Association between riding with an impaired driver and driving while impaired

Driving under the influence of cannabis versus alcohol: A mixed-methods study examining perceptions and related risk behaviors among US and Israeli adults

BACKGROUND

Despite the dangers of driving under the influence (DUI), little is known about DUI substance-specific risk perceptions or risk factors for riding with drunk/drugged drivers (RDD).

METHODS

In this sequential exploratory mixed-methods study, we conducted: 1) multivariable analyses of cross-sectional survey data from 2222 US and Israeli adults to identify correlates of perceived cannabis- vs. alcohol-related DUI risks (linear regression) and past-month RDD involving alcohol-only, cannabis-only, or both (alcohol-cannabis) (multinomial logistic regression); and 2) deductive-inductive thematic analyses of qualitative interview data from 84 participants to identify themes elaborating on survey findings regarding DUI-related risk perceptions.

RESULTS

54.0 % reported past-month alcohol use, 16.7 % cannabis use, 4.2 % alcohol-only RDD, 5.5 % cannabis-only RDD, and 7.9 % alcohol-cannabis RDD. Being from the US, not having children at home, and cannabis non-use correlated with lower perceived cannabis vs. alcohol DUI risk. Lower perceived cannabis vs. alcohol DUI risk correlated with cannabis-only and alcohol-cannabis (vs. no) RDD, and with alcohol-cannabis (vs. cannabis-only) RDD. Alcohol use correlated with alcohol-only (vs. no) RDD and alcohol-cannabis (vs. cannabis-only) RDD. Cannabis use correlated with cannabis-only and alcohol-cannabis (vs. no) RDD, and with alcohol-cannabis (vs. alcohol-only) RDD. Being from the US correlated with alcohol-only (vs. alcohol-cannabis and none) RDD and cannabis-only (vs. alcohol-cannabis) RDD; being from Israel correlated with alcohol-cannabis (vs. no) RDD. Qualitative data indicated most participants perceived greater risk of DUI of alcohol vs. cannabis and desired more effective DUI-related prevention and regulatory efforts.

CONCLUSIONS

Prevention interventions targeting DUI- and RDD-related risk perceptions are needed, particularly for high-risk populations.

Do adolescent trajectories of riding with an impaired driver and driving impaired predict similar behaviors in early adulthood?

BACKGROUND

A recent study shows four trajectories of riding with an impaired driver (RWI) and driving while impaired (DWI) from adolescence to emerging adulthood. We examined prospective associations of adolescent RWI/DWI trajectory class with early adulthood RWI/DWI behavior.

METHODS

Data were from the NEXT Generation Health Study (NEXT), a nationally representative longitudinal study (N = 2783) beginning with a 10th-grade cohort completing 7 annual assessment waves (W1-W7) between 2010 and 2016 and a later follow-up mixed methods study. Four RWI and DWI trajectories derived from a recently published latent class analysis study (RWI (last 12 months); DWI (last 30 days) dichotomized as ≥ once vs. none) were used: Abstainer, Escalator, Decliner, and Persister. In the follow-up examination, a purposive subsample (N = 105, 26.3 ± 0.5 y/o, Female 50.5%) of NEXT participants were selected by trajectory (31 Abstainers, 33 Escalators, 14 Decliners, and 27 Persisters) for in-depth interviews 4 years after NEXT. In interviews, self-reported RWI events (number of times) related to alcohol (Alc-RWI) or marijuana (MJ-RWI) use in the last 12 months, and DWI events (number of times) related to alcohol (Alc-DWI) & marijuana (MJ-DWI) use in January 2020 (pre-COVID pandemic) were collected using structured surveys. General linear models were used to examine associations of adolescents' RWI/DWI trajectories with early adulthood RWI/DWI behavior, controlling for sex, health status, education attainment, and work hours.

RESULTS

The mean number (SD) of Alc-RWI and MJ-RWI events reported by Escalators (3.83(2.48), 2.43(2.77)) and Persisters (3.83(2.43), 3.57(2.54)) were higher (p≤0.05) than Abstainers (0.82(1.42), 0.77(2.04)) and Decliners (1.81 (2.69), 1.38 (2.04)). Similarly, Escalators (1.61 (2.28), 1.88(2.69)) and Persisters (1.96(2.08), 1.93(2.48)) reported more Alc-DWI and MJ-DWI events than Abstainers (0.18 (0.53), 0.42(1.38)) and Decliners (0.00 (0.00), 0.08(0.28)). Linear regression models indicated membership in Escalator and Persister classes compared to Abstainer class was associated (p≤0.01) with higher engagement in RWI/DWI in early adulthood.

CONCLUSION

Adolescents with escalating and persistent high RWI/DWI may continue these health risking behaviors into their mid-twenties. Decliners during the transition maintained low RWI/DWI into their mid-twenties. Taken together, these findings suggest that earlier reduction may have long-term effects. Our findings can be used to inform the precision tailoring of prevention efforts aimed at effectively reducing alcohol/drug impairment crash injuries and related deaths among those in early adulthood.

Longitudinal perspectives of riding with a cannabis-impaired driver

OBJECTIVE

To explore decisions and perceptions of engaging in riding with a cannabis-impaired driver (RWI) during high school and young adulthood to build context around RWI-cannabis events.

