); and
• Other topics that emerged during the coding process (e.g., politics/corruption, targeting social/moderate versus heavy/hardcore drinkers, underage drinking, two-tiered justice system).

Story topics were coded for all stories.

Coding Procedures

A single coder experienced in content analysis conducted the coding task during a 5-week period from July 23, 2017, through August 27, 2017. Once the coding process began and stories were read in their entirety, 31 additional stories of the 618 that were originally included in the sample were eliminated, mostly because they were too short and lacked sufficient information for coding (n = 17). This led to a criterion that stories had to be at least three paragraphs in length to provide enough information for coding. Other reasons for eliminating stories were incomplete transcripts or finding that a story did not actually involve impaired driving (e.g., an article on drowsy driving that had one mention of impaired driving as a comparison regarding degree of impairment; a story about how numerous red flags, one of which was impaired driving along with owing back taxes, multiple divorces, and so forth should have resulted in revocation of an individual's security clearance; a story on research from the Netherlands on effects of alcohol and cannabis on aggression).

Because of the project timeline, the full sample of 587 stories could not be coded. After flipping a coin to randomly start with the first or second story to begin the coding process, every fourth story was coded. If the fourth story was one of the 31 stories eliminated, the next story was coded. This yielded a final sample of 147 coded stories.

As each story was reviewed, in addition to checking the appropriate codes, extensive notes were entered on a hard copy of the coding form. All “other” responses were specified so that emerging issues could be tracked. This led to the addition of several new codes over the course of the task (e.g., pulling justice/judge out of the other category and making it a separate category in voices; adding effects on enforcement/prosecution and targeting social/moderate drinkers versus heavy/hardcore drinkers to values), which are represented in the coding scheme listed at the end of this paper. Given that most of these new codes had emerged about halfway through the coding process, after the full sample of 147 stories was coded, a second pass was made through the first half of the stories to supplement notes taken and see if material needed to be recoded.

Data from the coding forms, excluding handwritten notes, were entered into an electronic form in Survey Gizmo. Data were exported into an Excel file, which was used to develop counts for all data points.

Overall Sample

Of the total sample of 147 coded stories, 139 (94.6 percent) were news focused, 4 (2.7 percent) were editorials, and 4 (2.7 percent) were opinion pieces. The number of stories in the sample by year of publication were 10 from 2010, 15 from 2011, 16 from 2012, 27 from 2013, 9 from 2014, 33 from 2015, 27 from 2016, and 10 from the first half of 2017.

Other descriptive information for the sample is presented in Table B-2 . Seventy percent of the news stories coded came from the newspaper sources, mostly The New York Times and The Washington Post . Newspaper stories tended to be around 550–570 words in length, while cable television news stories were about double that in length. This differential in story length is attributable to the fact that when cable television news outlets cover a story on alcohol-impaired driving, it is often a story that receives national attention. Additionally, depending on the show on which it is televised, the story may be part of an hour-long news magazine show (e.g., The Nancy Grace Show , Primetime Justice , The O'Reilly Factor ) in which stories may be discussed in one of three or four show segments or the entire show may be devoted to it.

Frequency Distribution of News Stories Across News Outlets for All Alcohol-Impaired Driving Stories, n = 147.

Newspaper stories, on the other hand, are shorter, due in part to the diversity of types of stories covered in this platform. Newspapers like The New York Times , The Washington Post , and The Wall Street Journal tend to cover both local events in their respective communities and events of national interest. Thus, their coverage of alcohol-impaired driving events includes a combination of highly publicized national incidents as well as short stories of local arrests and crashes, many of which are covered within a day or two of the event's occurrence before much information is known. These variations in story length between cable television news outlets and newspaper sources may also reflect assumptions about the differential attention spans of the public for material presented in a written versus visual format.

Episodic Versus Thematic Frames

Of the 147 alcohol-impaired driving news stories, 66 (44.9 percent) focused exclusively on discussing a specific incident of alcohol-impaired driving and, thus, are considered to have employed an episodic frame. The remaining 81 (55.1 percent) used a thematic frame, with a discussion of the broader societal issues either alone (e.g., a comparison of different versions of alcohol-impaired driving laws pending in a state's legislature, a traffic safety organization's recommendations that all states lower their illegal per se BAC limit from 0.08% to 0.05%) or in combination with an incident of alcohol-impaired driving (e.g., how a fiery school bus crash in a state was the impetus to a shift in norms and attitudes about alcohol-impaired driving and activism that resulted in stronger legislation, or renewed support for a stronger interlock law following the death of a police officer struck by an impaired driver while working on a holiday driving while impaired [DWI] task force).

