Naimi TS, et al. - In this repeated cross-sectional study, the researchers investigated the relationship between the restrictiveness of state alcohol policy environments and the likelihood of alcohol involvement among those dying in motor vehicle crashes in the United States. Results of this study suggested that strengthening alcohol policies, including those that don't particularly target impaired driving, could decrease alcohol-related crash fatalities. In addition, policies might also protect against crash fatalities involving blood alcohol concentration [BAC] levels below the current legal limit for driving in the United States.

Methods

• Using data from the Fatality Analysis Reporting System (1-year lag), state alcohol policies (operationalized by the Alcohol Policy Scale [APS]) from 1999 to 2014 were related to motor vehicle crash fatalities from 2000 to 2015.
• To account for clustering of multiple deaths within a crash and of multiple crashes occurring within states, alternating logistic regression models and generalized estimating equations were used.
• Independent associations of mutually exclusive subgroups of policies, including consumption-oriented policies vs driving-oriented policies were also examined.
• The study setting was the 50 US states.
• Study participants were 505,614 decedents aged at least 21 years from motor vehicle crashes from 2000 to 2015.
• Odds that a crash fatality was alcohol related (fatality stemmed from a crash in which ≥1 driver had BAC ≥0.08%) was the main outcome.

Results

• According to the findings obtained, there were 505,614 adult motor vehicle crash fatalities in the United States, of which 178,795 (35.4%) were alcohol related from 2000 to 2015.
• Findings revealed that each 10–percentage point increase in the APS score (corresponding to more restrictive state policies) was linked with reduced individual-level odds of alcohol involvement in a crash fatality (adjusted odds ratio [aOR], 0.90; 95% CI, 0.89-0.91); results were consistent among most demographic and crash-type strata.
• In addition, more restrictive policies had protective relationships with alcohol involvement among crash fatalities associated with BACs from greater than 0.00% to less than 0.08%.
• Consumption-oriented policies were independently protective for alcohol-related crash fatalities (aOR, 0.97; 95% CI, 0.96-0.98 based on a 10–percentage point increased APS score) after accounting for driving-oriented policies.