Skip to main content
You can also sort pages by filters.
Table of Contents
Download the Full Book

Effectiveness: 5 Star Cost: $$$
Use: Used in many jurisdictions but often only once or twice each year Medium
Used in many jurisdictions but often only once or twice each year
Time: Medium

The most common high-visibility seat belt law enforcement method consists of short (typically lasting 2 weeks), intense, highly publicized periods of increased belt law enforcement, frequently using checkpoints (in States where checkpoints are permitted), saturation patrols, or enforcement zones. This short-duration seat belt enforcement method was developed in Canada in the 1980s (Boase et al., 2004) and demonstrated in several U.S. communities (Williams & Wells, 2004). It was implemented statewide in North Carolina in 1993 using the Click It or Ticket slogan (Reinfurt, 2004), and subsequently adopted in other States under different names and sponsors (Solomon et al., 2004). NHTSA’s Click It or Ticket HVE model is described in detail in Solomon et al. (2003 and 2007).

All HVE programs include communications and outreach strategies that use some combination of earned media (e.g., news stories and social media) and paid advertising. Communications and outreach can be conducted at local, State, regional, or national levels.

Use: Most States currently conduct short-term, high-visibility belt law enforcement programs in May of each year as part of national seat belt mobilizations (Nichols, Chaffee, Solomon, & Tison, 2016). Some States also conduct seat belt mobilizations in November. NHTSA has supported these campaigns. More than 10,000 LEAs took part in the May 2017 campaign (NHTSA, 2018). See Milano et al. (2004) for a detailed account of the history and evolution of the national campaigns and NHTSA (2016) for a timeline of use over time.

Effectiveness: Hedlund et al. (2008) compared 16 States with high seat belt rates and 15 States with low seat belt rates. The single most important difference between the two groups was the level of enforcement (how much enforcement), rather than demographic characteristics or the amount spent on media. High-belt-use States issued twice as many citations per capita during their Click It or Ticket campaigns as low-belt-use States. Level of enforcement is also related to type of seat belt law. Nichols, Chaffe, Solomon, and Tison (2016) found that law enforcement in primary belt use law States issued more seat belt citations in the 2013 campaign than did law enforcement in secondary belt use law States.

The CDC’s systematic review of 15 high-quality studies (Dinh-Zarr et al., 2001; Shults et al., 2004) found that short-term, HVE programs increased belt use by about 16 percentage points, with greater gains when pre-program belt use was lower. Because many studies were conducted when belt use rates were considerably lower than at present, new programs likely will not have as large an effect. Following the enforcement program, belt use often dropped by about 6 percentage points demonstrating the ratchet effect typical of these programs (belt use increases during and immediately after the program and then decreases somewhat, but remains at a level higher than the pre-program belt use).

Media plays an instrumental role in HVE campaigns. The May 2002 Click It or Ticket campaign evaluation demonstrated the effect of different media strategies used in conjunction with enforcement (Solomon, Ulmer, & Preusser, 2002). Belt use increased by 8.6 percentage points across 10 States that used paid advertising extensively in their campaigns. Belt use increased by 2.7 percentage points across 4 States that used limited paid advertising and increased by only 0.5 percentage points across 4 States that used no paid advertising. From 2008 to 2013 National funding for the Click it or Ticket campaign remained steady at $8 million per year, while State funding for the campaign dropped from $16 million to $11 million per year (Nichols, Chaffe, Solomon, & Tison, 2016). Even though less funding was used to support the media portion of the program, the effect of repeating the CIOT campaign yearly acts as a booster shot for seat belt use awareness and behavior change. This is demonstrated by looking at indicators during that same period, i.e., CIOT tagline recognition increased from 73% to 83%, seat belt citations per 100,000 people dropped from 19 to 12 among reporting jurisdictions, and national observed daytime belt use increased from 83% to 87%.

Smaller-scale campaigns limited to a single travel corridor can yield a short-term improvement in observed seat belt usage along the corridor, but the effects appear to be limited to the enforcement area. Specifically, an HVE campaign conducted along a route frequented by commuters used inexpensive roadway signs and magnetic message strips on enforcement vehicles in the corridor, but only a press release was available to residents in a nearby city, which was typically the destination for commuters (Elliot et al., 2014). Although observed belt use improved significantly in the corridor, observed belt use and overall awareness of the seat belt campaign was unchanged in the nearby city. A likely explanation for this difference is lack of exposure to the location-specific campaign, since most respondents from the city reported traveling the route less than once a month.