Research question 1: Whose voices are represented most often and least often in alcohol-impaired driving news stories? Table B-3 presents the frequency distribution of voices that were represented across the 147 news stories. Most stories quoted or referenced information provided by multiple sources so the percentages do not total to 100 percent. The individuals and entities referenced most often in alcohol-impaired driving stories included law enforcement (27.2 percent; often via the public information officer or other official giving details from the police report), traffic safety advocates (21.1 percent), prosecutors (19.7 percent; typically discussing charges filed/to be filed or sentences sought), other attorney or legal analyst (18.4 percent; legal experts not directly involved in the prosecution or defense providing legal analysis and opinions on cases), and victim's family (15.6 percent; often in the aftermath of fatal crashes such as trial and sentencing of offenders or in stories that follow up on actions prompted by the crash such as new legislation), followed closely by perpetrators (15.0 percent) and the media (15.0 percent; investigative reporters on cable news shows). Those represented least often in alcohol-impaired driving stories were alcohol retailers (2.0 percent), perpetrator's family members (2.0 percent), victims (2.7 percent), medical and health professionals (3.4 percent), and callers into cable television shows (3.4 percent). The category “other” was represented in 40.8 percent of stories and consists of a diverse array of individuals and entities idiosyncratic to one or two stories, such as the director of public parks and a bicycle advocacy group representative quoted in a story about an injury crash in which a vehicle driven by a suspected impaired driver entered a biking path and struck a bicyclist, or an official with the National Conference of State Legislators in a story about calls for tougher state impaired driving legislation.

Frequency of Voices Represented in Alcohol-Impaired Driving Stories, n = 147.

Research question 2: What values or themes are expressed most frequently in alcohol-impaired driving news stories? The frequency with which different values or themes were discussed in the sample of stories is presented in Table B-4 . Because many stories were coded as having multiple themes, the percentages do not total 100 percent. The theme of individual problem/responsibility was the most frequently coded value/theme, occurring in half of the stories (50.3 percent). This is consistent with the fact that nearly half of the stories in the sample (44.9 percent) were incident-only stories that detailed an arrest or crash linked to alcohol consumption. In some cases, the perpetrator or others made a direct statement regarding the perpetrator's responsibility for the crash; however, in most cases, individual problem/responsibility was inferred by the fact that the story provided details of the incident (e.g., offender's impairment, driving actions that led to the crash, charges filed/to be filed) with no information suggesting the event was attributable to causes beyond the perpetrator's decision to drink and drive and subsequent actions on the road.

Frequency of Values/Themes Represented in Alcohol-Impaired Driving Stories, n = 147.

Other values/themes expressed relatively frequently included other topics associated with crashes and linked to them immediately afterward, such as victimization (28.6 percent), or later at their legal resolution, such as punishment (27.9 percent) and injustice (16.3 percent). These values/themes were followed by getting serious or tough on alcohol-impaired driving (13.6 percent) and failure of family (13.6 percent). The failure of family theme resulted, in large part, from the widespread media coverage of the Texas teen, dubbed the “affluenza” teen, who avoided prison for killing four and seriously injuring two persons in an alcohol-impaired driving crash he caused and instead was sentenced to rehabilitation and probation when his defense argued that his parents' coddling of him and failure to teach him responsibility or consequences for his actions led to his risky decision to drink and drive. Numerous stories about this crash appeared across media outlets in two spates—first in 2013 when the perpetrator's trial took place and again in 2015 after the perpetrator and his mother fled the United States for Mexico following the posting of a video on social media of an alleged probation violation.

Many values/themes incorporated throughout the coding process appeared with low frequencies (i.e., across six or seven stories), including the protective role of government (4.8 percent), targeting social versus heavy/hardcore drinkers (4.1 percent), avoiding holiday alcohol-impaired driving (4.1 percent), and five other values/themes were expressed even less frequently. Twenty-one stories (14.3 percent) were coded for “other” values/themes that occurred alone or in addition to more commonly expressed values/themes. Examples of these story-specific values/themes include the right to counsel of DWI offenders (in an opinion piece by a trial lawyer), positive-focused media messaging (in a news story on an alcohol-impaired driving campaign developed in one jurisdiction targeting young males), and possible public safety contributions of a ride-hailing service (in a story in which the company linked data on increases in its ridership to decreases in impaired driving).

