Population drinking and drink driving in <scp>N</scp>orway and <scp>S</scp>weden: an analysis of historical data 1957–89

Norström, Thor; Rossow, Ingeborg

doi:10.1111/add.12126

Cited by 11 publications

(7 citation statements)

References 51 publications

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“…It has been hypothesised that alcohol consumption at a population level (ie, per-capita alcohol consumption) is associated with driving under the influence of alcohol 15 . If correct, an unintended outcome of a change in BAC legislation could be a reduction in per-capita alcohol consumption.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the effects of lowering blood alcohol concentration limits for drivers on the rates of road traffic accidents and alcohol consumption: a natural experiment

et al. 2019

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SummaryBackgroundDrink driving is an important risk factor for road traffic accidents (RTAs), which cause high levels of morbidity and mortality globally. Lowering the permitted blood alcohol concentration (BAC) for drivers is a common public health intervention that is enacted in countries and jurisdictions across the world. In Scotland, on Dec 5, 2014, the BAC limit for drivers was reduced from 0·08 g/dL to 0·05 g/dL. We therefore aimed to evaluate the effects of this change on RTAs and alcohol consumption.MethodsIn this natural experiment, we used an observational, comparative interrupted time-series design by use of data on RTAs and alcohol consumption in Scotland (the interventional group) and England and Wales (the control group). We obtained weekly counts of RTAs from police accident records and we estimated weekly off-trade (eg, in supermarkets and convenience stores) and 4-weekly on-trade (eg, in bars and restaurants) alcohol consumption from market research data. We also used data from automated traffic counters as denominators to calculate RTA rates. We estimated the effect of the intervention on RTAs by use of negative binomial panel regression and on alcohol consumption outcomes by use of seasonal autoregressive integrated moving average models. Our primary outcome was weekly rates of RTAs in Scotland, England, and Wales. This study is registered with ISRCTN, number ISRCTN38602189.FindingsWe assessed the weekly rate of RTAs and alcohol consumption between Jan 1, 2013, and Dec 31, 2016, before and after the BAC limit came into effect on Dec 5, 2014. After the reduction in BAC limits for drivers in Scotland, we found no significant change in weekly RTA rates after adjustment for seasonality and underlying temporal trend (rate ratio 1·01, 95% CI 0·94–1·08; p=0.77) or after adjustment for seasonality, the underlying temporal trend, and the driver characteristics of age, sex, and socioeconomic deprivation (1·00, 0·96–1·06; p=0·73). Relative to RTAs in England and Wales, where the reduction in BAC limit for drivers did not occur, we found a 7% increase in weekly RTA rates in Scotland after this reduction in BAC limit for drivers (1·07, 1·02–1·13; p=0·007 in the fully-adjusted model). Similar findings were observed for serious or fatal RTAs and single-vehicle night-time RTAs. The change in legislation in Scotland was associated with no change in alcohol consumption, measured by per-capita off-trade sales (−0·3%, −1·7 to 1·1; p=0·71), but a 0·7% decrease in alcohol consumption measured by per-capita on-trade sales (−0·7%, −0·8 to −0·5; p<0·0001).InterpretationLowering the driving BAC limit to 0·05 g/dL from 0·08 g/dL in Scotland was not associated with a reduction in RTAs, but this change was associated with a small reduction in per-capita alcohol consumption from on-trade alcohol sales. One plausible explanation is that the legislative change was not suitably enforced—for example with random breath testing measures. Our findings suggest that changing the legal BAC limit for drivers in isolation does not impr...

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Section: Introductionmentioning

confidence: 99%

An evaluation of the effects of lowering blood alcohol concentration limits for drivers on the rates of road traffic accidents and alcohol consumption: a natural experiment

et al. 2019

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“…I T IS WELL recognized that alcohol intoxication contributes to a large proportion of traffic and nontraffic injuries in many countries (Skog, 2001a). Previous studies show that about 10 to 60% of all fatal traffic crashes appear to be alcohol-related and the countries with low alcohol consumption levels were found to have low alcohol-related traffic crash rates (Norstr€ om and Rossow, 2013). Furthermore, alcohol also plays a significant role in nontraffic injuries, such as accidental falls and drowning, injuries caused by fire, and other unintentional injuries .…”

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confidence: 99%

Alcohol Consumption and Fatal Injuries in Australia Before and After Major Traffic Safety Initiatives: A Time Series Analysis

Jiang

Livingston

Room

2015

Alcoholism Clin & Exp Res

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The magnitude and distribution of the preventive effects from the reduction in population drinking on fatal injuries vary across different gender and age groups, with the strongest preventive impacts on fatal injuries among people aged 15 to 29 and 70 years and above. The mechanisms behind these effects are unclear from this study, but are likely to be due to the strong association between per capita consumption and heavy drinking.