METHODS

Participants were sampled from the NEXT Generation Health Study (NEXT), a 7-year national cohort study of adolescent health behaviors. Four RWI and driving while impaired (DWI) trajectories classes (i.e., Abstainer, Escalator, Decliner, Persister) were previously derived.A theoretical model based on ecological systems theory guidedin-depth semi-structured interviews to includecomplex, social-developmental and environmental multi-level factors affectingpersonal experiences with RWI-cannabis during high school, after high school, and during young adulthood. Participants (n = 105) were purposively selected from each trajectory class for follow-up, in-depth, qualitative interviews. All interviews were conducted via Zoom between March and September 2020.

RESULTS

Two unique themes emerged as facilitators of RWI-cannabis: "Driving Context" and "Trust in Driver". "Legal Concerns" and "Concerns with Safety Emerge with Age" were themes that described deterrents to RWI-cannabis.

CONCLUSIONS

Current data suggest that youth RWI-cannabis occurs during daytime hours and while driving to everyday activities. Youth report legal concerns as a potential deterrent to RWI-cannabis in high school and concerns for safety emerge in young adulthood. The multifaceted nature of RWI-cannabis among young drivers identifies potential complexities for programming designed to reduce RWI/DWI-cannabis.

Injunctive Norms and Driving Under the Influence and Riding With an Impaired Driver Among Young Adults in Washington State

PURPOSE

Alcohol- and cannabis-impaired driving behaviors remain a public health concern especially among young adults (i.e., ages 18-25). Limited updates to prevention efforts for these behaviors may be due, in part, to limited understanding of malleable psychosocial predictors. The current study assessed associations between perceived injunctive norms (i.e., acceptability) of driving under the influence of alcohol (DUI-A) and cannabis (DUI-C), and riding with a driver under the influence of alcohol (RWI-A) and cannabis (RWI-C) in Washington State young adults.

METHODS

Participants included 1,941 young adults from the 2019 cohort of the Washington Young Adult Health Survey. Weighted logistic regressions assessed the associations between peer injunctive norms and impaired driving-related behaviors.

RESULTS

A weighted total of 11.5% reported DUI-A, 12.4% DUI-C, 10.9% RWI-A, and 20.9% RWI-C at least once in the past 30 days. Overlap between the outcomes was observed, indicating some young adults had engaged in multiple impaired driving-related behaviors. After controlling for substance use frequency, weighted logistic regressions indicated more positive perceived injunctive norms were associated with nearly 2 ½ times higher odds of DUI-A, 8 times higher odds of DUI-C, 4 times higher odds of RWI-A and six and a half times higher odds of RWI-C.

DISCUSSION

Results increase the understanding of how injunctive norms-a potentially malleable psychosocial factor-are associated with four impaired driving-related outcomes. Prevention programs that focus on assessing and addressing the norms of these outcomes individually and collectively, such as normative feedback interventions and media campaigns, may be helpful in reducing these behaviors.

Study design to evaluate a web-intervention to prevent alcohol and cannabis-impaired driving and use among adolescents in driver education

BACKGROUND

Alcohol and cannabis are the most commonly used substances among adolescents in the U.S. The consequences related to using both substances together are significantly higher relative to use of either substance alone. Teens' propensity to engage in risky driving behaviors (e.g., speeding, rapid lane changes, and texting) and their relative inexperience with the timing and duration of cannabis' effects puts them at heightened risk for experiencing harms related to driving under the influence. Use of alcohol and cannabis peak at age 16, the legal age teens may apply for a provisional driver's license in some states. Targeting novice teen drivers prior to licensure is thus an ideal time for prevention efforts focused on reducing alcohol and/or cannabis initiation, use, and impaired driving.

METHODS

The current study proposes to evaluate the efficacy of webCHAT among 15.5 to 17-year-old adolescents (n = 150) recruited at driver education programs. WebCHAT is a single session online intervention that aims to prevent alcohol and cannabis use and risky driving behaviors. We will recruit adolescents enrolled in driver education programs, and stratify based on whether they used cannabis and/or alcohol in the past 3 months (60% screening negative and 40% screening positive). All participants will receive usual driver education and half will also receive webCHAT. We will test whether webCHAT in addition to usual driver education reduces alcohol and/or cannabis initiation or use and reduces risky driving attitudes and behaviors (intent to drive after drinking/using, riding as a passenger with someone who drank/used) compared to teens in usual driver education over a 6-month period. We will also explore whether variables such as beliefs and perceived norms serve as explanatory mechanisms for our outcomes.

DISCUSSION

The study has the potential to promote public welfare by decreasing adolescent initiation and use of cannabis and alcohol and reducing risky driving behaviors that can have substantial monetary, personal, and social costs. The study recruits adolescents who are at risk for substance use as well as those who are not and it is delivered remotely during a teachable moment when adolescents receive driver education. Trial registration This study was registered with ClinicalTrials.gov on July 13, 2021 (NCT04959461). https://clinicaltrials.gov/ct2/show/NCT04959461.

