5.5 Designated Drivers
Overall Effectiveness Concerns: The countermeasure effectiveness has been examined in a few research studies. There have been some positive research findings in terms of driver awareness of the countermeasure. However, the balance of evidence regarding the effectiveness of this countermeasure in reducing crashes remains inconclusive.
Designated drivers are people who agree not to drink so they can drive their friends who have been drinking. Formal designated driver programs in drinking establishments provide incentives such as free soft drinks for people who agree to be designated drivers. Usually, though, designated driver arrangements are completely informal. Designated driver programs focus on specific actions taken at drinking establishments, which contrast with designated driver mass media campaigns that seek to raise awareness of this countermeasure and promote its informal use among the general driving population (see Section 5.2).
The designated driver concept has been questioned on two grounds: (1) designated drivers may still drink, though perhaps less than the passengers; and (2) it may encourage passengers to drink to excess. Previous national roadside surveys found self-identified designated drivers were more likely to have positive BACs in comparison to all drivers on the road (Fell et al., 1997; Lacey et al., 2009). Also, some designated drivers had very high BACs, especially those coming from bars. Apparently, some groups of drinkers had selected the designated drivers near the end of a night of drinking. To be effective, Voas and Lacey (2011) argue the designated driver must be chosen before the drinking begins, and must be willing to abstain (or substantially limit) his or her drinking.
Use: The designated driver concept is widely understood and accepted. Surveys show that designated driver use is common. In NHTSA’s general population survey of 7,000 people, some 44% said they had served as designated drivers during the past year, and 33% reported riding with designated drivers (Moulton et al., 2010). In a multi-year survey by the Traffic Injury Research Foundation of a random representative sample of American drivers 21 and older, 98% of respondents agreed that having a designated driver was important (Vanlaar et al., 2017). Using the 2016 survey results of these drivers, 71% stated they had served as designated drivers and 64% reported nearly always using designated drivers. On the other hand, around 19% reported never using designated drivers, and 8% reported they had been passengers with impaired drivers in the past 30 days.
Effectiveness: Because designated drivers are informally determined and somewhat imprecisely defined, it’s no surprise there are little data on the impact of designated drivers on crashes. CDC’s systematic review found insufficient evidence to determine the effectiveness of designated driver programs (Ditter et al., 2005). A review from Australia concluded that designated driver programs can successfully increase awareness and use of designated drivers, but evidence for changes in alcohol-related crashes is inconclusive (Nielson & Watson, 2009). However, the authors note the lack of supporting evidence “does not necessarily mean that such programs should be discouraged. On the contrary, it highlights the need for them to be better implemented and evaluated” (Nielson & Watson, 2009, p.36).
The “Skipper” designated driver program in Queensland, Australia, is a good example of a partially successful program. The program provides free soft drinks to people who agree to stay sober and serve as designated drivers. The program was pilot-tested in 41 venues, and was heavily advertised through radio, earned media, and on-premise promotions. Self-report surveys showed awareness for the program was very high, and the proportion of respondents who reported acting as, or using, designated drivers increased after the program was implemented (Watson & Watson, 2014). However, roadside surveys found no change in the proportion of drivers who had been drinking, and there were no changes in alcohol-related crashes.
Costs: The only cost associated with informal designated driver programs is for publicity. Designated drivers can be promoted independently or can be included with other impaired-driving publicity. Establishments that operate formal designated driver programs have minimal costs for the drinks provided and for publicity.
Time to implement: Designated driver promotion can be implemented in a few weeks and formal programs can be established equally quickly.