Research question 3: What specific topics are included in alcohol-impaired driving news stories most and least often? Table B-5 displays the frequency of mentions of a wide array of topic categories and specific story topics across the sample of alcohol-impaired driving stories. The categories of topics represented most often in stories were prevention/intervention approaches to dealing with alcohol-impaired driving (63.9 percent; e.g., prevention/general deterrence, intervention/specific deterrence, sanctions, harm reduction), responsibility for the problem (61.2 percent), scope of the alcohol-impaired driving problem (53.1 percent), and the combination category of emergent issues (72.1 percent). The single-item category community, which consisted of grassroots advocacy efforts, and the category impaired-driving system successes were the categories that were least frequently mentioned, appearing in just 2.0 and 4.1 percent of news stories, respectively.

Frequency of Alcohol-Impaired Driving Issues and Specific Topics Represented in Alcohol-Impaired Driving Stories, n = 147.

Among specific story topics, those with the most mentions were personal responsibility (52.4 percent), human toll (37.4 percent), specific deterrence strategies for reducing recidivism and protecting the public (34.0 percent), sanctions (27.9 percent), and public health toll (23.1 percent); the “other” category of story-specific topics was represented in 46.9 percent of stories. With few exceptions, the remaining specific topics related to alcohol-impaired driving appeared in less than 10 percent of stories. The topics alcohol-impaired driving system successes-alcohol retailer and alcohol-impaired driving system failure/problem-unspecified did not appear in any of the news stories in the sample. Numerous other topics were mentioned just once or twice across the 147 news stories.

Stories with Alcohol-Impaired Driving Incidents (n = 104)

Table B-6 presents the frequency with which news stories involving alcohol-impaired driving incidents involved different types of events (e.g., fatal crash, arrest without crash), substances used, and persons of public interest, including celebrities and local persons of prominence in the community (e.g., local politician, well-known businessperson). In terms of type of incident, more than half of the stories on impaired-driving events were about a fatal crash (56.7 percent) and just over a quarter of stories were about an arrest without a crash (26.9 percent); injury crashes and property-damage-only crashes each accounted for 6.7 percent of stories.

Frequency of Incident Types, Substances Involved, and Noted Persons in News Stories with Alcohol-Impaired Driving Incidents, n = 104.

Regarding substance involvement, over 85 percent of stories suggested that alcohol was the sole substance used and the basis for intoxication. It should be noted that most stories of alcohol-impaired driving incidents did not directly specify alcohol involvement, but mentioned that a driver was “intoxicated” or “impaired” and/or that the driver was charged with DUI or DWI. In this overwhelming majority of cases, the assumption was that the substance involved was alcohol; if another drug was mentioned, then it was coded alone or together with alcohol, as described in the story. The combination of alcohol and prescription medications and alcohol and illicit drugs accounted for 3.8 and 2.9 percent of stories, respectively. In four cases (3.8 percent) the driver was reported to have tested positive for all three substances, and in one case (1.0 percent) the driver was speculated to have taken a prescription drug, GHB, alone.

Over the course of the coding process, it was noted that among some stories that appeared in the sample multiple times across sources and over time, reports of substance involvement for the same incident differed. In one crash that appeared in numerous stories in 2013 at the time of trial and again in 2015 after a potential probation violation, most stories referenced alcohol; only a few stories reported alcohol and cannabis or alcohol and Valium and a single story reported all three substances. Some of the discrepancies in substance involvement are likely attributable to the reporting of events within days of their occurrence before toxicology reports are available. In stories that run in one news cycle only, the information on other substances may become available after the story has ceased to be covered. Thus, the involvement of drugs may be underrepresented in news stories.

Celebrities were mentioned in 13.5 percent of stories with alcohol-impaired driving incidents, always as the perpetrator. For local persons of prominence in the community (i.e., those with name recognition and known widely in their community but not celebrities on a national or international scale), such individuals were represented in 15.4 percent of stories as perpetrators and 2.9 percent of stories as victims.

Research question 4: How extensively across time and consequences is the coverage of alcohol-impaired driving incidents in news stories? Information on the distribution of the news stories with alcohol-impaired driving incidents across different time frames and the frequency with which different consequences associated with alcohol-impaired driving events were reported is presented in Table B-7 . Nearly two-thirds of stories (63.5 percent) were reported more than a month after their occurrence. This is associated with the fact that 38 of the 104 stories involving alcohol-impaired incidents also discussed broader societal issues, often dealing with advocacy or policy efforts undertaken in the aftermath of a crash. Just over one-quarter of the stories (26.0 percent) reported alcohol-impaired driving events that had occurred within a week.

Time Frame of Reporting and Extensiveness of Coverage Over Time of Alcohol-Impaired Driving Incidents, n = 104.