Since 2002 and especially after 2003, there has been a history of using extensive paid advertising both nationally and in States to support the Click it or Ticket campaign with clear enforcement images and messages (Milano et al., 2004). The 2013 Click It or Ticket (CIOT) campaign used extensive paid advertising ($8 million nationally and $11 million in individual States). National observed seat belt use following CIOT was statistically unchanged from 2012 to 2013 (86% and 87%, respectively). While the effect of CIOT on observed belt use cannot be isolated from the effect of other interventions, national observed seat belt use increased from 79% to 87% over 11 years of CIOT activity (2003 – 2013) (Nichols, Chaffe, & Solomon, & Tison, 2016).

Costs: High-visibility enforcement campaigns are expensive. They require extensive time from State highway safety office and media staff and often from consultants to develop, produce, and distribute publicity and time from LEOs to conduct the enforcement. Paid advertising increases a campaign’s effectiveness, but can be quite expensive. In the average State, paid advertising costs were nearly $350,000 for the 2007 campaign (Solomon, Preusser, Tison, & Chaudhary, 2009). More recently, the 2013 Click It or Ticket campaign used extensive paid advertising ($8 million nationally and $11 million in individual States) (Nichols, Chaffe, & Solomon, & Tison, 2016).

Time to implement: An HVE program (including media) requires 4 to 6 months to plan and implement.

Other issues:

  • Effects in primary and secondary belt law States: High-visibility enforcement campaigns are effective in both primary and secondary law States. NHTSA’s 2003 evaluation found that belt use increased by 4.6 percentage points across the primary law States and by 6.6 percentage points across the secondary law States with the primary law States having had higher use rates before the campaigns (Solomon et al., 2003). NHTSA’s evaluation of the 2004 Click It or Ticket campaign found that the campaign increased belt use in 25 secondary jurisdictions by an average of 3.7 percentage points. Belt use decreased in the remaining 5 jurisdictions by an average of 2.3 percentage points (Solomon et al., 2007). NHTSA examined the effect of enforcement in the 2012 Click It or Ticket campaign and found that citations per 10,000 residents were twice as high in States with primary laws (16 citations versus 8 citations) as those with secondary laws (Hinch, Solomon, & Tison, 2014). The authors suggested that increasing citations in secondary States (when drivers are stopped for other violations) could be an opportunity to increase belt use.
  • Effects on low-belt-use groups: The CDC’s systematic review observed that short-term, HVE campaigns increased belt use more among traditionally lower-belt-use groups, including young drivers, rural drivers, males, African Americans, and Hispanics (Shults et al., 2004). See the Seat Belts and Child Restraints chapter, Section 3.2 for further discussion on strategies to reach low-belt-use groups. Similarly, a more recent study also found that increases in observed seat belt use in an enforcement area were greatest among the groups that had the lowest baseline usage rates, such as males, passengers, and drivers of pickup trucks (Elliot et al., 2014).
  • Nighttime programs: A three-year high-visibility nighttime seat belt enforcement program conducted in Maryland successfully raised nighttime seat belt use (Retting et al., 2018). This program included five waves of HVE coupled with extensive paid and earned media campaigns. The primary message of the ad campaign was that “Cops are cracking down on seat belt violations, especially at night.” Driver awareness of the seat belt enforcement increased significantly during the HVE period. Furthermore, despite the fact that seat belt use rates were already high in this region (90-95%), there was a small but significant increase in observed nighttime seat belt use in three of the five waves when compared to a pre-HVE period. Control sites showed no changes in nighttime belt use across the same timeframe. A similar pattern was observed with unbelted injury crashes at night. These rates dropped at HVE sites when compared to the pre-HVE period and control sites showed no change in crash rates. Similar to the Washington program, nighttime unbelted drivers were more likely to have poorer driving records and more prior citations for speeding, negligent/reckless driving, license-related offences, and crashes.