Alcohol policies and impaired driving in the United States: Effects of driving- vs. drinking-oriented policies

Ziming Xuan, Jason G. Blanchette, Toben F. Nelson, Timothy C. Heeren, Thien H. Nguyen, Timothy S. Naimi


Xuan, Z., Blanchette, J., Nelson, T., Heeren, T., Nguyen, T., & Naimi, T. (2015). Alcohol policies and impaired driving in the United States: Effects of driving- vs. drinking-oriented policies. The International Journal Of Alcohol And Drug Research, 4(2), 119-130. doi:

Aims: To test the hypotheses that stronger policy environments are associated with less impaired driving and that driving-oriented
and drinking-oriented policy subgroups are independently associated with impaired driving.

Design: State-level data on 29 policies in 50 states from 2001-2009 were used as lagged exposures in generalized linear
regression models to predict self-reported impaired driving.

Setting: Fifty United States and Washington, D.C.

Participants: A total of 1,292,245 adults (≥ 18 years old) biennially from 2002–2010.

Measures: Alcohol Policy Scale scores representing the alcohol policy environment were created by summing policies weighted
by their efficacy and degree of implementation by state-year. Past-30-day alcohol-impaired driving from 2002–2010 was
obtained from the Behavioral Risk Factor Surveillance System surveys.

Findings: Higher Alcohol Policy Scale scores are strongly associated with lower state-level prevalence and individual-level risk of impaired driving. After accounting for driving-oriented policies, drinking-oriented policies had a robust independent association with reduced likelihood of impaired driving. Reduced binge drinking mediates the relationship between drinking-oriented policies and impaired driving, and driving-oriented policies reduce the likelihood of impaired driving among binge drinkers.

Conclusions: Efforts to reduce alcohol-impaired driving should focus on reducing excessive drinking in addition to preventing driving among those who are impaired.


Alcohol policy; alcohol-impaired driving; public health law; binge drinking

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