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Reducing the Costs of Drinking and Driving
Pages 336-387

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From page 336...
... Indeed, few authors on the subject can resist citing the "motor wagons" editorial in the Quarterly Journal of Inebriety in 1904. Despite the long history of concern and the many attempts to control the problem, drunken driving is still perceived as a major highway safety problem.
From page 337...
... We must therefore determine the costs generated by the problem in order to compare them with the costs imposed by possible solutions. This section examines the magnitude and distribution of costs resulting from drunken driving.
From page 338...
... .i Clearly, a better indication of the importance of solving a problem than calculating the associated costs would be to calculate the costs that would be eliminated if it were solved. To determine the maximum preventable costs of drunken driving, I first examine the BAC levels of drivers involved in various types of accidents and those of control groups of drivers selected at random from times and places similar to those at which the accidents being controlled for occurred.
From page 339...
... The correlations with drinking frequency bias Table 2 toward underestimating the accident reduction, since those who currently drive drunk, if sober, would have a lower accident risk than those who currently drive sober. The second bias results from a disputed but probable positive association between "problem drinking" or "alcoholism" and both drunken driving and accident risk while sober (Smart 1969, Noble 1978b, pp.
From page 340...
... In 1977, motor vehicle traffic accidents resulted in 49,500 deaths, 1.9 million disabling injuries, arid $15.5 billion of property damage in the United States (National Safety Council 1976~. (The $15.5 billion figure is based on $520 per accident-involved vehicle [Jones and Joscelyn 19783.)
From page 341...
... Department of Transportation 1968, p. 614.4 Viewed in this way, drunken driving looks less 4 This is not to say that 75 percent of drivers drive with the high BAC levels associated with greatly increased accident risk (see Table C-1 in Appendix C)
From page 342...
... EXPOSURE REDUCTION OVE RVIEW The strategy of drinking-driving countermeasure that occurs first to most people is exposure reduction: reducing the amount of drunken driving that takes place and thereby reducing accident costs. This section examines several potential ways of achieving exposure reduction: · General deterrence: countermeasures that seek to prevent drivers in general from combining driving with drinking in excess of legally prescribed limits (0.10 percent BAC in most states)
From page 343...
... 20~. The percentage of fatally injured drivers with BAC levels of greater than or equal to 0.08 percent dropped from 27 percent before passage to 17 percent the following year (Comptroller General of the U.S.
From page 344...
... we should note that since the date of Ross's study, incidence of illegally high BAC levels among drivers killed in Britain has continued to climb, until it now substantially exceeds the incidence before passage of the act. Mere evaporation of the deterrent effect cannot account for this.
From page 345...
... Despite the lack of documented successes in the United States for countermeasures to deter drunken driving by increasing the risk of arrest and punishment, this approach appears to have won favor among state highway safety officials. A recent survey by the U.S.
From page 346...
... From present evidence, then, it appears that when drivers' perceived risk of arrest and punishment for drunk driving is sufficiently increased, drunk driving is deterred and accidents are reduced. In Britain, fatalities from traffic accidents decreased by 23 percent in response to the Road Safety Act, and similar legislation in Canada brought about a temporary reduction of 8 percent.
From page 347...
... A typical BAC level for a person brought to trial for DWI is 0.15 percent and would be the result of consuming six to seven drinks. It is probably safe to say that most drivers have never driven after consuming this much alcohol.
From page 348...
... 66~. The difficulty of convicting any but the most blatantly impaired may be the reason that a Norwegian government committee, in the wake of Ross' Scandinavian study, has recommended abolishing the mandatory prison term for DWI convictions with a BAC level of 0.05-0.12 percent, and reducing the mandatory prison sentence for those convicted with BAC levels exceeding 0.12 percent from 21 days to 7 days (Comptroller General of the U.S.
From page 349...
... Furthermore, not all efforts at public information and education are intended to achieve general deterrence that is, not all are targeted at affecting the behavior of potential drinking drivers. For instance, the efforts included in the U.S.
From page 350...
... There are three avenues for using public information and education to achieve general deterrence. The first is to inform potential drunk drivers of the risks they face accident and arrest- if they drive while drunk.
From page 351...
... A final avenue is to use public information and education to provide potential drunk drivers with information that will make it easier for them to avoid driving while dangerously or illegally drunk. Such information might include simple rules of thumb for determining how many drinks a person of given body weight can drink on a full and an empty stomach before reaching 0.10 percent BAC (e.g., simple sobriety tests one might give oneself to decide whether or not to drive, or socially and economically acceptable alternatives to driving when one realizes one has had too much to drink)
From page 352...
... This mariner of driving would probably increase the chance of less serious accidents as well as arrest. Since drunk drivers with previous DWI arrests are more likely to be experienced drunk drivers than those without, we would expect drunk drivers with previous DWI arrests to be more heavily represented among drivers in less serious accidents than in fatal accidents.
From page 353...
... yields the following observations: · No credible evaluation has shown that any educational or therapeutic treatment reduces future accidents of a person arrested for DWI more than traditional punitive treatment does. However, at least two studies of intensive treatment for general alcohol abuse showed a decline in the future incidence of accidents and rearrests combined (Organisation for Economic Co-operation and Development 1978, pp.
From page 354...
... Unfortunately, this information does not seem to be available, although data concerning the predriving drinking venue of DWI arrestees may be available.6 It seems reasonable to assume, however, that a large fraction of drunk drivers, h In the process of its 'iDUI Protect described in the text the California Department of Alcoholic Beverage Control collected data on where persons had been drinking who were arrested for driving under the influence of alcohol.
From page 355...
... As mentioned above, public information and education campaigns have been used to try to increase third-party intervention. These campaigns face the same difficulties as those attempting general deterrence; no truthful information that could be provided is likely to have much impact on a third party's perception of the risk inherent in drunk driving by others, since present perceptions appear to be fairly accurate.
From page 356...
... . Courts in ten states without dram shop acts, five states with such acts, and the District of Columbia have imposed civil liability on commercial servers of alcoholic beverages by court decision .
From page 357...
... There was no evaluation of the project's impact on drunken driving or accidents. Nonetheless, it is significant as an example of involvement of a state ABC department in drunk-driving countermeasures, and as an instance of a government agency developing and recommending standards of practice for servers of alcohol to avoid intoxication and subsequent drunk driving by patrons.
From page 358...
... Those who drink more often are at less risk at ally given BAC level. To the degree that the association between age and sensitivity to BAC is due to lack of drinking experience, raising the drinking age will merely transfer high accident risk from drivers under 20 to those recently turned 21.
From page 359...
... If potential drunk drivers are identified, then some sort of alcohol education or other preventive measure may work. If actual drinking drivers are identified, then the problem is the same as that of reducing recidivism (specific deterrence)
From page 360...
... The inconvenience and expense would be more easily justified if detectors were installed only in the cars of persons with previous DWI convictions. One would expect such persons to have a greater likelihood of driving drunk in the future than do drivers in general and, indeed, empirical evidence suggests that this expectation is correct (Jones and Joscelyn 197S, p.
From page 361...
... Red ucing Recid ivism (Specific DeterrenceJ Since only a small number of drivers involved in alcohol-related accidents have previous arrests for drunk driving, the potential savings from reducing recidivism is sharply limited. Even if all persons with drunkdriving arrests were prevented from ever combining drinking and driving again, the reduction in motor vehicle traffic accidents would be only about 1-3 percent, although absolute cost savings would not be trivial.
From page 362...
... If so, then raising the drinking age would merely transfer increased accident risk from drivers under 21 to those just over 21. There is at present no compelling case for denying persons between the ages of 18 and 21 the same access to alcohol as all other persons who have attained .
From page 363...
... The question involves estimating the "risk elasticity of drunken driving." If a 1-percent decrease in the risk of drunk driving led to a 1percent increase in the amount of drunk driving (i.e., if elasticity equals one) , then our efforts to reduce risk would seem vain.
From page 364...
... effective in lowering the risk of drivers with elevated BAC levels, but implementing the measures does not require knowing which drivers are likely to be impaired. Passive restraint systems, for instance (such as air bags or automatic seat belts)
From page 365...
... —even measures that offer no protection to persons with zero BAC levels should be evaluated and assigned priority In relation to all proposed measures to reduce the risk of driving in general. In a world of limited resources there is no defense for spending a dollar to reduce alcohol-related accidents if the same expenditure would be more effective if applied to reducing motor vehicle traffic accidents in general.
From page 366...