Fatores de Risco e proteção para Acidentes de Transporte Terrestre nos Adolescentes Brasileiros, PeNSE 2015/2019

Objetivo: descrever a prevalência de fatores de risco e proteção para acidentes de transporte terrestre (ATT) entre adolescentes brasileiros. Métodos: foram analisados dados da Pesquisa Nacional de Saúde do Escolar, de 2015 e 2019, referentes aos indicadores de risco e/ou proteção no trânsito. Foram estimadas as prevalências e respectivos intervalos de confiança de 95% (IC95%), segundo sexo, faixa etária e tipo de escola. Resultados: dos escolares de 13 a 17 anos entrevistados, 33,3% (IC95%:32,1;33,7) referiram ter dirigido veículo motorizado ou ter sido transportado em veículo conduzido por alguém que tinha consumido bebida alcoólica, 38,1% (IC95%:37,4;38,7) afirmaram ter sido transportados por quem utilizava o celular enquanto dirigia, 17,5% (IC95%:16,8;18,2) referiram não usar cinto de segurança no banco da frente e 30,2% (IC95%:29,4;30,9) no banco de trás, e 27,1% (IC95%:26,5;27,7) dos estudantes relataram ter sido transportado por condutor alcoolizado. Entre 2015 e 2019, o uso do cinto de segurança no banco de trás, reduziu de 33,7% para 30,2%, e de capacete ao andar de moto, aumentou de 84,6% para 88,9%. Conclusão: a prevalência de escolares que dirigiam ou andavam com pessoas sob efeito do álcool ou que usavam o celular enquanto dirigiam foi elevada. Além disso, o uso de cinto de segurança no banco de trás foi baixo. Entre 2015 e 2019, reduziu o uso de cinto de segurança no banco de trás e aumentou o uso de capacete. É necessário d ampliar as estratégias de educação no trânsito para os adolescentes, seus familiares e responsáveis.

A randomized pilot trial of a mobile phone-based brief intervention with personalized feedback and interactive text messaging to reduce driving after cannabis use and riding with a cannabis impaired driver

INTRODUCTION

Driving after cannabis use (DACU) and riding with a cannabis-impaired driver (RWCD) are national public health concerns. Though driving impairments and increased crash risk make DACU and RWCD two of the riskiest cannabis-related behaviors, many continue to drive after use and ride with others who are under the influence and do not view DACU or RWCD as dangerous. The current study examined the efficacy of an accessible, low-cost, mobile phone-based brief intervention aimed at reducing DACU and RWCD among college cannabis users in the context of a randomized three-group pilot trial.

METHOD

Participants were 97 college cannabis users (67.4 % women; average age = 21.34; 80.4 % Caucasian) who endorsed DACU at least three times in the past three months. After completing baseline measures, the study randomly assigned participants to one of three conditions: a) a substance impaired-driving personalized feedback plus MI-style interactive text messaging intervention (PF + MIT); b) a substance impaired-driving personalized feedback only intervention (PF); and c) a substance information control condition (IC). All conditions completed outcome measures three months postintervention.

RESULTS

Generalized linear mixed models (GLMM) analyses indicated that after controlling for sex, cannabis users in the PF + MIT condition significantly reduced DACU and RWCD over time compared to those in the IC condition.

CONCLUSIONS

These findings provide preliminary support for the short-term efficacy of a mobile phone-based intervention in decreasing DACU and RWCD among college cannabis users. Future research should determine whether these reductions in driving behaviors persist past three months.

Daily level predictors of impaired driving behaviors in young adults: Protocol design for utilizing daily assessments

Background

Motor vehicle crashes remain a leading cause of death among young adults (ages 18–25) in the United States. Many drivers implicated in these crashes are under the influence of alcohol, cannabis, or the simultaneous use of alcohol and cannabis. Extremely limited research has assessed impaired driving behaviors and their predictors at the daily level. Perceived norms and motives to use substances have empirical support suggesting they may impact impaired driving-related behavior. Novel approaches to assess these associations at the daily level are needed and may inform future intervention and prevention programs.

Objective

The goal of the current study is to utilize electronic daily assessments to assess driving under the influence of alcohol, cannabis, or simultaneous use and riding with a driver impaired by these substances to assess variability and predictors of these impaired driving-related behaviors at the daily level. This present manuscript details a protocol, measures, and a plan of analyses to assess how within-person differences in perceived norms and motives to use are associated with the likelihood of engaging in impaired driving-related behaviors.

Methods

Participants include young adults in Washington State who report simultaneous use in the past month and either driving under the influence of alcohol, cannabis, or simultaneous use, or riding with a driver under the influence of both substances in the past 6 months. Individuals who verify their identity and meet eligibility requirements will complete a baseline assessment after which they will be scheduled for training on the daily assessment procedure via Zoom. Next, they will be invited to complete daily surveys on Thursday, Friday, Saturday, and Sunday every other week for 6 months and a 6-month follow up assessment. Analyses will utilize multilevel models with days nested within individuals.

Results

The study is currently recruiting participants. A total of 192 participants have been recruited and 100 have completed the study protocol. Data collection is expected to be completed in Fall 2022.

