Alcohol misuse: tackling the UK epidemic - London

BMA Board of Science
Measures to reduce drink-driving
Considerable reductions in the incidence of drink-drive road incidents and related deaths have
occurred in the UK since 1980. This has most likely resulted from numerous factors including
police enforcement of drink-drive legislation, the use of portable devices to measure samples of
drivers’ breaths, tough penalties for drink-driving (prison terms, fines and mandatory
disqualification), high level anti-drink-drive campaigns, and improvements in automobile design.
As noted previously, however, the number of fatalities and serious injuries resulting from drinkdrive
road crashes remains significantly high.
In the UK, the BAC limit is 80mg/100ml which is among the highest in Europe (see Figure 17).
Research has found that there is a marked deterioration in driving performance between a BAC of
50mg/100ml and 80mg/100ml. The relative crash risk of drivers with a BAC of 50mg/100ml is double
that for a person with a zero BAC, and the risk rises to 10 times for a BAC of 80mg/100ml. 114
Drinking
by drivers with a BAC between 50mg/100ml and 80mg/100ml is a significant but largely hidden cause
of road traffic crashes, and has been estimated to account for 80 road deaths a year in England. 173
Studies in Sweden, Australia and the USA have consistently found lowering legal blood alcohol limits
116, 145, 153, 174-178
to produce reductions in the incidence of drink-driving and related crashes.
Newly qualified drivers are felt to be particularly at risk of alcohol-related road crashes as a result of
their limited driving experience. As noted previously, the highest rates of drink-drive accidents per
100,000 licence holders occur in the 17 to 19 age group, followed by those in the 20 to 24 age
group. 97
Evaluation of the introduction of lower BAC limits as part of new driver licensing systems
have shown them to be effective in reducing collisions among young drivers and novice drivers. 179-182
In the USA and Australia, the introduction of BAC limits between 10 and 20mg/100ml for young
116, 145,
drivers aged under 21 have been found to reduce levels of drink-driving and fatal road crashes.
153, 183-185
In Spain, it is illegal for all newly qualified drivers to drive with a BAC in excess of
15mg/100ml for the two years after they have obtained their driving licence.
Enforcement of drink-drive legislation is essential for compliance. In the UK, this is operated
through selective breath testing and high-profile media campaigns. Selective breath testing
requires police to have judged that a motorist has consumed alcohol before implementing the test.
This deterrence-based policy is insufficient as many offenders may be able to avoid detection.
Random breath testing permits police to stop motorists who are not suspected of committing an
offence or of being involved in an incident. This is an advantageous approach as motorists are
unable to influence the likelihood of being tested. With the exception of Denmark and the UK,
random breath testing is permitted throughout the EU. 186
Research in Australia has found that
highly visible, random testing can have a sustained and significant effect in reducing levels of
145, 153, 176
drink-driving, alcohol-related road traffic crashes and associated injuries and fatalities. One
study found random testing to be twice as effective as selective testing, with a reduction in fatal
crashes of 35 per cent and 15 per cent respectively. 176
Alcohol misuse: tackling the UK epidemic 57