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“…The study's area-based analyses, using Norwegian and Swedish data, demonstrated a strong and statistically significant association; as alcohol consumption per capita increases or decreases, so does the incidence of driving under the influence of alcohol. 22 We are not aware of any studies that have evaluated whether or not a legal reduction in the BAC limit (for a whole country) has led to a reduction in that country's population drinking. This could be a wider, unintended, outcome that can be attributed to change in BAC legislation.…”

Section: Association Between Blood Alcohol Concentration and Populatimentioning

confidence: 99%

Impact of legislation to reduce the drink-drive limit on road traffic accidents and alcohol consumption in Scotland: a natural experiment study

et al. 2019

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Background It is widely recognised that drink driving is a leading cause of road traffic accidents (RTAs). There is evidence that changing the drink-drive limit from a blood alcohol concentration of 0.08 to 0.05 g/dl is effective in reducing RTAs. Scotland changed the blood alcohol concentration limit to 0.05 g/dl on 5 December 2014. Aims To assess whether or not the numbers and rates of RTAs and per capita alcohol consumption in Scotland were reduced because of the 2014 drink-drive legislation. To assess whether or not the 2014 change in legislation provided good value for money. Design A natural experimental, quantitative study. The control group was England and Wales, that is, the other countries in Great Britain, where the drink-drive legislation remained unchanged. Setting Great Britain. Participants The entire population of Scotland, England and Wales for the period of January 2013–December 2016. Intervention The change to drink-drive legislation in Scotland. Outcome measures The counts and rates of RTAs; and per capita alcohol consumption. Methods For the numbers and rates of RTAs (both traffic flow and population denominators were used), and separately for the intervention and control trial groups, negative binomial regression models were fitted to panel data sets to test for a change in outcome level after the new 2014 legislation was in place. To obtain a ‘difference-in-differences’ (DiD)-type measure of effect, an interaction term between the intervention group indicator and the binary covariate for indicating pre and post change in legislation (‘pseudo’-change for the control group) was assessed. For off- and on-trade per capita alcohol sales, and separately for the intervention and control trial group, seasonal autoregressive integrated moving average error models were fitted to the relevant time series. Results The change to drink-drive legislation was associated with a 2% relative decrease in RTAs in Scotland [relative risk (RR) 0.98, 95% CI 0.91 to 1.04; p = 0.53]. However, the pseudo-change in legislation was associated with a 5% decrease in RTAs in England and Wales (RR 0.95, 95% CI 0.90 to 1.00; p = 0.05). For RTA rates, with traffic flow as the denominator, the DiD-type estimate indicated a 7% increase in rates for Scotland relative to England and Wales (unadjusted RR 1.07, 95% CI 0.98 to 1.17; p = 0.1). The change to drink-drive legislation was associated with a 0.3% relative decrease in per capita off-trade sales (–0.3%, 95% CI –1.7% to 1.1%; p = 0.71) and a 0.7% decrease in per capita on-trade sales (–0.7%, 95% CI –0.8% to –0.5%; p < 0.001). Conclusion The change to drink-drive legislation in Scotland in December 2014 did not have the expected effect of reducing RTAs in the country, and nor did it change alcohol drinking levels in Scotland. This main finding for RTAs was unexpected and the research has shown that a lack of enforcement is the most likely reason for legislation failure. Future work Investigations into how the public interpret and act on changes in drink-drive legislation would be welcome, as would research into whether or not previous change in drink-drive legislation effects on RTAs in other jurisdictions are associated with the level of enforcement that took place. Trial registration Current Controlled Trials ISRCTN38602189. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 12. See the NIHR Journals Library website for further project information.

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Population drinking and drink driving in Norway and Sweden: an analysis of historical data 1957–89

Abstract: In Norway and Sweden, as total population level of alcohol consumption increases or decreases so does the incidence of driving while intoxicated.

Cited by 11 publications

References 51 publications

An evaluation of the effects of lowering blood alcohol concentration limits for drivers on the rates of road traffic accidents and alcohol consumption: a natural experiment

An evaluation of the effects of lowering blood alcohol concentration limits for drivers on the rates of road traffic accidents and alcohol consumption: a natural experiment

Alcohol Consumption and Fatal Injuries in Australia Before and After Major Traffic Safety Initiatives: A Time Series Analysis

Impact of legislation to reduce the drink-drive limit on road traffic accidents and alcohol consumption in Scotland: a natural experiment study

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