Regarding consequences stemming from the alcohol-impaired driving incidents, those mentioned most frequently included pretrial processes (e.g., charges, jail, bond, indictment), which were covered in 44.2 percent of stories; victim's physical injuries, mentioned in 31.7 percent of stories; impacts on victim's family, found in 26.0 percent of stories; and sentencing of perpetrators, mentioned in 24.0 percent of stories. Again, the “other” category containing idiosyncratic or story-specific ramifications such as a swimmer's suspension from competition by USA Swimming and loss of corporate endorsements was coded in 55.8 percent of stories. The remaining consequences associated with impaired driving were each mentioned in less than 10 percent of news stories.

Research question 5: To what extent do news stories on alcohol-impaired driving incidents focus on victims compared to perpetrators? Stories on alcohol-impaired driving overwhelmingly focused on perpetrators (78.8 percent), owing in part to the fact that more than half of the stories involved fatal crashes. Although victims were mentioned, stories tended to focus on the actions leading up to the incident and consequences for perpetrators in terms of charges, trial, and sentencing. Victims were the focus of stories in 11.5 percent of cases. In three cases (2.9 percent), stories about an alcohol-impaired driving incident focused equally on perpetrator and victim, and in seven cases (6.7 percent), the focus of the story was on another individual other than perpetrator or victim (e.g., a police officer standing trial for perjury for her testimony given in an earlier DWI case who was acquitted of charges; a father who allowed an underage drinking party in his home after which one of the partygoers caused a fatal crash; two teens facing charges for allowing a fellow underage drinking partygoer to drive home).

Stories with a Broader Social/Environmental Focus (n = 81)

Research question 6: What approach to discussing larger societal/environmental issues do news stories taking a thematic frame to the issue of alcohol-impaired driving use? Table B-8 displays the occurrence of different approaches to discussing broader societal/environmental issues across the 81 thematically framed news stories on alcohol-impaired driving. Because thematic news stories often used multiple techniques to discuss social issues linked to alcohol-impaired driving, percentages do not sum to 100. Approaches or foci used to present a thematically framed story most often involved discussion of program/policy/legislation (39.5 percent), historical/epidemiological trends or information (37.0 percent), and calls for action/more action on the issue of alcohol-impaired driving (19.8 percent). In 17.3 percent of stories on alcohol-impaired driving there was discussion of broader societal issues by discussing alcohol/drinking culture or linking an incident to issues of politics/corruption, bias/preferential treatment by the judicial system, or illegal immigration. The most infrequently used approach to thematic framing was the discussion of sales/marketing/promotion of alcohol (3.7 percent).

Frequency of Approaches to Discussing Societal/Environmental Issues in Thematic News Stories on Alcohol-Impaired Driving, n = 81.

Fifty-one unique stories presented a thematic frame through the discussion of a program, policy, and/or legislation; historical context or epidemiological trends; and/or calls to action. To investigate whether the use of these three approaches to thematic framing was associated with discussions about efforts to reduce the occurrence of alcohol-impaired driving through targeting individuals or the general population, the prevention/intervention approaches within specific topics were examined for these 51 stories. The prevention/intervention approaches included three that are focused on broad populations of all drivers or all drinkers. These include general deterrence strategies (e.g., per se BAC limits, information/educational campaigns relating to impaired driving), harm reduction efforts to separate drinking and driving (e.g., sober rides, use of designated drivers), and other alcohol policies (e.g., alcohol taxes, legislation on dram shop, responsible beverage service, furnishing alcohol to minors). The other two categories of prevention/intervention approaches to alcohol-impaired driving focus on individuals, specifically impaired-driving offenders, and include specific deterrence (i.e., strategies designed to reduce recidivism through means such as ignition interlocks, assessment/treatment, supervised probation) and punishment (e.g., fines, jail).

Across the 51 stories a fairly even distribution across the two foci of prevention and intervention strategies emerged, with 17 stories (33.3 percent) coded as focusing on an individually targeted policy related to specific deterrence or punishment only, 16 stories (31.4 percent) focused exclusively on a general population approach, and 12 stories (23.5 percent) that included a combination of general population and individually focused approaches to dealing with the problem of alcohol-impaired driving. Six stories (11.8 percent) were coded for using a broader social/environmental approach; however, the specific topics discussed were not related to prevention/intervention of impaired driving but issues such as illegal immigration, efforts to establish online criminal registries, and underage drinking education efforts.

