Enforcement of alcohol-impaired driving laws in the United States: a national survey of state and local agencies

Alcohol Enforcement in the United States From 2010 to 2019

OBJECTIVE

Despite the important role of enforcement in reducing alcohol-related harms, few studies have assessed alcohol enforcement efforts, particularly over time. We assessed the prevalence of alcohol law enforcement strategies at two time points.

METHOD

Of a random sample of U.S. local law enforcement agencies (i.e., police, sheriff) surveyed in 2010, 1,028 were resurveyed in 2019 (742/1,028 [72%] response rate). We assessed changes in alcohol enforcement strategies and priorities within three domains: (a) alcohol-impaired driving, (b) alcohol sales to obviously intoxicated patrons (i.e., overservice), and (c) underage drinking.

RESULTS

Agencies reported placing higher priority on enforcement of alcohol-impaired driving and overservice in 2019 versus 2010. For alcohol-impaired driving enforcement strategies, we found increases over time in use of saturation patrols and in enforcing laws prohibiting open containers of alcohol in motor vehicles, but not in use of sobriety checkpoints. Approximately 25% of agencies conducted overservice enforcement in both years. For all strategies directed at underage drinking, enforcement decreased over time with more agencies using strategies aimed at underage drinkers versus alcohol suppliers (alcohol outlets, adults) in both years.

CONCLUSIONS

Agencies reported continued low levels or declines in enforcement across most strategies despite reported increases in prioritizing alcohol enforcement. More agencies could adopt alcohol control enforcement strategies, including an increased focus on suppliers of alcohol to youth rather than on underage drinkers, and increased awareness and enforcement of selling alcohol to obviously intoxicated patrons. Use of these strategies has the potential to reduce health and safety consequences of excessive alcohol use.

Strategies Used by Local Law Enforcement Agencies to Prevent Overservice of Alcohol in the United States

Overservice of alcohol, defined as commercial provision of alcohol to an individual who is obviously intoxicated, is illegal in most states and contributes to motor vehicle crashes and violence. Law enforcement agencies use various strategies that aim to reduce overservice at licensed alcohol establishments (e.g., bars, restaurants). Place of Last Drink (POLD) data collection is an emerging overservice enforcement strategy. POLD identifies patterns of overservice, which can provide support for targeted interventions to prevent overservice at offending establishments. We describe the prevalence of POLD and other overservice enforcement strategies and associations with agency characteristics, which has important implications for public health and safety. We conducted a national survey of 1024 municipal (e.g., town, city) and county law enforcement agencies in 2019 (response rate = 73%). We assessed the use of overservice enforcement strategies conducted by the agencies over the past year. We examined associations of each type of overservice enforcement strategy with agency and jurisdiction characteristics using regression models. 27% of responding agencies reported conducting overservice enforcement and 7% conducted POLD data collection specifically. Municipal (vs. county) agencies and agencies with an officer assigned primarily to alcohol enforcement activities were significantly more likely to conduct overservice enforcement generally but not POLD data collection specifically. Overservice enforcement in general, and POLD data collection specifically, are not widely conducted. Prevention of overservice has the potential to reduce harms related to excessive alcohol consumption. Increased evaluation of overservice enforcement strategies should be prioritized.

Quantitative tools and measurements for assessing the implementation of regulatory policies in reducing alcohol consumption and alcohol-related harms: A scoping review

ISSUES

Implementation of alcohol control policy is a global priority as alcohol contributes to negative individual health and societal impacts. However, there are no available reviews that comprehensively provide tools and measurements for assessing the implementation of alcohol control policy. This study reviews tools and measurements for assessing alcohol policy implementation. Policies considered include alcohol pricing and taxation, alcohol marketing control, physical availability control and drink-driving policy.

APPROACH

We conducted a scoping review from Scopus, Web of Science and the World Health Organization's website. We included studies on policy implementation for the four most effective prevention policies published worldwide between 2000 and 2021.

KEY FINDINGS

The search yielded 11,654 articles and these were narrowed down to 39 included studies. Of these 39 studies, almost half assessed the implementation of a drink-driving policy (n = 19), followed multipolicy (n = 12) and physical availability control (n = 8). There was no single study assessing policy implementation of pricing and taxation or alcohol marketing control. The majority of the studies were conducted in high-income countries (n = 31). Globally, there is no standardised tool or guidelines for measuring the policy implementation of these four policies. The tools for measuring policy implementation mostly focused on a single policy, and few covered multiple policies.