Conclusions

This study utilizes a novel design to assess impaired driving and predictors at the daily level among young adults at high risk of impaired driving-related behaviors. Findings will provide unique data that will shape the knowledge base in the field of social science and public health substance use research and that may be helpful for future prevention and intervention efforts on impaired driving.

Trajectories and Outcomes of Adolescents that Ride With an Impaired Driver/Drive While Impaired

INTRODUCTION

For young drivers, independent transportation has been noted to offer them opportunities that can be beneficial as they enter early adulthood. However, those that choose to engage in riding with an impaired driver (RWI) and drive while impaired (DWI) over time can face negative consequences reducing such opportunities. This study examined the prospective association of identified longitudinal trajectory classes among adolescents that RWI and DWI with their later health, education, and employment in emerging adulthood.

METHODS

We analyzed all seven annual assessments (Waves, W1-W7) of the NEXT Generation Health Study, a nationally representative longitudinal study starting with 10^th grade (2009-2010 school year). Using all seven waves, trajectory classes were identified by latent class analysis with RWI (last 12 months) and DWI (last 30 days) dichotomized as ≥once = 1 vs. none = 0.

RESULTS

Four RWI trajectories and four DWI trajectories were identified: abstainer, escalator, decliner, and persister. For RWI and DWI trajectories respectively, 45.0% (N=647) and 76.2% (N=1,657) were abstainers, 15.6% (N=226) and 14.2% (N=337) were escalators, 25.0% (N=352) and 5.4% (N=99) were decliners, and 14.4% (N=197) and 3.8% (N=83) persisters. RWI trajectories were associated with W7 health status (χ²=13,20, p<.01) and education attainment (χ²=18.37, p<.01). Adolescent RWI abstainers reported better later health status than RWI escalators, decliners, and persisters; and decliners reported less favorable later education attainment than abstainers, escalators, and persisters. DWI trajectories showed no association with health status, education attainment, or employment.

CONCLUSIONS

Our findings suggest the importance of later health outcomes of adolescent RWI. The mixed findings point to the need for more detailed understanding of contextual and time-dependent trajectory outcomes among adolescents engaging in RWI and DWI.

Alcohol-related deaths among young passengers: An analysis of national alcohol-related fatal crashes

INTRODUCTION

There is consensus that riding with an impaired driver (RWI) constitutes a major threat to public health. The aim of this study was to characterize the factors contributing to the motor-vehicle deaths of 15-20 year-old (y/o) passengers that RWI with a peer.

METHOD

Secondary analyses of the 2010-2018 Fatality Analysis Reporting System. 5,673 passengers aged 15-20 y/o killed while riding in passenger cars with a driver aged 21 or older, 3,542 of these drivers also aged 15-20 y/o. Analyses were conducted between October 2019 and December 2020.

RESULTS

Sixty-three percent of the young passengers were killed while riding with a driver 15-20 y/o. Of these drivers, 26.8% had a blood alcohol concentration (BAC) >0.00 g/dL and 77.1% had a BAC ≥0.08 g/dL. Compared with those occurring during the day on weekdays, fatalities of young passengers who RWI with a peer driver with a BAC ≥ 0.08 g/dL often occurred on weekend nights (OR = 8.2) and weekday nights (OR = 5.2), and when the passenger and driver were both male (OR = 1.8). Race/ethnicity was not a significant contributor to RWI fatalities.

CONCLUSIONS

Most 15-20 y/o RWI fatalities occurred on weekends, at night, when the driver was a young peer with a high BAC, and the passenger and driver were male. The high prevalence of fatalities in these high-risk situations suggests that young driver-passenger dynamics may contribute to alcohol-related fatalities. Practical Applications: To curb RWI fatalities among underage passengers, countermeasures should focus not only on underage drinking drivers and riders, but also on drinking drivers of all ages. Prevention should increase focus on situations in which both the young passenger and young driver are males.

Riding with an impaired driver and driving while impaired among adolescents: Longitudinal trajectories and their characteristics

PURPOSE

The purpose of this study was to identify and characterize trajectory classes of adolescents who ride with an impaired driver (RWI) and drive while impaired (DWI).

METHODS

We analyzed all 7 annual assessments (Waves W1-W7) of the NEXT Generation Health Study, a nationally representative longitudinal study starting with 10th grade (2009-2010 school year). Using all 7 waves, latent class analysis was used to identify trajectory classes with dichotomized RWI (last 12 months) and DWI (last 30 days; once or more = 1 vs. none = 0). Covariates were race/ethnicity, sex, parent education, urbanicity, and family affluence.

RESULTS

Four RWI trajectories and 4 DWI trajectories were identified: abstainer, escalator, decliner, and persister. For RWI and DWI trajectories respectively, 45.0% (n = 647) and 76.2% (n = 1,657) were abstainers, 15.6% (n = 226) and 14.2% (n = 337) were escalators, 25.0% (n = 352) and 5.4% (n = 99) were decliners, and 14.4% (n = 197) and 3.8% (n = 83) persisters. Race/ethnicity (χ² = 23.93, P = .004) was significantly associated with the RWI trajectory classes. Race/ethnicity (χ² = 20.55, P = .02), sex (χ² = 13.89, P = .003), parent highest education (χ² = 12.49, P = .05), urbanicity (χ² = 9.66, P = .02), and family affluence (χ² = 12.88, P = .05) were significantly associated with DWI trajectory classes.