Within each of the three framing techniques, there was considerable variability in the patterns of general population versus individual focus of prevention/intervention approaches. For the 32 stories within the program, policy, and legislation category, individually targeted strategies were discussed most often and were contained in 13 stories (40.6 percent), with 9 stories (28.1 percent) addressing strategies targeting the general population, and 7 stories (21.9 percent) focused on both prevention and intervention strategies. For the 16 stories in call to action, the most prevalent approach was a discussion of a combination of general population and individually focused approaches found in 8 stories (50.0 percent), with 4 stories (25.0 percent) discussing individually focused strategies and 2 stories (12.5 percent) discussing general population strategies exclusively. Finally, among the 30 stories employing a discussion of historical context or epidemiological trends, an even distribution was seen, with 10 stories (33.3 percent) focused on general population strategies, followed closely by 9 stories (30.0 percent) focused on individually targeted strategies and 9 stories (30.0 percent) on a combination of general population and individually focused approaches.

The current study was undertaken to determine how alcohol-impaired driving is framed in today's news environment. The sample of 147 news stories was split, with 45 percent using an episodic frame by focusing on a single incident of impaired driving and 55 percent using a thematic frame by placing the issue within a larger social context. Overall, news stories most frequently expressed values of individual problem/responsibility, victimization, and punishment. Within story topics covered, categories represented most often across all stories were prevention/intervention approaches, responsibility, and scope of the problem. Finally, for the entire sample, the voices most often represented in news stories included law enforcement, traffic safety advocates, prosecutors, and other attorneys/legal analysts. In terms of stories with alcohol-impaired driving events, stories overwhelmingly (almost 80 percent of the time) focused on perpetrators.

These findings suggest two trends in alcohol-impaired driving news stories over the past 7.5 years. First, the pattern of codes across these variables is consistent with the preponderance of fatal crashes among stories, which were nearly 57 percent of stories with alcohol-impaired driving incidents or 40 percent of the entire sample of stories. Such incidents evoke more sense of victimization and discussion of punishment than other types of impaired-driving incidents. Additionally, with a focus in stories on the actions of the perpetrator directly leading up to the incident, they communicate a message of personal responsibility for the arrest or crash, in which the individual is held responsible for drinking and driving. Second, the relatively high representation of the category, scope of the problem, and inclusion of traffic safety advocates as the voice with the second highest prevalence across stories reflect the influence of thematic-framed stories dealing with the issue of alcohol-impaired driving in terms of a community problem, with input from advocates who can speak to the statistics on the public health toll and the efforts aimed at reducing the problem.

Although thematic framing of stories places the problem of alcohol-impaired driving within a broader societal context, it does not ensure that approaches discussed for solving the problem necessarily target social and environmental factors. Among the stories using the most frequent techniques for thematic framing, a substantial proportion focused on individually targeted solutions (33 percent) or issues not directly associated with impaired driving (12 percent), often recounting the details of impaired driving events, highlighting individuals' bad decision making, and discussing the need for action or policy changes focused on efforts to punish offenders or control their drinking and driving. It should be noted that efforts to rehabilitate and control impaired driving offenders are advanced by traffic safety advocates and popular among policy makers because they not only target offenders but serve to support public health and safety by either keeping offenders off the road or ensuring that they do not drive with alcohol in their systems. Strategies such as ignition interlocks, electronic monitoring of offenders, and intensive supervision and probation allow offenders to remain with their families and keep their jobs while protecting the public and, therefore, are an important part of the arsenal of impaired driving countermeasures.

Focusing on individually targeted policy approaches to impaired driving, however, means that issues such as the culture of alcohol use, sales and promotion of alcohol, and the responsibility of persons and entities other than offenders often receive scant attention in news stories, even those with a thematic frame. Prevention efforts that target socio-cultural and policy contexts are critically important as they hold the promise of creating an environment in which heavy drinking and drinking and driving are not condoned or facilitated and, thus, help prevent the problem from occurring rather than dealing with offenders after an event has taken place. In the current analysis, slightly more than half of the stories in the entire sample used a thematic frame and, among those using the three most frequent thematic framing approaches, only 55 percent included a discussion of solutions targeting the broader social context of impaired driving and population-based approaches to the problem. To move forward in reducing impaired driving fatalities, efforts to engage news outlets in media advocacy on the issue should focus on encouraging news organizations to move away from stories of simple problem descriptions to those that contain more critical analysis of the social/environmental causal factors and discussion of broader-based solutions through primary prevention.

No other content analyses in the published literature were located that matched the focus of this one on alcohol-impaired driving in general or that used a similar sampling frame, with coding of both newspaper and cable television news stories. However, a comparison to another study of framing analysis of impaired driving stories is worth noting. In a study that examined motor vehicle crashes with injuries in U.S. newspapers between 1999 and 2002, researchers reported that among their sample of 473 stories, most reports in newspapers (97 percent) used an episodic frame. In summarizing their results, Rosales and Stallones (2008 , p. 477) explained that “the majority of reports included information on the type of crash, but characteristics about people and vehicles were rarely reported.” Thus, according to the authors, newspaper accounts are incomplete sources of information for influencing public attitudes and supporting public health agendas.

