Ziming Xuan1, Jason G Blanchette2, Toben F Nelson3, Timothy C Heeren4, Thien H Nguyen1, Timothy S Naimi5. 1. Department of Community Health Sciences, Boston University School of Public Health, Boston, MA. 2. Section of General Internal Medicine, Boston Medical Center, Boston, MA. 3. Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN. 4. Department of Biostatistics, Boston University School of Public Health, Boston, MA. 5. Department of Community Health Sciences, Boston University School of Public Health, Boston, MA; Section of General Internal Medicine, Boston Medical Center, Boston, MA.
Abstract
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.
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.
Entities:
Keywords:
Alcohol policy; alcohol-impaired driving; binge drinking; public health law
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