Reintroduction planned alcohol checks
Regular alcohol checks are effective in reducing the number of alcohol-related crashes (see the question How effective are alcohol checks?), but in traffic, enforcement of drink driving laws has strongly declined in the last few years. In 2020 and 2021, COVID-19 clearly contributed to the decline [6], but in the preceding years, the number of alcohol checks had already decreased. In 2016, the number of wide-scale alcohol tests at DUI checkpoints was almost half that of 2013 [3]. In 2017, fewer than 19,000 drink drivers came into contact with the criminal justice system, a 32% reduction of the 2012 number that amounted to slightly over 27,000 ([2] based on Public Prosecution Department figures).
A reason for this decrease is the lack of effectiveness of the wide-scale alcohol checks or DUI checkpoints due to drivers’ increasing ability to avoid them by up-to-the-minute information on social media/apps [76]. Although it is indeed harder to ‘catch’ offenders in this way, DUI checkpoints can affect the subjective chance of apprehension; road users’ estimation of the chance of being checked. If road user groups use social media to inform one another, the one target group that is especially receptive to information about alcohol checks is the drink driver group. To achieve maximum effectiveness, large-scale alcohol tests at DUI checkpoints can be alternated with flexible alcohol checks that are of shorter duration and more often change locations. In Australia, it was found that small-scale alcohol checks by three to five police officers (instead of eight to twelve) could achieve a similar crash reduction [77].
Introduction of a 0-limit/further lowering of the limit
The European Transport Council advises a zero-tolerance policy for alcohol use in traffic, which in practice entails a 0.2 ‰ alcohol limit in Europe [78]. At a BAC lower than 0.5‰, driving skills are already adversely affected (see the question What is the effect of alcohol on driving behaviour?) and crash risk increases (see the question What are the risks of driving under the influence of alcohol?).
In several countries – Brazil [79] [80], Chile [81] [82], Japan [83], Uruguay [84], Taiwan [85] and Sweden [86] – proof was found that lowering the alcohol limit from 0.5 or 0. 6‰ to a lower limit (0.2 or 0.3‰) positively affects road safety. The lower limits were always coupled with a significant reduction of alcohol-related road crashes or road casualties. On the basis of scientific knowledge, it was estimated that for Belgium introduction of a 0-limit (instead of 0,5‰) would probably result in an annual reduction of 10 to 17 road deaths (2.4% to 3.9%) [87]. A majority of Dutch road users (65%) also support a 0-limit for alcohol use in traffic; throughout Europe, 67% of road users are in favour of this measure [88].
The effectiveness of lower limits does, however, depend on the level of traffic law enforcement. Most road users will only adjust their behaviour if they think that there is a fair chance of being checked [89] (see SWOV fact sheet Traffic enforcement) The rather low chance of apprehension probably explains why previous lower limits for novice drivers were not effective in the Netherlands (see the question How effective is the lower alcohol limit for novice drivers?)
Public communication & education about alcohol use
It has not been proved that public communication by itself, without additional measures such as police surveillance, reduces drink driving (see the question How effective is the Bob campaign?) and SWOV fact sheet Public Service Advertising.
To improve public communication in the Netherlands, researchers of the Trimbos Institute advocate a more setting-related form of public communication about alcohol and drug use in traffic, which should be a better fit for the current hotspot approach (targeting events, hotels/restaurants/cafes, certain areas, Friday evening work socials) to enforcement concerning alcohol and drug use [5]. Campaigns about values and standards are also advocated to make friends hold each other to account for driving under the influence of alcohol and/or drugs [5]. The researchers also call for evaluation of such campaigns on the basis of behavioural measurements.
Yet, there is evidence, mostly based on US studies, that long-term education programmes at schools and universities about the general (multiple) risks of alcohol (and other substances) can reduce alcohol consumption among young people [90] [91] [92]. These universal prevention programmes have a broader scope than just the prevention of driving under the influence. The Trimbos Institute also sees several possibilities to improve the preventive approach to drink driving by better collaboration between the health and road safety domains [5]. Specific opportunities for collaboration are, for example:
- Elaborate the theme of driving under the influence and add it to the treatment protocols for clients and their loved ones;
- Link up with prevention programmes of the Dutch Addiction Association and the Dutch Addiction Probation Service;
- Develop a strategy for calling to account road users who intend to get into their cars while under the influence of substances. To this effect, a protocol could be developed for groups of friends and professionals working at hospitality venues, at festivals and in sports canteens.
Prevention of alcohol offences and ankle tags
For a more prevention-oriented approach towards alcohol offenders in traffic, Goldenbeld, Houwing & Blom [29] distinguish three directions in which policy and measures can be further developed in the Netherlands:
- Better profiling of alcohol offenders can be helpful in developing better prevention measures or providing a better referral to criminal and administrative measures (or forms of assistance).
- New preventive measures should be developed targeting serious (alcohol) offenders who, as we already know, are not helped effectively by current policy.
- Prevention should have a broader approach than addressing serious or repeat offenders in traffic. Not just actual alcohol offenders, but also potential or future offenders, need to be addressed by the policy and stimulated to change their behaviour.
An example of a preventive measure is regular or continuous monitoring of alcohol consumption by alcohol offenders. In the US, alcohol offenders whose alcohol consumption is measured through an ankle tag, were found to hardly reoffend when wearing the tag. Offenders who did reoffend were found to do so at a later time than the offenders in a control group [93]. Dutch ankle tag pilots proved to diminish alcohol consumption and delinquent behaviour, while tagged wearers were mostly positive about this means to monitor behaviour [94]. In 2020, the minister of Justice and Security indicated to intend to introduce this alcohol meter in the Netherlands as well [94]. How the ankle tag will affect driving under the influence is still unknown, and will mostly depend on how frequently judges will impose the measure.
Reduce alcohol consumption
An effective national policy to reduce alcohol consumption contributes to diminishing the alcohol problem and drink driving. Particularly measures aimed at the cost price and marketing of alcohol are effective in reducing alcohol consumption at a national level [95]. In addition, employers and event organisers could take responsibility, by preventing excessive alcohol consumption. The negative social consequences of frequent and excessive alcohol use go beyond the domain of road safety [95]. Campaigns only have a supportive effect: information campaigns and education do increase problem awareness, but are not enough to realise sustained behaviour changes [95].