Because the current study examined stories involving crashes, arrest-only events, and alcohol-impaired driving without alcohol-impaired driving incidents, a lower percentage of stories were found to have an episodic frame (45 percent), a rate nearly one half of that found in the study by Rosales and Stallones (2008) . This suggests that when assessing the news coverage of alcohol-impaired driving, the sampling methods used to select the platforms and the types of news stories to be included in the analysis may substantially affect the results. Stories confined to crashes are likely to recount details of the incident often in its immediate aftermath; stories on impaired driving without a crash event will more likely discuss causal factors beyond individuals and increase the prevalence of thematic framed stories.

The current study provides up-to-date information on alcohol-impaired driving in the news, yet has several limitations. First, the sample size of 147 stories is small. Unlike other content analyses undertaken as part of longer-term research projects, this content analysis had to be planned and executed within 6 to 8 weeks; thus, it was not possible to code a large sample.

Second, the short time frame also made it necessary to have the coding conducted by a single coder rather than a cadre of trained coders. Using multiple coders requires an extensive training and practice phase, ongoing reliability assessments throughout training and actual coding, retraining as needed, and a reconciliation process for the portion of the actual sample of stories that is double coded. Such a process was infeasible in this case, which resulted in a limited sample size and lack of reliability data. However, the fact that the sample was coded in a relatively short period of 5 weeks may have reduced the likelihood of changes in coding practices over time.

Third, because the purpose of the study was to look at the current and recent past years' news environment, stories had to be coded using archival means, primarily transcripts in LexisNexis. Although transcripts provide a full record of stories developed for dissemination in text format and presented in platforms such as newspapers, transcripts of stories broadcast on television are not as conducive to capturing information as comprehensively. For cable television programs, transcripts of stories can be incomplete for several reasons (e.g., video segments are not seen and the material transcribed is partial with persons in videos often identified simply as “unidentified male” or “unidentified female”). Additionally, because hosts and multiple guests often talk at the same time so that discussion is indecipherable by transcribers, information is missing as places in the transcript will simply designate “cross talk.” Finally, because the coder cannot access the visual content, some material is harder to understand as context is lost. When information is not accessible in its originally developed format, there are inherent difficulties in coding stories across platforms.

Finally, because the current sample was drawn from a combination of a limited number of newspapers (mostly published on the East Coast) and several cable television news outlets, there may have been selection bias in terms of the types of stories covered in this content analysis. This may have influenced the results in several ways. First, to the extent that there are cultural differences across regions of the United States regarding impaired driving, the values/themes may have reflected those of East Coast and urban areas disproportionately. Second, news outlets that focus on a national audience (such as USA Today and the three cable television news outlets) cover only the most serious or egregious incidents and, thus, do not cover the number and breadth of impaired-driving crashes as news sources that focus on local events in the community or both local and national events (e.g., The Washington Post and The New York Times ). The fact that this framing analysis adopted a broad focus on all types of impaired-driving stories not limited to crashes and the inclusion of several national news outlets together likely reduced the occurrence of incident-only (i.e., episodic) stories in this analysis.

In the future, content coding of news stories can be improved in several ways. First, with a longer planning phase, it will be possible to review stories and develop methods specifically tailored to the different story formats. Second, conducting content analyses of current news stories in which content can be recorded in real time in the format it is disseminated (e.g., recording television shows that can be watched by coders) would avoid problems of coding in formats different from that in which stories were originally developed. Third, digital media deserves more attention. Content analyses have already been conducted of posts to online news message boards covering alcohol-impaired driving enforcement, but young people are increasingly turning to nontraditional sources for their news, including online social networks such as Facebook and Twitter, and these are not as easy to access ( Connor and Wesolowski, 2009 ). Use of these platforms and the rise in citizen journalism may have significant implications for what types of content on alcohol-impaired driving are covered as news and how.