CONCLUSIONS

Among adolescents transitioning into emerging adulthood, race/ethnicity is a common factor associated with RWI and DWI longitudinal trajectories. Our results suggest that adolescent RWI and DWI are complex behaviors warranting further detailed investigation of the respective trajectory classes. Our study findings can inform the tailoring of prevention and intervention efforts aimed at preventing illness/injury and preserving future opportunities for adolescents to thrive in emerging adulthood.

Association between a delay in driving licensure and driving while impaired and riding with an impaired driver among emerging adults

BACKGROUND

Teens who delay driving licensure may not be subject to graduated driver licensing restrictions that are known to reduce crash risk. We explored the association of delay in licensure with driving while impaired (DWI) and riding with an impaired driver (RWI) among emerging adults.

METHODS

Data from the NEXT Generation Health Study, starting with 10th grade (2009-2010), were analyzed. The outcome variables were Wave 7 (W7) self-reported DWI and RWI as dichotomous variables. The independent variable was delay in licensure. Covariates included sex, urbanicity, race/ethnicity, family structure, parent education, family affluence, teen's highest education, minimum legal drinking age laws, and onset age of alcohol use. Descriptive analysis and logistic regressions were conducted.

RESULTS

Of 2525 participants eligible for licensure, 887 reported a delay in licensure by 1-2 years (38.9%, weighted) and 1078 by > 2 years (30.3% weighted) across 7 waves. In W7, 23.5% (weighted and hereafter, 5.6% once, 17.8% ≥twice) of participants reported DWI and 32.42% (5.6% once, 25.4% ≥twice) reported RWI. Logistic regressions showed no overall significant association of delay in licensure with either W7 RWI or W7 DWI. However, in stratified analyses, among African American youth, delay in licensure was positively associated with DWI (OR = 2.41, p = 0.03) and RWI (OR = 2.72, p = 0.05). Among those with ≤ high school or lower education by W7, delayed licensure was positively associated with RWI (OR = 2.51, p < 0.01).

CONCLUSIONS

While in the overall sample, delayed licensure did not appear to be associated with DWI or RWI, our findings suggest that delayed licensure may be of concern to teen risk of DWI and RWI among African Americans and among those with lower educational attainment. Furthermore, as two-thirds of youth delayed licensure, more research is needed to determine whether this is more of a positive (i.e., protective) factor by reducing their exposure to crash risk or a negative (i.e., risk) factor due to their missing important driver safety stages of graduated driver licensing.

Binge Drinking and Drunk Driving Among Current Drinkers in Thailand: Analysis of Cigarette Smoking and Alcohol Drinking Behavior Surveys From 2007 to 2017

This study aimed to evaluate the association between binge drinking and drunk driving among the Thai population. Data in 2007, 2011, and 2017 of the Thai National surveys on Tobacco and Alcohol Consumption were analyzed. The household surveys collected information from the population, aged >15 years, using a face-to-face interview. There were 89 002 current drinkers from the 3 waves of surveys. About 40% reported drunk driving in the past 12 months. Binge drinking accounted for 17.3%, 17.8%, and 42.8% of the current drinkers in 2007, 2011, and 2017, respectively. The prevalence of drunk driving also increased from 36.6% to 57.7% over the 10-year period. Both occasional binge drinkers and regular binge drinkers showed about twice the risk of drunk driving (range of odds ratios [ORs] from 1.81; 95% confidence interval [95% CI] = 1.71-1.92 to OR 2.96; 95% CI = 2.64-3.31), compared with non-binge drinkers, and these OR increased by drinking frequency.

Transportation Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2019

Motor-vehicle crashes are a leading cause of death and nonfatal injury among U.S. adolescents, resulting in approximately 2,500 deaths and 300,000 nonfatal injuries each year. Risk for motor-vehicle crashes and resulting injuries and deaths varies, depending on such behaviors as seat belt use or impaired or distracted driving. Improved understanding of adolescents’ transportation risk behaviors can guide prevention efforts. Therefore, data from the 2019 Youth Risk Behavior Survey were analyzed to determine prevalence of transportation risk behaviors, including not always wearing a seat belt, riding with a driver who had been drinking alcohol (riding with a drinking driver), driving after drinking alcohol, and texting or e-mailing while driving. Differences by student characteristics (age, sex, race/ethnicity, academic grades in school, and sexual identity) were calculated. Multivariable analyses controlling for student characteristics examined associations between risk behaviors. Approximately 43.1% of U.S. high school students did not always wear a seat belt and 16.7% rode with a drinking driver during the 30 days before the survey. Approximately 59.9% of students had driven a car during the 30 days before the survey. Among students who drove, 5.4% had driven after drinking alcohol and 39.0% had texted or e-mailed while driving. Prevalence of not always wearing a seat belt was higher among students who were younger, black, or had lower grades. Riding with a drinking driver was higher among Hispanic students or students with lower grades. Driving after drinking alcohol was higher among students who were older, male, Hispanic, or had lower grades. Texting while driving was higher among older students or white students. Few differences existed by sexual identity. Multivariable analyses revealed that students engaging in one transportation risk behavior were more likely to engage in other transportation risk behaviors. Traffic safety and public health professionals can use these findings to reduce transportation risk behaviors by selecting, implementing, and contextualizing the most appropriate and effective strategies for specific populations and for the environment.