IMPLICATIONS

We recommend developing standardised tools and measurements to monitor policy implementation across multiple policies at country levels.

CONCLUSION

This review highlighted a lack of comprehensive and standardised tools to assess policy implementation and the limited number of studies on alcohol policy implementation in low- and middle-income countries.

Do alcohol policies affect everyone equally? An assessment of the effects of state policies on education-related patterns of alcohol use, 2011-2019

BACKGROUND

Public policies are a powerful tool to change behaviors that may harm population health, but little is known about how state alcohol policies affect different population groups. This study assesses the effects of a comprehensive measure of the state alcohol regulatory environment (the State Alcohol Policy Score or SAPS) on heavy drinking-a risk factor for premature death-on different population groups, defined by levels of educational attainment, then by race/ethnicity, and sex.

METHODS

We pool each state's Behavioral Risk Factor Surveillance Survey (BRFSS) 2011-2019 and use robust Poisson regression analyses that control for individual-level factors, state-level factors (1 year lagged SAPS score for each state, state fixed effects), and year fixed effects to assess the relationship between SAPS and heavy drinking behaviors by education group. Interaction terms test whether education moderates the relationship by race/ethnicity and gender.

RESULTS

SAPS scores increased 2010-2018, but substantial gaps persist between states. A 10 % increase in a state's alcohol policy score is associated with a 2 % lower prevalence in current drinking (APR=0.97, 95 % CI=0.97-0.97, p < 0.0011) although not for those with a high school education or less. A 10 % increase in the SAPS was associated with a 3 % lower prevalence of heavy drinking; interaction terms in models reveal that a 10 % increase in the SAPS was associated with a lower prevalence of heavy drinking among those with less than a college education.

CONCLUSION

Narrowing gaps in alcohol policies between states may reduce heavy drinking among those with lower educational attainment.

Alcohol-impaired driving among adults-USA, 2014-2018

INTRODUCTION

Alcohol-impaired driving (AID) crashes accounted for 10 511 deaths in the USA in 2018, or 29% of all motor vehicle-related crash deaths. This study describes self-reported AID in the USA during 2014, 2016 and 2018 and determines AID-related demographic and behavioural characteristics.

METHODS

Data were from the nationally representative Behavioral Risk Factor Surveillance System. Adults were asked 'During the past 30 days, how many times have you driven when you have had perhaps too much to drink?' AID prevalence, episode counts and rates per 1000 population were estimated using annualised individual AID episodes and weighted survey population estimates. Results were stratified by characteristics including gender, binge drinking, seatbelt use and healthcare engagement.

RESULTS

Nationally, 1.7% of adults engaged in AID during the preceding 30 days in 2014, 2.1% in 2016 and 1.7% in 2018. Estimated annual number of AID episodes varied across year (2014: 111 million, 2016: 186 million, 2018: 147 million) and represented 3.7 million, 4.9 million and 4.0 million adults, respectively. Corresponding yearly episode rates (95% CIs) were 452 (412-492) in 2014, 741 (676-806) in 2016 and 574 (491-657) in 2018 per 1000 population. Among those reporting AID in 2018, 80% were men, 86% reported binge drinking, 47% did not always use seatbelts and 60% saw physicians for routine check-ups within the past year.

CONCLUSIONS

Although AID episodes declined from 2016 to 2018, AID was still prevalent and more common among men and those who binge drink. Most reporting AID received routine healthcare. Proven AID-reducing strategies exist.

An examination of how alcohol enforcement strategies by sheriff and police agencies are associated with alcohol-impaired-driving fatal traffic crashes