• Alcoholalert.com. 2011 Drunk driving statistics. n.d. [September 3, 2017]. http://www ​.alcoholalert ​.com/drunk-driving-statistics.html .
• Benjamin D. A FrameWorks Institute FrameByte: Episodic vs thematic stories. 2007. [September 5, 2017]. https://www ​.frameworksinstitute ​.org/assets ​/files/framebytes/framebytethematic ​.pdf .
• Clegg Smith K, Wakefield M, Siebel C, Szczypka G, Slater SJ, Terry-McElrath Y, Emery S, Chaloupka FJ. ImpacTeen Research Paper Series, No. 21. May, 2002. Coding the news: The development of a methodological framework for coding and analyzing newspaper coverage of tobacco issues.
• Connor SM, Wesolowoski K. Posts to online news message boards and public discourse surrounding DUI enforcement. Traffic Injury Prevention. 2009; 10 :546–551. [ PubMed : 19916124 ]
• Iyengar S. Framing responsibility for political issues: The case of poverty. Political Behavior. 1990; 12 (1):19–40.
• NCSA (National Center for Statistics and Analysis). Traffic safety facts, 2015 data—Alcohol-impaired driving. Washington, DC: National Highway Traffic Safety Administration; 2016.
• Rosales M, Stallones L. Coverage of motor vehicle crashes with injuries in U.S. newspapers, 1999-2002. Journal of Safety Research. 2008; 39 (5):477–482. [ PMC free article : PMC2659876 ] [ PubMed : 19010121 ]
• Slater MD, Hayes AF, Goodall CE, Ewoldsen DR. Increasing support for alcohol-control enforcement through news coverage of alcohol's role in injuries and crime. Journal of Studies on Alcohol and Drugs. 2012; 73 :311–315. [ PMC free article : PMC3281988 ] [ PubMed : 22333339 ]
• Yanovitzky I. Effect of news coverage on the prevalence of drunk-driving behavior: Evidence from a longitudinal study. Journal of Studies on Alcohol. 2002; 63 :342–351. [ PubMed : 12086135 ]
• MEDIA CONTENT ANALYSIS: FRAMING OF ALCOHOL-IMPAIRED DRIVING NEWS STORIES

View in own window

FRAME AND FOCUS (episodic versus thematic)

Alcohol-impaired driving incident featured [if N, skip to Broader Focus]

Incident type

• _________ Arrest without crash (i.e., based on driving behavior)
• _________ Injury crash
• _________ Fatal crash
• _________ Property-damage-only crash
• _________ Other
• If Other, specify __________________________

Time frame of reporting

• _________ Immediately after incident (i.e., within 6 days)
• _________ Short term (i.e., 1–4 weeks after incident)
• _________ Long term (i.e., more than 1 month after incident)
• _________ Unclear

Ramifications of incident covered [Code all that apply]

• _________ Victim's physical injuries
• _________ Psychological effects on victim
• _________ Other impacts on victim—e.g., lost job/wages, disability
• _________ Impact on victim's family
• _________ Physical impact on perpetrator—e.g., injuries
• _________ Psychological effects on perpetrator—e.g., guilt, remorse
• _________ Other impacts on perpetrator—e.g., financial, job
• _________ Pretrial—e.g., charges, bond, home confinement
• _________ Trial
• _________ Sentencing

Perpetrator–Victim Focus

• [Code both Perpetrator and Victim only if 50-50 split in focus]
• _________ Perpetrator
• _________ Victim

Celebrity —involvement of national/international public figure (e.g., entertainer, athlete) [Code all that apply]

• _________ Passenger in vehicle with suspected impaired driver
• _________ Passenger in vehicle with victim
• _________ Other (e.g., party host)

Local person of prominence/interest —involvement of local person known in the community before incident such as high-profile businessperson, elected official [Code all that apply]

Substance involvement in incident [Code all that apply]

• _________ Alcohol
• _________ Rx drugs
• _________ Illicit drugs
• _________ Drugs, unspecified

Broader focus on societal/environmental issues [Code all that apply; If N, skip to Voices]

• _________ Historical/epidemiological
• _________ Call for action/more action on alcohol-impaired driving
• _________ Program/policy/legislation
• _________ Alcohol/drinking culture
• _________ Sales/marketing/promotion of alcohol
• _________ Court challenges to laws, police practices
• Links to other social issues
• _________ Politics/corruption
• _________ Two-tiered justice system
• _________ Illegal immigration
• VOICES (all stories)

Whose voice is represented by providing information, being quoted or cited as source of info [Code all that apply]

• _________ Law enforcement
• _________ Prosecutor
• _________ Policy maker
• _________ Victim's family
• _________ Perpetrator's family
• _________ Traffic safety advocates—e.g., MADD, IIHS, community alcohol-impaired driving task force/coalition
• _________ Government public health/safety org.—e.g., NHTSA, NTSB, CDC
• _________ Alcohol industry or industry-funded lobbying/advocacy groups
• _________ Alcohol retailers—e.g., owners/managers of local bars, clubs, or restaurants
• _________ Researcher
• _________ Medical/health professional
• _________ Perpetrator's attorney
• _________ Other attorney/legal analyst
• _________ Media
• _________ Callers into show
• VALUES (all stories) [Record type of content included in categories]

