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2 Current Environment: Alcohol, Driving, and Drinking and Driving
Pages 63-108

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From page 63...
... For alcohol-impaired driving, there are two contexts that are especially salient and worth examining: the alcohol environment (e.g., social and cultural drinking norms, availability, pricing, and regulation) and the driving environment (e.g., road safety infrastructure, public transportation, and driving patterns)
From page 64...
... . Drinking Behaviors and Trends Alcohol consumption, while intertwined with many social and cultural norms in the United States, is not uniform across all populations (Babor, 2010a)
From page 65...
... .3 The NESARC study also found the largest increases in alcohol consumption, alcohol-impaired driving, and alcohol use disorder in women, older adults, individuals of racial or ethnic minority, and individuals with lower income and educational attainment (Grant et al., 2017) .4 Social and cultural norms of alcohol use vary by gender and among ethnic groups in the United States (Galvan and Caetano, 2003)
From page 66...
... . For example, research suggests an increase in binge drinking among younger and older women (Breslow et al., 2017; Dwyer-Lindgren et al., 2015)
From page 67...
... ; more recent data are not available about which kinds of alcohol are most common among alcohol-impaired drivers today, but beer continues to claim the most consumer dollars of the three main types of alcohol beverages (beer, wine, and distilled spirits) (Impact Databank, 2017a,b)
From page 68...
... . Because of commercial speech protection afforded by judicial interpretations of the First Amendment, alcohol advertising is primarily selfregulated by the alcohol industry.
From page 69...
... It is also important to recognize that there may be a basic conflict of interest for the alcohol industry between the need to maintain profitability and growth and efforts to reduce the prevalence of underage drinking and intoxication, both of which can lead to alcohol-impaired driving. Researchers estimated that in 2001 (the most recent year for which these estimates are available)
From page 70...
... . Systematic reviews have found that young drinkers who consume mixtures of alcohol and energy drinks are at higher risk for binge drinking and driving, riding as a passenger in a vehicle with an intoxicated driver, and being arrested for driving while impaired (Babor et al., 2018; McKetin et al., 2015; Striley and Khan, 2014)
From page 71...
... . In addition to encouraging greater alcohol consumption among younger audiences, the alcohol industry's marketing promotions and sponsorships may also target women and other high-risk and/or vulnerable populations (Babor et al., 2018)
From page 72...
... ALCOHOL-IMPAIRED DRIVING TRENDS In the United States an adult driver is considered to be alcohol impaired by state law when his or her BAC is 0.08 grams per deciliter (g/dL) or higher.8 The term driver can refer to the operator of any motor vehicle, including motorcycles, passenger cars, light trucks, and large trucks.
From page 73...
... .9 This reduction is noteworthy because during this time period, vehicle miles traveled increased substantially, indicating significant progress in past efforts to reduce alcohol-impaired driving fatalities. Despite this progress, alcohol-impaired driving persists today, and alcohol-impaired driving fatalities have constituted almost 31 percent of overall motor vehicle crash fatalities in the last 10 years from 2006 to 2016 (Michael, 2017; NCSA, 2016a, 2017a)
From page 74...
... found that the percentage of motor vehicle crash deaths involving alcohol-impaired driving in the United States, 31 percent, was the second highest among 19 OECD countries (Sauber-Schatz et al., 2016)
From page 75...
... Children are particularly vulnerable to alcohol-impaired driving crash fatalities. Among children ages 14 and younger who were killed in motor vehicle crashes in 2016, 17 percent died in alcohol-impaired driving crashes, 54 percent of whom were occupants of vehicles with drivers who had BAC levels of 0.08% or higher, 29 percent of whom were occupants in other vehicles, and 17 percent of whom were nonoccupants (pedestrians, cyclists, or others)
From page 76...
... These findings do not account for the differences in limits set by laws between countries and the underreporting of alcohol-related crashes, yet they highlight an important disparity in alcohol-related crash fatalities. Lower fatality rates in other high-income countries suggest that the United States needs to make significantly more progress in reducing motor vehicle crash deaths to catch up to its peer nations.
From page 77...
... However, it is important to note that while these types of driving have garnered much of the public's attention, alcohol-impaired driving remains the most dangerous form of risky driving and constitutes the highest proportion of motor vehicle crash fatalities owing to human choices among distracted driving, restraint use, speeding, and drowsy driving (Compton and Berning, 2015; NCSA, 2016b)
From page 78...
... A similar pattern emerges when comparing alcohol- and drugimpaired driving. Data from the National Survey on Drug Use and Health show that in 2014 the prevalence of driving under the influence of alcohol was higher than the prevalence of driving under the influence of illicit drugs by twofold, and a high proportion of those driving under the influence of drugs were concurrently under the influence of alcohol (Lipari et al., 2016; SAMHSA, 2015)
From page 79...
... PATTERNS OF ALCOHOL USE AND DEMOGRAPHICS This section provides an overview of important demographics that need to be considered when approaching the problem of alcoholimpaired driving. First, based on the public health perspective outlined in Chapter 1, the importance of considering health equity and the social determinants of health is discussed.
From page 80...
... They can contribute to differences in the burden of crashes, fatalities, injuries, and chronic health conditions that result from alcohol abuse and impaired driving among populations based on education, race and ethnicity, socioeconomic status, geography, and so on. In an effort to address alcohol use/abuse and impaired driving, it is important to move beyond the individual level and consider the social
From page 81...
... . While this disparity has held constant for decades, there is limited research suggesting that female drivers are becoming increasingly involved in alcohol-impaired driving crashes (Vaca et al., 2014)
From page 82...
... and found that binge drinking was most common among those with household incomes of $75,000 or more, whereas alcohol dependence (DSM-IV) was more common among those with annual household incomes of less than $25,000.
From page 83...
... . Per Capita Alcohol Consumption At the population level, alcohol consumption has historically been associated with the incidence of alcohol-related traffic fatalities (Voas and 14 Binge drinking was defined in this study as five or more drinks for men and four or more drinks for women during one or more occasions (i.e., typically over a period of 2 hours)
From page 84...
... A substantial body of evidence indicates that binge drinking is strongly associated with alcohol-impaired driving (Flowers et al., 2008; Hingson et al., 2017; Naimi et al., 2009; Quinlan et al., 2005) .15 The 2012 BRFSS findings revealed that respondents who reported binge drinking accounted for 85 percent of alcohol-impaired 15The BRFSS definition for binge drinking was changed in 2006 from five or more drinks on one or more occasions (i.e., typically over a period of 2 hours)
From page 85...
... Furthermore, more than half of alcohol-impaired drivers who reported binge drinking were not classified as heavy drinkers based on their average daily consumption, yet they had more than twice the odds of driving impaired than those who were not binge drinkers or heavy drinkers, when adjusting for age, sex, marital status, education, and income (Flowers et al., 2008)
From page 86...
... The problem of alcohol-impaired driving fatalities is related to both excessive drinking and to driving after one is impaired. Given the handin-glove relationship between binge drinking and alcohol-impaired driving, it is easy to overlook the importance of interventions to reduce alcohol consumption, and binge drinking in particular, among the general population.
From page 87...
... . A recent analysis of FARS data showed that the majority of deaths from alcohol-impaired driving crashes from 2000 to 2013 occurred in the South (45.6 percent)
From page 88...
... However, among all alcohol-impaired driving fatalities in 2014, 52 percent occurred in rural areas and 47 percent occurred in urban areas. Vehicle miles traveled (VMT)
From page 89...
... •  ural areas are disproportionally affected by alcohol-impaired driving crashes R and fatalities. •  er capita alcohol consumption and hazardous drinking are increasing.
From page 90...
... Vehicle miles traveled experienced a downturn in 2009 -- most likely from the financial crisis; it has since increased and is now at the highest level in U.S. history (FHWA, 2017)
From page 91...
... Findings from a U.S. Department of Transportation study showed that 73 percent of overall motor vehicle crash fatalities took place in urban fringe areas -- about 5 miles out from an urban boundary -- suggesting that such "urban edge" transition zones are an important consideration for effective points for intervention (Subramanian, 2009)
From page 92...
... A general downward trend in traffic fatalities has taken place over the past decade; however, a slight increase occurred in 2012, and in 2016 there were 37,461 fatalities, the highest since 2008 (NCSA, 2017a) , as well as an estimated 2.44 million injuries in 2015 (NCSA, 2016b)
From page 93...
... . Their findings also indicated that in 2010 alcohol-related crashes accounted for 22 percent of all motor vehicle crash costs and that crashes involving drivers with a BAC of 0.08% or higher accounted for more than 90 percent of the economic costs and societal harm associated with alcohol-related crashes (Blincoe et al., 2015)
From page 94...
... . Annual employer costs of alcoholimpaired driving crashes from 1998 to 2000 were estimated to be $9.2 billion (Zaloshnja et al., 2007)
From page 95...
... (e.g., alcohol consumption, drinking to impairment, and driving while impaired)
From page 96...
... Advocates for Highway and Auto Safety rates each state according to the implementation of what they deem as three optimal impaired driving laws: ignition interlock laws for all offenders, child endangerment laws, and open container laws (Advocates for Highway and Auto Safety, 2017) (see Figure 2-5)
From page 97...
... Studies have found that rates of binge drinking and self-reported alcohol-impaired driving are lower in states with more restrictive alcohol policy environments (Naimi et al., 2014; Xuan et al., 2015a,b)
From page 98...
... 2018. The role of the alcohol industry in policy interventions for alcohol-impaired driving.
From page 99...
... 2016. Motor vehicle crash deaths: How is the US doing?
From page 100...
... 2008. Patterns of alcohol consumption and alcohol-impaired driving in the United States.
From page 101...
... 2017. Alcohol policies and alcohol-related motor vehicle crash fatalities among young people in the US.
From page 102...
... 2017. Alcohol marketing and youth alcohol consumption: A systematic review of longitudinal studies published since 2008.
From page 103...
... 2014. Apparent per capita alcohol consumption: National, state, and regional trends, 1977–2012.
From page 104...
... 2017. Alcohol policies and alcohol-related motor vehicle crash fatalities among U.S.
From page 105...
... 2011. Effects of dram shop liability and enhanced overservice law enforcement initiatives on excessive alcohol consumption and related harms: Two community guide systematic reviews.
From page 106...
... 2013. Emergency medical services response to motor vehicle crashes in rural areas.
From page 107...
... 2014. Female drivers increasingly involved in impaired driving crashes: Actions to ameliorate the risk.
From page 108...
... American Journal of Drug and Alcohol Abuse 40(3)


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