Longitudinal Associations of 12th-Grade Binge Drinking With Risky Driving and High-Risk Drinking

OBJECTIVE

To study the longitudinal associations of 12th-grade binge drinking with driving while impaired (DWI), riding with an impaired driver (RWI), blackouts, extreme binge drinking, and risky driving (self-reported Checkpoints Risky Driving Scale) among emerging adults up to 4 years after leaving high school.

METHODS

The data were all 7 waves (W 1 to W 7 of the NEXT Generation Health Study; a US nationally representative study (N = 2785) with a probability cohort of 10th-graders (mean age = 16.2 years; SE = 0.03) starting in the 2009-2010 year. Binary and ordinal logistic regressions were used for the analysis.

RESULTS

Binge drinking prevalence in W1 to W3 was 27.2%, 23.8%, and 26.8%, respectively. Twelfth-grade binge drinking was associated with a higher likelihood of DWI, RWI, blackouts, and risky driving in W4 to W7 and extreme binge drinking in W7. Adolescents who binged ≥3 times in high school were more likely to DWI, RWI, blackout (W4 to W7), be involved in extreme binge drinking (W7), and report riskier driving several years after high school. In some waves, parental practices appeared to have enduring effects in protecting against DWI, RWI, and blackouts.

CONCLUSIONS

Twelfth-grade binge drinking is a robust predictor of early adulthood DWI, RWI, blackout, extreme binge drinking, and risky driving. Our study suggests that ongoing parental practices could be protective against DWI, RWI, and blackouts once adolescents transition from high school into early adulthood. Prevention programs that incorporate binge drinking-focused screening and bolster parental practices may reduce the likelihood of later major alcohol-related health-risk behaviors and consequences in emerging adults.

Emerging Adults Riding With Marijuana-, Alcohol-, or Illicit Drug-Impaired Peer and Older Drivers

OBJECTIVE

The purpose of this study was to examine the prevalence and covariates among emerging adults of riding with an impaired peer or older adult driver (RWI) because of marijuana (MJ), alcohol (ALC), or illicit drugs (ID).

METHOD

Data were from Waves 4 (W4, N = 2,085) and 5 (W5, N = 2,116) of the NEXT Generation Health Study, collected in 2013-2014, 1 and 2 years after high school. W5 RWI was specified for substance-specific impaired peer and older adult (peer/older adult) drivers. Multinomial logistic regressions estimated W5 association of substance-specific RWI with W4 RWI, and W5 heavy episodic drinking, MJ use, and school/residence/work status.

RESULTS

At W5, 33% of the participants reported RWI in the past year, including riding with ALC- (21%), MJ- (17%), and ID- (5%) impaired peer drivers and ALC- (2%), MJ- (4%), and ID- (0.7%) impaired older adult drivers. W4 RWI was associated with W5 RWI with impaired peer/older adult drivers for ALC- (adjusted odds ratio [AOR] = 4.28, 2.69) and MJ-RWI (AOR = 2.34, 3.56). W5 heavy episodic drinking was positively associated with W5 peer ALC-related RWI (AOR = 2.16) and peer/older adult MJ-related RWI (AOR = 2.38, 5.45). W5 MJ use was positively associated with W5 peer ALC-related RWI (AOR = 2.23), peer/older adult MJ-related (AOR = 10.89, 2.98), and peer/older adult ID-related (AOR = 9.34, 4.26) RWI. ID-related RWI was higher among those not attending 4-year college (AOR = 3.38), attending technology school (AOR = 16.23), living on their own (AOR = 6.85), or living on campus (AOR = 11.50).

CONCLUSIONS

The high prevalence of RWI among emerging adults occurred mostly with ALC- or MJ-impaired peer drivers. The findings support the need for precisely tailored programs to prevent impaired driving according to substance use and age.

Putting Adolescents at Risk: Riding With Drinking Drivers Who Are Adults in the Home

OBJECTIVE

Alcohol-related car crashes are a leading cause of adolescent death, and one in five U.S. adolescents reports recent riding in a car with a drinking driver. How often the driver is an adult in the home (e.g., parent) is unknown. Pediatric visits offer an opportunity to counsel families to reduce this risk. Our study aim was to determine the prevalence of recent riding with a drinking driver (RWDD) who was an adult in the home among adolescent primary care patients and to identify the demographic and environmental (substance use among family members) profiles of those at increased risk.

METHOD

We recruited 12- to 18-year-olds arriving for routine medical care between 11/2005 and 10/2008 from nine practices in New England. Computer self-administered questionnaires assessed demographics, past-3-month RWDD, driver characteristics, and parent/sibling substance use. We computed adjusted relative risk ratios using multiple logistic regression modeling.