What are the underlying values/themes expressed in the story [Code all that apply]

• _________ Victimization
• _________ Injustice
• _________ Punishment
• _________ Individual problem or responsibility
• _________ Collective problem or responsibility
• _________ Alcohol retailer/industry problem or responsibility
• _________ Failure of family
• _________ Entitlement/above the law
• _________ Liberty/personal freedom
• _________ Effects on alcohol-impaired driving enforcement/prosecution
• _________ Economic interests
• _________ Cultural change in norms/attitudes
• _________ Personal engagement/activism
• _________ Protective role of government
• _________ Influence of special interests beyond industry
• _________ Recovery/personal transformation
• _________ Targeting social versus heavy/hardcore drinkers
• _________ Need for evidence-based prevention
• _________ Experiential learning to prevent risky driving
• _________ Avoiding holiday alcohol-impaired driving
• _________ Getting serious/tough on alcohol-impaired driving
• TOPICS (all stories)

What topics are discussed in the story [Code all that apply]

• _________ Public health toll—effects on society in terms of deaths, injuries, costs
• _________ Human toll—impact on victims, survivors, offenders
• _________ Personal—responsibility of individual drinkers, parents of minors, other
• _________ Third party-enforcement (e.g., ABC, police)
• _________ Third party-court and/or probation system
• _________ Third party-government/policy makers
• _________ Third party-alcohol retailers
• _________ Third party-alcohol industry
• _________ Third party-other
• _________ Prevention/general deterrence—countermeasures directed at general driving population (e.g., per se BAC limits, public information/education, checkpoints)
• _________ Intervention/specific deterrence—countermeasures directed at offenders to reduce recidivism and support public safety (e.g., license suspension/revocation, ignition interlocks, DWI courts/ISP, assessment/treatment services, court-mandated sobriety)
• _________ Sanctions—countermeasures focused on punishment of offenders (e.g., fines, jail, home confinement)
• _________ Harm reduction—efforts to separate drinking and driving (e.g., sober ride programs, designated driver, ridesharing [Uber, Lyft])
• _________ Other alcohol policies (e.g., taxes, restrictions on use/density, dram shop, RBS, alcohol promotion)
• _________ New tools/technology for police, courts/probation, retailers—geospatial mapping of crashes/calls for service, passive sensors, tools for checking IDs, etc.
• _________ New tools/technology for drinkers/drivers—BAC estimators, breathalyzers in cars, driverless cars, etc.
• _________ Grassroots advocacy efforts—community-based efforts (e.g., alcohol-impaired driving coalition/task force, work of traffic safety advocates, other citizen-led efforts)
• _________ Failures in alcohol-impaired driving system overall/unspecified
• _________ Failures in/greater action needed on alcohol-impaired driving legislation/policy
• _________ Failures in/greater action needed on enforcement of alcohol laws (e.g., sobriety checkpoints, compliance checks)
• _________ Failures in/greater action needed from court system (e.g., sentencing offenders, monitoring offenders)
• _________ Failures in/greater action needed from alcohol retailers (e.g., RBS training, improved ID checking, dram shop liability)
• _________ Failures in/greater action needed from alcohol industry
• _________ Failures in/greater action needed from others (e.g., universities, fraternities)
• If Other, specify__________________________
• _________ Alcohol-impaired driving system overall/unspecified
• _________ Successes on alcohol-impaired driving legislation/policy
• _________ Successes on enforcement of alcohol laws
• _________ Successes related to court system (i.e., judiciary, probation)
• _________ Successes related to alcohol retailers (e.g., RBS training, improved ID checking)
• _________ Successes related to alcohol industry
• _________ Successes related to other entities (e.g., universities, fraternities)
• _________ Irresponsible parenting/family dysfunction
• _________ Change in lifestyle/direction/purpose
• _________ Underage drinking
• _________ Individual vs. state's rights
• _________ Other issues (e.g., holiday drinking, gang violence)
• Cite this Page Fisher DA. Content Analysis of Alcohol-Impaired Driving Stories in the News. In: National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities; Negussie Y, Geller A, Teutsch SM, editors. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington (DC): National Academies Press (US); 2018 Jan 17. B.
• PDF version of this title (6.4M)

In this Page

Related information.

• PMC PubMed Central citations
• PubMed Links to PubMed

Recent Activity

• Content Analysis of Alcohol-Impaired Driving Stories in the News - Getting to Ze... Content Analysis of Alcohol-Impaired Driving Stories in the News - Getting to Zero Alcohol-Impaired Driving Fatalities

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers