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Baker;, S. Braver, E. R.; Chen, L-H; Li, G.; Williams, A. F.; "Drinking histories of fatally injured drivers" Injury Prevention 2001;7:272-275. Main outcome measure: Problem drinking indicators.
Results: At least one indicator of potential problem drinking, primarily heavy drinking, was reported for 68% of drivers with very high BACs (0.15+g/dl), 41% with BACs of 0.10 - 0.14 g/dl, 32% with BACs of 0.01&endash;0.09 g/dl, and 7% with zero BACs. Spouses provided more credible responses than other relatives: they were more likely to report at least occasional drinking and driving among deceased drivers with high BACs. For the most direct signs of problem drinking (described as a problem drinker during the last month of life or frequently driving after having five or more drinks), spousal reports suggested the prevalence of problem drinking among drivers with very high BACs was 22% (having both indicators), 32% (frequently driving after having five or more drinks), 44% (described as problem drinker), or 57% (having either indicator). Conclusions: Drivers with BACs of 0.10+ g/dl were far more likely than sober drivers to be described as having markers of problem drinking.

However, many did not have indicators suggestive of problem drinking. In addition to programs focused on repeat offenders or problem drinkers, countermeasures such as sobriety checkpoints that target a broader spectrum of drinking drivers are appropriate.

Bartell, K.; Gross, C.; DiGuiseppi, C.; "Creation of a register on alcohol-impaired driving" INJURY PREVENTION (2006). To facilitate the identification of the best available evidence in the field of alcohol-impaired driving prevention, the Colorado Injury Control Research Center, in collaboration with the Cochrane Injuries Group, has begun to develop a register of controlled evaluations of interventions targeting drunk driving. This effort is being supported by the National Center for Injury Prevention and Control, part of the US Centers for Disease Control and Prevention.

Chamberlain, E.; Solomon, R,; "The tooth fairy, Santa Claus, and the hard core drinking driver" INJURY PREVENTION (2001); 7: 272 - 275. Key points:
--The recent focus on "hard core" drinking drivers marginalizes the impaired driving problem and inhibits substantive legislative reform.
--A sizable percentage of so-called "social drinkers" engage in binge drinking behavior that is sufficient to produce BAC in the typical "hard cored" range.
--Nearly 20% of licensed drivers in Canada continue to drive and drink.
--Infrequent drinkers have a much higher relative risk of crash than heavy drinkers with the same BACs.
--It would be prudent to discard the value laden labels of "social drinkers" and "hard core" drinking divers and focus instead on the high risk drinking behaviors.

Cummings, P.; Rivara, F. P.; Olson, C. M.; Smith, K. M.; "Changes in traffic crash mortality rates attributed to use of alcohol, or lack of a seat belt, air bag, motorcycle helmet, or bicycle helmet, United States, 1982-2001.", INJURY PREVENTION (2006), 12: 148-154. There were 858,741 traffic deaths during the 20 year period. Estimated deaths attributed to each factor were: (1) alcohol use 366,606; (2) not wearing a seat belt, 259,239; (3) lack of an air bag 31, 377; (4) no motorcycle helmet 12,095; (5) no bicycle helmet 10,552. Over the 20 years mortality rates attributed to each risk factor declined: alcohol by 53%, not wearing a seat belt 49%; lack of an air bag 17%; no motorcycle helmet by 74%; no bicycle helmet by 39%. There were 153,168 lives saved by decreased drinking and driving, 129,297 by increased use of seat belts, 4305 by increased air bag prevalence, 6475 by increased use of motorcycle helmets, and 239 by increased use of bicycle helmets. Decreased alcohol use and increased use of seat belts were associated with substantial reductions in crash mortality from 1982 through 2001. Increased presence of air bags, motorcycle helmets, and bicycle helmets were associated with smaller reductions.

Gillan, J. S.; "Legislative advocacy is key to addressing teen driving deaths", INJURY PREVENTION (2006); 12 (Supplement 1): 144-148. The increased crash risk for young, novice drivers, especially in their teenage years, has been a growing concern at both the state and federal levels. Teenage drivers are involved in fatal crashes at more than double the rate of the rest of the population per 100,000 licensed drivers. The best way of stemming these losses is to enact laws adopting graduated licensure systems that restrict young , novice drivers to conditions that reduce crash risk exposure when they first operate motor vehicles and to educate the public on the need for this legislation. Legislated teenage driving restrictions involve night-time vehicle driving restrictions, prohibitions on other teenage passengers, and the required presence of supervising adults. These restrictions are relaxed as teenage drivers successfully progress through initial and intermediate stages of graduated licensure before being granted unrestricted driver licenses. Unfortunately, many states have incomplete graduated licensing systems that need further legislative action to raise them to the desirable three-stage system that has been shown repeatedly to produce the greatest safety benefits. These state efforts should be buttressed by federal legislation hat has proved to be crucial in allied driver behavioral concerns. Because reducing crash risk involves other strategies, stringent enforcement of primary seat belt laws as well as improved motor vehicle crash avoidance capabilities and crash worthiness must accompany efforts to reduce young driver crash risk.

Shults, R. A.; Sleet, D A; Elder, R W;Ryan, G W ; Sehgal, M; "Association between state level drinking and driving countermeasures and self reported alcohol impaired driving". Injury Prevention Jun 01, 2002 8: 106-110. (Results: Of the 64 162 BRFSS respondents who reported drinking any alcohol during the past month, 2.1% of women and 5.8% of men reported at least one episode of alcohol impaired driving in the past month. Those living in states with a MADD grade of "D" were 60% more likely to report alcohol impaired driving than those from states with a MADD grade of "A" (odds ratio 1.6, 95% confidence interval 1.3 to 2.1). The association existed for men and women.
Conclusion: These findings suggest that stronger state level DUI countermeasures are associated with lower rates of self reported alcohol impaired driving.)

Smith, W. A.; "Social marketing: an overview of approach and effects", INJURY PREVENTION (2006), 12:1: 38-43. This paper reviewed the application of commercial and social marketing to teen driving safety. It drew on a wide range of information, including evaluation studies of specific programs as well as standards of practice within these two professions. Social marketing has been widely applied for more than three decades in the fields of public health, environmental protection, and political marketing with significant success. This paper attempts to distinguish between the practice of commercial marketing, whose goal is a profit, and the practice of social marketing, whose goal is a societal benefit. Issues of sustainability, segmentation, differences in behavioral characteristics, and cultural competence are discussed with specific examples drawn from the transportation safety literature. This paper suggests that social marketing, especially the Click It Or Ticket campaign, presents a viable companion to control and education approaches to behavior change to promote teen driving safety.

updated 12/19/16