Objective: Over 10,000 people die in alcohol-impaired-driving traffic crashes every year in the U.S. Approximately half of alcohol-impaired drivers report their last drink was at a bar or restaurant, and most bars and restaurants serve alcohol to patrons who are already intoxicated, known as overservice. Law enforcement agencies use various strategies to address alcohol-impaired driving and overservice but research on the effectiveness of these strategies is limited. Our objective was to assess whether law enforcement efforts focusing on alcohol-impaired driving and alcohol overservice were associated with alcohol-impaired-driving fatal traffic crashes.Methods: We conducted a survey of police and sheriff agencies in 1,082 communities across the U.S. in 2010 regarding their alcohol enforcement practices. We assessed whether the agency conducted: (1) alcohol overservice enforcement and (2) alcohol-impaired driving enforcement (sobriety checkpoints, saturation patrols, open container, overall alcohol-impaired driving enforcement). From the Fatality Analysis Reporting System (2009-2013), we obtained counts of alcohol-impaired-driving fatal traffic crashes (at least one driver had blood alcohol content ≥ 0.08) within the agency's jurisdiction boundary and within a 10-mile buffer. Using multi-level regression, we assessed whether each enforcement type was associated with alcohol-impaired-driving fatal crashes (per 100,000 population). For both the jurisdiction boundary and 10-mile buffer, we ran stratified models based on community/agency type: (1) small town/rural police; (2) urban/suburban police and (3) sheriffs.Results: In jurisdiction boundary models, urban/suburban communities where police conducted overservice enforcement (compared to those that did not) had fewer alcohol-impaired-driving fatal crashes (5.0 vs. 6.6; p = 0.01). For the 10-mile buffer, small town/rural communities where police agencies conducted overservice enforcement (compared to those that did not) had fewer alcohol-impaired-driving fatal crashes (16.9 vs. 21.2; p = 0.01); we found similar results for small town/rural communities where police used saturation patrols (18.7 vs. 22.1; p = 0.05) and had overall high alcohol-impaired driving enforcement (18.7 vs. 22.1; p = 0.05). The direction and the size of the effects for other types of enforcement and agencies were similar, but not statistically significant.Conclusions: Alcohol enforcement strategies among police agencies in small town/rural communities may be particularly effective in reducing alcohol-impaired fatal traffic crashes. Results varied by enforcement, agency and community type.

Variation in Alcohol Policy Enforcement Across Urban and Nonurban Communities

PURPOSE

The goal of this study was to assess whether different types of communities (ie, urban, suburban, small town, and rural) vary in the alcohol enforcement activities they conduct.

METHODS

We conducted a cross-sectional study using data from a national survey of local law enforcement agencies.

DATA

The survey assessed enforcement of a range of alcohol policies at 1,082 law enforcement agencies. U.S. Census data were used to categorize agencies based on community type.

RESULTS

Agencies in urban areas conducted more enforcement activities than agencies in other community types. Urban agencies were more likely than rural agencies to conduct underage compliance checks (prevalence ratio [PR]: 0.42; CI: 0.34-0.53), saturation patrols (PR: 0.80; CI: 0.67-0.95), sobriety checkpoints (PR: 0.68; CI: 0.53-0.86), and enforcement aimed at illegal sales to intoxicated patrons (PR: 0.59; CI: 0.42-0.81). Urban agencies were also more likely than small town agencies to do compliance checks (PR: 0.66; CI: 0.56-0.79) and sobriety checkpoints (PR: 0.75; CI: 0.61-0.91), and they were more likely than suburban agencies to do compliance checks (PR: 0.67; CI: 0.57-0.78) and enforcement actions around the sale of alcohol to intoxicated patrons (PR: 0.64; CI: 0.45-0.90), provision of alcohol to minors (PR: 0.77; CI: 0.65-0.92), and consumption by minors (PR: 0.90; CI: 0.82-0.99).

CONCLUSIONS

Enforcement of alcohol laws differs by community type. Future research is needed to identify mechanisms to increase enforcement by agencies in different types of communities.

It Is More Than Just Alcohol: A Criminological Perspective on Routine Drinking Activities, Opportunity, and Alcohol-Related Crashes

This project expands on the “routine drinking activities” perspective by examining alcohol outlets, alcohol-related crashes, and theoretically derived contextual measures. Using census tract–level data from two U.S. cities, we draw on the prevention literature and routine activities theory to develop measures of alcohol availability and context. Spatially lagged regression models examined both direct and conditional relationships between alcohol outlets and alcohol-related crashes. Results indicate that the alcohol outlet and crash relationship was moderated by contextual factors (e.g., driving under the influence [DUI] enforcement and environmental hazards). Thus, alcohol availability may be just a part of a broader community system that affects the opportunity for alcohol-related crashes to occur.

Alcohol-Impaired Driving and Perceived Risks of Legal Consequences

BACKGROUND

Driving while impaired (DWI) is a threat to public health. Codified legal sanctions are a widely implemented strategy to reduce DWI. However, it is unclear that sanctioning affects individual risk perceptions so as to deter alcohol-impaired driving.