RESULTS

Among 2,096 adolescents (86% participation rate; mean age = 15.8 years, SD = 2.0; 58% girls; 65% White non-Hispanic), 8.2% reported past-3-month RWDD who was an adult in the home (36.6% of those reporting any past-3-month RWDD). Risk was higher for girls, younger adolescents (<17 year olds), White non-Hispanic and Hispanic versus Black youth, those with non-college-graduate parents, and those with substance-involved parents.

CONCLUSIONS

For a substantial proportion of adolescent primary care patients RWDD, the driver is a parent or other household adult, suggesting an important target for screening and counseling.

Marijuana and other substance use among male and female underage drinkers who drive after drinking and ride with those who drive after drinking

The study sought to describe the occurrence of adolescent driving after drinking (DD) and riding with a driver who had been drinking (RWDD) and associations with substance use for both males and females. As part of screening for a randomized controlled trial, we surveyed 16-20year olds (N=3418) recruited from an emergency department (ED) and analyzed data from those reporting past-year alcohol consumption (n=2150, 58% females). DD was reported by 22% of females and 28% of males and RWDD was reported by 39% of females and 38% of males, also in the past year. In regression models, risky alcohol use and past-year marijuana use were associated with increased odds of DD and RWDD for females and males. Marijuana use was a strong predictor, with odds increased by 2.3 and 1.7 times for DD among females and males respectively and 1.4 times for RWDD for females and males. Prescription drug misuse was also associated with RWDD for females and for both males' and females' reported DD. The findings highlight the alarming rate of DD and RWDD among both males and females and suggest ED-based injury prevention efforts consider such risky road behavior as well as consider their substance use. Future research might also further examine the effects of driving under influence of substances, particularly marijuana, and the negative synergistic effects of co-ingestion prior to driving.

Passengers at risk: a multi-level analysis of the decision to travel with a drunk driver

AIMS

To assess the impact of demographic, intrapersonal and environmental factors on the likelihood in Chile of becoming a passenger of an alcohol-impaired driver (PAID).

DESIGN

Multi-level cross-sectional study.

SETTING

Data were acquired from two large-scale household surveys of representative samples of Chile's Metropolitan Region.

PARTICIPANTS

The study included 1341 individuals ≥ 16 years; 696 of them reported engaging in PAID.

MEASUREMENT

The primary outcome was self-reported frequencies of having accepted a ride with an alcohol-impaired driver.

FINDINGS

PAID was associated significantly with 'age' [odds ratio (OR) = 0.99, 95% confidence interval (CI) = 0.98-0.99, P = 0.03], 'traffic safety beliefs' (OR = 0.17, 95% CI = 0.078-0.44, P = 0.00), 'time exposure as passenger' (OR = 1.00, 95% CI = 1.00-1.01, P = 0.00) and 'sex' (OR = 0.67, 95% CI = 0.53-0.87, P = 0.00). In women, PAID was associated with 'age' (OR = 0.98, 95% CI = 0.97-0.99, P = 0.02), 'traffic safety beliefs' (OR = 0.17, 95% CI = 0.05-0.59, P = 0.00) and 'low quality of public bus stops' (OR = 0.97, 95% CI = 0.98-0.99, P = 0.01). Younger women with high education levels were more likely to engage in PAID than younger women with low education levels. In men, PAID was associated with 'traffic safety beliefs' (OR = 0.13, 95% CI = 0.02-0.63, P = 0.01) and 'time exposure as passenger' (OR = 1.00, 95% CI = 1.00-1.01, P = 0.02).

CONCLUSIONS

In Chile, men are at higher risk of becoming a passenger of an alcohol-impaired driver (PAID) than women. In women, PAID appears to be associated with lower traffic safety beliefs, lower quality of public bus stations and an interaction between education and age. In men, PAID is associated with lower traffic safety beliefs and higher time exposure as passenger.

The characteristics of young Indigenous drink drivers in Queensland, Australia

OBJECTIVE

This study investigates the prevalence and characteristics of first drink driving convictions among young Aboriginal and Torres Strait Islander (Indigenous) Australians (aged from 14 to 24) and considers some of the risk factors associated with recidivism.

METHODS

Convictions recorded between 2006 and 2013 were extracted from the Queensland Department of Justice and Attorney General database. Convictions were regrouped by gender, age, Accessibility/Remoteness Index of Australia classification, and sentence severity. Chi-square analyses and logistic regression were conducted to identify group differences in offense characteristics for gender and recidivism (recidivists versus nonrecidivists).

RESULTS

The sample consisted of 1,583 individuals (74.1% males) convicted in the 8-year period. Gender comparisons showed that there was no significant difference in age at time of first offense, blood alcohol concentration (BAC) level at apprehension, or type of penalty received between males and females. However, males received larger fines and longer periods of license disqualification. Comparisons for reoffending and non-reoffending revealed that males, drivers aged 14-17 years of age and 18 to 20 years of age, and inner regional drivers were more likely to reoffend.

CONCLUSIONS

There were limited differences between females and males or recidivists and nonrecidivists at first conviction. Convictions for drink driving may provide an opportunity for early alcohol intervention with Indigenous young drivers (<20 years) because it is likely to be an individual's first alcohol-related conviction.