... Risk-reducing measures that affect drinking drivers by the same mechanism that they affect drivers in general are best considered in the context of general traffic safety. Those concerned with alcohol-related problems should check that the procedures used by traffic safety authorities to select countermeasures accurately take into account differential impacts on drinking drivers.
From page 367...
... It may be possible to redesign portions of the driving environment to decrease the impact on accident risk of degradation of these skills. Cars driven by persons likely to drive drunk, such as those with previous DWI convictions, could be held to higher standards of crashworthiness than cars in general.
From page 368...
... . Each ASAP attempted to integrate and improve enforcement, prosecution, screening, and treatment countermeasures so as to reduce drunken driving and associated accidents in its geographic area.
From page 369...
... The programs are treated as if they were applying well-developed technology to solving a problem (I use the term "service" here in a broad sense to include arresting drunk drivers, repairing roads, etc)
From page 370...
... It is therefore counterproductive to run government programs relating to drunken driving as if the primary purpose was service provision. Persons concerned with research and experimental design should work with those concerned with service provision and program management from the earliest planning and budgeting stages of drinking-driving countermeasure programs.
From page 371...
... associated with various BAC levels for drivers in the United States. I examine the studies here solely to determine the relationship between BAC and accidents, although the studies are rich in other information.
From page 372...
... Holcomb (1938) Alcohol in relation to traffic accidents.
From page 373...
... (1974) The Role of the Drinking Driver in Traffic Accidents,
From page 374...
... 52) , I suspect that it caused a small decrease in the frequency of drunken driving by moderate drinkers (who would have positive BAC levels below about 0.104.
From page 375...
... National Highway Traffic Safety Administration technical report DOT HS-801 826. Washington, D.C.: U.S.
From page 376...
... The subgroup of case observations to which controls were matched did not show a significantly or systematically different distribution of BAC levels than the earlier, unmatched case data. I have therefore pooled all case data.
From page 377...
... BAC test was performed by the municipal medical examiner on each member of case group. TABLE A-7 New York: Survey Results and Relative Risk BAC # Control No Control # Accident % Accident Ratio Risk 0 195 77.38 14 41.18 0.53 1.00 <0.02 14 5.56 0 0.00 0.00 0.00 0.02~.099 34 13.49 3 8.82 0.65 ~ 1.23 0.1~0.249 9 3.57 2 5.88 1.65 3.12 0.25 0.399 0 0.00 15 44.12 I have interpolated these results into my standard BAC categories by assuming uniform density of observations within each of the study?
From page 378...
... APPENDIX B: ADJUSTING VERMONT DATA TO REFLECT ALL FATAL ACCIDENTS The Vermont Study (see Appendix A) reports the BAC levels only for fatally injured drivers, but for purposes of computing the possible savings from drinking-driving countermeasures we need to know the BAC distribution of all drivers involved in accidents in which anyone was killed.
From page 379...
... I multiply the number of nondriver fatalities in each BAC range by 72/164 to arrive at the figures in Table B-2. TABLE B-2 Adjusted Number of Drivers Responsible for Fatal Accidents BAC (%)
From page 380...
... Several drivers passing each control site are randomly selected and their BAC levels measured. These observations constitute the "control group." Drivers in both the accident group and control group are classified into BAC ranges, and the results are presented in Table C-1.
From page 381...
... What are the probabilities of an accident occurring when one unit of accident exposure is driven by a driver at various BAC levels?
From page 382...
... D is the risk multiplier due to the fraction of drivers among the N trips who have elevated BAC levels. S is the number of trips sampled at each control site.
From page 383...
... Table C-2 shows the relative risk of driving in several BAC categories, as derived from the controlled epidemiological studies in Table 1 of this paper. TABLE C-2 Relative Risk of Accident Involvement per Unit of Driving in Various BAC Ranges' as Computed from Several Studies Injury Property Damager Fatal, Injury, Grand Rapids.
From page 384...
... If all drunken driving was eliminated, without changing any individual's driving patterns (mileage, route, etc.) , then we would compute a new Bi for each BAC range merely by setting relative risk for every range equal to one.
From page 385...
... (1974) The Role of the Drinking Driver in Traffic Accidents (The Grand Rapids Study)
From page 386...
... Results of National Alcohol Safety Action Projects. National Highway Traffic Safety Administration (DOT-HS-804-033~.
From page 387...
... (1975) A Psychometric Investigation of Drivers' Concern for Road Safety and Their Opinions of Various Measures for Accident Prevention.


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