METHODS

Using survey data collected from individual drivers, police, and defense attorneys specializing in DWI in 8 U.S. cities, we investigated whether risk perceptions about legal consequences for alcohol-impaired driving, both the risk of being stopped if driving while alcohol-impaired and receiving specific penalties following a DWI, deter alcohol-impaired driving. First, we analyzed how different drivers' risk perceptions about being pulled over and facing criminal sanctions related to their self-reported alcohol-impaired driving in the year following the interview at which risk perceptions were elicited. Second, using data from an experimental module in which individual's risk perceptions were randomly updated by the interview, we analyzed how each driver's beliefs about his or her own future alcohol-impaired driving responded to randomly generated increases in the apprehension probability and sanction magnitude.

RESULTS

Higher probabilities as estimated by the individuals of being pulled over corresponded to less alcohol-impaired driving in both analyses. Conversely, there was no statistical relationship between perceptions of criminal sanctions for DWI and alcohol-impaired driving with 1 exception-a small significant negative relationship between duration of jail time following a DWI conviction and alcohol-impaired driving.

CONCLUSIONS

Perceptions regarding the threat of being apprehended for alcohol-impaired driving were related to actual self-reported driving, while perceived sanctions following a DWI conviction for DWI generally were unrelated to either actual self-reported alcohol-impaired driving or the person's estimate of probability that he or she would drive while alcohol-impaired in the following year. Increasing certainty of apprehension by increasing police staffing and/or conducting sobriety checks is a more effective strategy for reducing alcohol-impaired driving than legislating increased penalties for DWI.

Impaired driving enforcement practices among state and local law enforcement agencies in the United States

INTRODUCTION

Alcohol-impaired driving (DUI) persists as a substantial problem, yet detailed data on DUI enforcement practices are rarely collected. The present study surveyed state and local law enforcement agencies about their DUI enforcement activities.

METHOD

Telephone interviews were conducted with law enforcement liaisons in state highway safety offices. Officers from a nationally representative sample of municipal, county, and state law enforcement agencies were also interviewed about their agency's DUI enforcement activities, including the types of enforcement, frequency of use, and whether activities were publicized. Response rates were 100% among law enforcement liaisons, 86% among county agencies, 93% among municipal agencies, and 98% among state agencies.

RESULTS

Based on the highway safety office survey, 38 states conducted sobriety checkpoints in 2011. Nationally, 58% of law enforcement agencies reported that they conducted or helped conduct sobriety checkpoints during 2011-12, with 14% of all agencies conducting them monthly or more frequently. The vast majority (87%) of agencies reported conducting dedicated DUI patrols. However, dedicated DUI patrols were less likely to be publicized than checkpoints. Less than a quarter of agencies reported using passive alcohol sensors to improve detection of alcohol-impaired drivers.

CONCLUSIONS

Results show that 38 states conducted sobriety checkpoints in 2011, little changed from a previous survey in 2000. Despite evidence of effectiveness, many agencies do not conduct frequent, publicized DUI enforcement or use passive alcohol sensors.

PRACTICAL APPLICATIONS

The survey suggests that there are several areas in which impaired driving enforcement could be improved: increasing the frequency of special enforcement, such as sobriety checkpoints and/or dedicated patrols; publicizing these efforts to maximize deterrent effects; and using passive alcohol sensors to improve detection of alcohol-impaired drivers.

Association between alcohol-impaired driving enforcement-related strategies and alcohol-impaired driving

All states in the U.S. prohibit alcohol-impaired driving but active law enforcement is necessary for effectively reducing this behavior. Sobriety checkpoints, saturation patrols, open container laws, and media campaigns related to enforcement efforts are all enforcement-related strategies for reducing alcohol-impaired driving. We conducted surveys of all state patrol agencies and a representative sample of local law enforcement agencies to assess their use of alcohol-impaired driving enforcement-related strategies and to determine the relationship between these enforcement-related strategies and self-reported alcohol-impaired driving behavior obtained from the Behavioral Risk Factor Surveillance System. We found that sobriety checkpoints, saturation patrols, and enforcement of open container laws were associated with a lower prevalence of alcohol-impaired driving but, more importantly, a combination of enforcement-related strategies was associated with a greater decrease in alcohol-impaired driving than any individual enforcement-related activity. In addition, alcohol-impaired driving enforcement-related strategies were associated with decreased alcohol-impaired driving above and beyond their association with decreased binge drinking. Results suggest law enforcement agencies should give greater priority to using a combination of strategies rather than relying on any one individual enforcement activity.