Riding with Impaired Drivers Among Recent Latino Immigrants in Southern Florida

In a previous effort we showed that compared with immigrants who are permanent residents, undocumented immigrants are more likely to binge drink, but less likely to drink while impaired (DWI) partly due to their limited amount of driving. This report examines a related risk: riding with an impaired driver (RWI). Data came from an ongoing longitudinal sample of Latino immigrants to Miami-Dade County, FL. Descriptive analyses and regression techniques were applied. While DWI rates among Latino immigrants is heavily limited by their access to a car, RWI rates were not restricted by driving limitations, nor related to participants' legal immigration status (LIS). RWI rates were linked only to heavy drinking. Because it is not affected by driving limitations, RWI for these Latino immigrants is perhaps a more immediate risk than DWI. Addressing RWI among Latino immigrants should be a priority for traffic safety to Miami/Dade country.

Off-Road Vehicle Crash Risk during the Six Months after a Birthday

Background

Off-road vehicles are popular and thrilling for youth outside urban settings, yet sometimes result in a serious crash that requires emergency medical care. The relation between birthdays and the subsequent risk of an off-road vehicle crash is unknown.

Methods

We conducted a population-based before-and-after longitudinal analysis of youth who received emergency medical care in Ontario, Canada, due to an off-road vehicle crash between April 1, 2002, and March 31, 2014. We identified youth injured in an off-road vehicle crash through population-based health-care databases of individuals treated for medical emergencies. We included youth aged 19 years or younger, distinguishing juniors (age ≤ 15 years) from juveniles (age ≥ 16 years).

Results

A total 32,777 youths accounted for 35,202 emergencies due to off-road vehicle crashes within six months of their nearest birthday. Comparing the six months following a birthday to the six months prior to a birthday, crashes increased by about 2.7 events per 1000 juniors (18.3 vs 21.0, p < 0.0001). The difference equaled a 15% increase in relative risk (95% confidence interval 12 to 18). The increase extended for months following a birthday, was not observed for traffic crashes due to on-road vehicles, and was partially explained by a lack of helmet wearing. As expected, off-road crash risks did not change significantly following a birthday among juveniles (19.2 vs 19.8, p = 0.61).

Conclusions

Off-road vehicle crashes leading to emergency medical care increase following a birthday in youth below age 16 years. An awareness of this association might inform public health messages, gift-giving practices, age-related parental permissions, and prevention by primary care physicians.

Transitions in Riding With an Alcohol/Drug-Impaired Driver From Adolescence to Emerging Adulthood in the United States

OBJECTIVE

The purpose of this study was to examine changes and predictors of changes in riding with an alcohol/drug-impaired driver (RWI) from 10th grade through the first post-high school year.

METHOD

Transition models were used to estimate the association of four waves (W1-W4) of RWI with W4 environmental-status variables and time-varying covariates in the NEXT Generation Health Study, a nationally representative cohort of U.S. 10th graders (N = 2,785).

RESULTS

Overall, 33% (weighted) of adolescents reported RWI in the past 12 months in W1, and slightly declined in W2 (24%), W3 (27%), and W4 (26%). Across time, transition models with generalized estimating equations showed that RWI was more likely among those who previously reported RWI (ORs from 3.62 to 3.66, p < .001), substance use (ORs from 1.81 to 1.82, p < .001), and heavy episodic drinking (ORs from 1.85 to 1.86, p < .001). Those living on college campuses were somewhat more likely to engage in RWI (OR = 1.38, .05 < p <.10) than those living at home. The effects of parental monitoring knowledge and peer alcohol/substance use on RWI were suppressed when individual substance use and heavy episodic drinking were taken into consideration.

CONCLUSIONS

Substance use and heavy episodic drinking in previous waves and the history of RWI were persistent factors of RWI in a dynamic pattern. The setting in which emerging adults live during their first post-high school year could affect their engagement in RWI. The findings suggest that harm-reduction strategies should focus on the identification of early RWI coupled with reduction of substance use and heavy episodic drinking.

The Predictive Influence of Youth Assets on Drinking and Driving Behaviors in Adolescence and Young Adulthood

Drinking and driving among adolescents and young adults remains a significant public health burden. Etiological research is needed to inform the development and selection of preventive interventions that might reduce alcohol-involved crashes and their tragic consequences. Youth assets-that is, skills, competencies, relationships, and opportunities-can help youth overcome challenges, successfully transition into adulthood, and reduce problem behavior. We examined the predictive influence of individual, relationship, and community assets on drinking and driving (DD) and riding with a drinking driver (RDD). We assessed prospective relationships through analysis of data from the Youth Assets Study, a community-based longitudinal study of socio-demographically diverse youth. Results from calculation of marginal models using a Generalized Estimating Equation approach revealed that parent and peer relationship and school connectedness assets reduced the likelihood of both drinking and driving and riding with a drinking driver approximately 1 year later. The most important and consistent asset that influenced DD and RDD over time was parental monitoring, highlighting the role of parental influence extending beyond the immediate teen driving context into young adulthood. Parenting-focused interventions could influence factors that place youth at risk for injury from DD to RDD, complementing other evidence-based strategies such as school-based instructional programs and zero tolerance Blood Alcohol Concentration laws for young and inexperienced drivers.