Abstract
This article reviews trends in drinking and driving in the USA, Australia, Sweden and the UK. The trend was downward until the late 1990s. Australia and Sweden conduct random breath testing; the USA has a higher alcohol purchase age and police checkpoints where drivers are screened for alcohol; the UK requires compulsory alcohol testing after crashes and whenever motorists are stopped for traffic law violations. Progress stalled in the 1990s and the proportion of fatally injured drivers with alcohol in their blood has increased in Sweden and the UK. Testing has declined which is seen as a major factor.