This report is a highway safety impact evaluation of four underage drinking prevention programs. The National Highway Traffic Safety Administration (NHTSA), through the National Association of Governor’s Highway Safety Representatives ( now called the Governors Highway Safety Association [GHSA]), and with the cooperation of several Governor’s Highway Safety Programs (GHSPs), funded five underage drinking prevention programs around the country2 with the ultimate objective of reducing youth alcohol-related crashes. This effort was implemented as a pilot test of whether the perceived success of the Washing-ton Regional Alcohol Program (WRAP) youth activities could be replicated in other jurisdictions and to provide objective evidence of their effectiveness. WRAP was initiated in 1982 and involved a partnership of public-sector and private-sector organizations. This study also aimed to describe the implementation process and to note any problems or issues that arose during that process.
An important aspect of the project was for GHSA to provide technical assistance to each of the sites, particularly in their needs assessment and strategic planning process prior to implementation of actual programs. This technical assistance was provided by persons who were involved in that process for WRAP. Each of the pilot programs was initially funded by grants from its state Governor’s Highway Safety Programs. The five programs were located in Chesterfield County, Virginia; Detroit, Michigan; Omaha, Nebraska; Travis County, Texas; and Salt Lake County, Utah.
In July 1984, Congress enacted P. L. 98-363, Section 6 of which set a national minimum drinking age (MLDA) of 21. States that failed to adopt 21 as the mini-mum drinking age as provided by law were subject to having a certain portion of their federal highway construction funds withheld from apportionment. By 1988, all of the states had adopted a minimum drinking age of 21. In 1987, the United States General Accounting Office (GAO) reviewed and synthesized some 50 pertinent studies (U.S. General Accounting Office, 1987). It found that raising the MLDA generally reduces alcohol-related crashes for the affected age groups. The amount of reduction attributed to the MLDA legislation varied. For example, in four “sound” studies using data from several states, the reduction ranged from 5% to 28%. The GAO study also found that the available evidence supported the claim that the higher MLDA also reduces alcohol consumption and driving after drinking. NHTSA estimates that, cumulatively through 2000, over 20,000 lives have been saved by minimum drinking age laws (U.S. Department of Transportation NHTSA, 2001).
The concept of zero tolerance laws for youth is based on the following proposition: since it is illegal for persons under 21 to drink (or depending on the state, purchase or possess) beverage alcohol, it should also be illegal for them to drive with any alcohol in their system. Unfortunately, until fairly recently, many states’ drinking driving laws failed to acknowledge this, and the “legal limit” remained at .08 or .10 for drivers of all ages. Now, chiefly due to Section 320 of P. L. 104-59 (signed November 28, 1995), federal legislation establishing a national zero tolerance standard of a blood alcohol concentration of .02 or greater for an individual under the age of 21 and withholding penalties similar to the 1984 law encouraging MLDA laws, all states and the District of Columbia have zero tolerance laws.
At least four prior studies examined the highway safety impact of zero tolerance laws, and one of these also considered issues related to publicizing the law. Blomberg (1992) evaluated a Maryland law that prohibited driving by persons under age 21 with a BAC of .02 or more. The evaluation employed an interrupted time series analysis of had been drinking (HBD) crashes as judged by the investigating officers. It also developed a public information and education (PI&E) campaign and implemented the campaign in six Maryland counties about a year after the law went into effect. The evaluation considered the impact of two interventions, the law itself and the PI&E program publicizing the law and its sanctions. The study found a statewide reduction in HBD crashes involving drivers under age 21 of about 11% associated with the adoption of the law, but found no statewide effect associated with the PI&E campaign. However, a separate analysis of the interventions in just the six counties conducting the PI&E campaign found positive effects for both interventions, 21% for the introduction of the law and a further 30% for the PI&E. These findings were strengthened by survey results regarding the awareness of the law by the target group of drivers.
Hingson, Heeren, and Winter (1994) performed a before-and-after study of 12 states in which such laws became effective during the 1983-1991 period. In their study, the percentage change in nighttime single-vehicle fatal crashes involving the target group in each state was compared with that in another nearby state3. The effects of enforcement level and PI&E were not considered in the evaluation. The authors found that eight of the twelve law states experienced a positive effect and concluded that “if all states adopted .00 or .02 percent limits for drivers ages 15-20, at least 375 fatal single vehicle crashes at night would be prevented each year.”
A third evaluation was a multi-state impact analysis of zero tolerance laws (Voas, Tippetts, and Fell, 1999). The study involved a regression analysis of data from NHTSA’s Fatality Analysis Reporting System (FARS) for the years 1982 - 1997. The measure of effectiveness used in the analysis was the ratio of alcohol-involved target-age drivers in fatal crashes to non-alcohol involved target-age drivers in fatal crashes. Again, the effects of enforcement level and PI&E were not considered in the evaluation. The study found that such laws were associated with a 24% reduction in the proportion of underage drinking drivers in fatal crashes.
Most recently, Lacey, Jones, and Wiliszowski (2000) examined the effect of zero tolerance laws in four states and found reductions ranging from none to 40% attributable to the adoption or major changes in zero tolerance laws.
Thus, even though MLDA and zero tolerance laws have been shown to be effective in reducing alcohol-related crashes among youth, such crashes remain a significant problem for those under 21. It has been hypothesized that the broad ranges of effectiveness observed for both MLDA and zero tolerance laws have been partly attributable to lack of comprehensive community-based activities to effectively address underage drinking and limited enforcement of these laws4.
The perceived success of the Washington, DC area program in mobilizing community activity to address this problem led NHTSA and GHSA to initiate this pilot program to test the transferability of its approach to other communities. The basic approach involves developing broad-based community coalitions to address the problem, having the coalitions focus their efforts on specific areas of need by conducting a comprehensive needs assessment, developing a strategic plan based on addressing identified needs, and implementing that plan. The model calls for a project coordinator in the community to staff coalition activities and coordinate implementation.
The pilot sites were provided technical assistance and training by GHSA, particularly in the needs assessment and strategic planning phases. This technical assistance was provided by professionals who had been involved in underage drinking prevention coalition activities in the Washington, DC area. As an out-growth of that activity, they developed ten volumes of "How To" Guides on Underage Drinking Prevention (Beer and Leonard, 2001) which provide a detailed description of the process to be undertaken in implementing an underage drinking prevention program in a community.
Through interaction with program participants in each of the four jurisdictions where a program was implemented, a brief description of the elements of each program was developed. Crash data were obtained from the state level custodians of those data for each of the jurisdictions, and interrupted time series were conducted to assess the effect each program may have had on proxy measures of alcohol-related crashes5.
Each of these four case study chapters contains a description of the program implemented in each site and a crash analysis. The project’s conclusions are presented in Chapter 6, and a bibliography of references is provided at the end of the report.
4A community-based program conducted by Wagenaar and associates (1999) in the mid-1990s, is a notable exception. The program, called Communities Mobilizing for Change on Alcohol (CMCA), was a randomized 15-community trial of a community-organizing intervention designed to reduce the accessibility of alcoholic beverages to youths under the legal drinking age. The communities were located in Minnesota and Wisconsin. An evaluation by of the effect of the CMAC program on alcohol-related crashes is described by Wagenaar, Murray, and Toomey (2000). The authors observed net declines in the intervention communities for all traffic crash indicators, but the decline in alcohol-related crash surrogates was not significant, possibly be-cause (as the authors noted) of the small numbers of such crashes involving the target group