Strong alcohol policies protect against drunk driving deaths among young people

Motor vehicle crashes are a leading cause of death among young people in the United States. Forty percent of deadly car crashes involve a drunk driver in Massachusetts, and the state falls within the top twenty-five percent for rates of young people killed in a drunk driving crash.

"Half of all young people who die in crashes are driven by someone who has been drinking," says lead author Scott Hadland, MD, a pediatrician at BMC and the study's corresponding author. "But with stronger alcohol policies at the state level, we saw a significantly lower likelihood of alcohol-related deaths."

The study used an alcohol policy scale that assessed 29 alcohol policies across the United States, which were designed to reduce alcohol consumption or prevent impaired driving, and cross referenced them with the number of people under 21 who died in crashes involving alcohol, approximately 85,000, over the course of 13 years. States were ranked based on how restrictive their alcohol laws were, including higher alcohol taxes and zero-tolerance policies for young people drinking and driving.

"We've seen research that shows the relationship between specific alcohol laws and drunk driving deaths, but no one has looked at the broader picture of the policy environment in different states," said Timothy Naimi, MD, MPH, a general internal medicine physician and alcohol epidemiologist at BMC who served as senior author of the study.

Researchers found as state alcohol laws became more restrictive, the likelihood of a young person being killed in a drunk driving crash decreased and led to less alcohol consumption as a whole. Additionally, almost half of underage youth who died in alcohol-related crashes were passengers, not drivers; and about 80% of those passengers were being driven by adults aged 21 or older who had been drinking.

Most of the deadly crashes happened during the weekend, in the evening or at night. The impact of state alcohol policies on drunk driving deaths was consistent for males and females, and generally held for both drivers and passengers.

"When it comes to preventing impaired driving and deaths of young people, alcohol control policies clearly matter," says Hadland, who is also an assistant professor of pediatrics at Boston University School of Medicine. "We found that those policies don't have to necessarily be ones that prevent drunk driving, or that specifically target young people."

"Since most young people who died as passengers in a car were driven by an adult over 21 who had been drinking, alcohol laws that prevent adult drinking are also critical," said Naimi who is also an associate professor of medicine and public health at Boston University School of Medicine and Public Health. "We must also focus on strategies that reduce excessive drinking, rather than focusing exclusively on interventions to prevent driving among those who are already impaired."