The motivation for this study was the observation that Belgium has a severe problem with drunk driving, which is apparently worse than in most other European countries. We asked ourselves the questions: “what can we learn from countries that at this point score much better”. Therefore, an exploratory study was designed to gain insight into how other countries have been successful in preventing driving under the influence of alcohol. The information is based on an expert survey in a number of well performing countries and starts from previous recommendations of the DRUID project (Schulze et al., 2012). Furthermore, quantitative data from previous EU projects (e.g. DRUID, SARTRE4) were included in the analysis. For the study we selected four countries with a (very) low prevalence of driving under the influence of alcohol (Sweden, Finland, Poland and Estonia), two countries with a striking improvement of their DUI situation in the last decade (Greece and Ireland) and the best performing neighbouring country of Belgium (Netherlands). For these countries, the measures against driving under the influence of alcohol were explored and compared. Key results The main results regarding prevalence, social acceptability and measures against drunk driving are summarized. A table gives an overview of descriptive variables regarding driving under the influence of alcohol in the seven selected countries and in Belgium. The countries are ranked according to their performance in the field of driving under the influence of alcohol above the legal limit (DUI). With respect to DUI Sweden, Finland, Poland and Estonia are the four best performing countries in the SARTRE4 comparison of 19 European countries. In a comparison of the relative position of the countries within the SARTRE 3 and 4 measurements in 2002 and 2010 Greece and Ireland show a remarkable improvement of their DUI situation. Nevertheless, Greece still has a relatively high DUI prevalence (just below the average of the 19 European countries). The best performing neighbouring country of Belgium in the SARTRE4 measurement were the Netherlands. Other descriptive characteristics: Striking additional features of countries with a very low DUI prevalence (Sweden, Finland, Poland and Estonia) were: * low legal alcohol limit with a BAC of 0.2 g / L (except Finland); * low prevalence of perceived DUI among friends (social norm), especially in Scandinavian countries (Sweden and Finland); in the former Eastern bloc countries (Poland and Estonia) the perceived DUI among friends is around the average of the 19 SARTRE4 countries; * High level of experience alcohol checks; * High level of perceived likelihood of being checked for alcohol (subjective alcohol check probability) Scandinavian countries but not in earlier Eastern Bloc countries. The annual national consumption of alcohol does not appear to be directly linked to the prevalence of drunk driving. It is noteworthy that some very good performing countries also have very high alcohol consumption. Social acceptability of driving under the influence of alcohol (DUI): According to the national experts drunk driving is totally unacceptable in Sweden, Finland, Poland and Ireland, unacceptable in Estonia and slightly acceptable in Greece. According to the Belgian national attitude measurement drunk-driving is unacceptable (84%) among most drivers, but only totally unacceptable among 56% of the drivers. Availability of alcohol: In most countries alcohol is freely available from 18 years on. In Sweden and Finland the accessibility of alcohol is restricted. Alcohol can be served from 18 years on, drinks with a low alcohol concentration (Sweden up to 3.5 vol. %; Finland up 4.7 vol. %) can be sold in regular shops also from 18 years on, but stronger alcohol can only be sold from 20 years on in particular alcohol stores. In the Netherlands the selling of alcohol is restricted in gas stations along the highway. Legal alcohol limit: Most well performing countries have an alcohol limit of 0.2 g/L (Sweden, Estonia and Poland). In all other countries the general alcohol limit is set at BAC 0.5 g/L with often a lower legal limit (BAC 0.2 g/L) for specified driver groups. These are novice drivers in most cases (the Netherlands, Ireland, and Greece), but also professional drivers (Ireland, Greece, Belgium) and in Greece also motorized two (three) - wheelers. Enforcement: All selected countries within this study have continuous drunk driving enforcement throughout the whole year with increased drunk driving enforcement during special period(s) of the year, such as Christmas, midsummer or other national holidays. Each country communicates to the public about these intensified enforcement-periods in one way or the other. In almost all of these countries alcohol checks are mandatory for drivers involved in accidents resulting in injury. Only in Greece and the Netherlands this measure is only partially put into practice. Penalties: In comparison with Belgium do most selected countries have more severe sanctions on alcohol traffic offences. Poland appeared to have the most severe sanctions, in which DUI offences with a BAC of 0.2/0.5 g/L can already be sentenced with a fine, a driving ban between 6 months and 3 years and additional imprisonment of 5-30 days Most of the well performing countries (Sweden, Estonia, the Netherlands and partly in Finland) offer driver rehabilitation programmes to DUI offenders. Moreover, Sweden, Finland, the Netherlands provide alcohol interlock programmes. These programmes are combined with counselling and close monitoring in most cases. In none of the countries alcohol interlocks are mandatory for specific driver groups (e.g. professional drivers). Only in Finland: vehicles in school transport have to be equipped with alcohol interlocks, but this only if the municipality orders and pays for the transport. Education and awareness rising campaigns: In all selected countries the theme "alcohol and driving" is addressed in driving education and partly in school education. Furthermore, most countries conduct systematic awareness rising campaigns or communicate in another ways systematically about the risks of alcohol in traffic. In most countries the road safety campaigning/risk communication is a multidisciplinary approach, developed in collaboration with actors from different policy areas such as road safety, health and education. Key recommendations: All countries with low DUI prevalence are using a comprehensive countermeasure system which consists of different elements such as legislation, enforcement and/or education. Based on the analysis of good practices we identified the following possibilities to improve the DUI situation in BE: * further increase the enforcement activities (alcohol checks), especially concerning the systematic alcohol checks in case of accident resulting in injury; * keep on combining the preventive (random checks) and repressive (selective checks) approaches; *further increase the public visibility of the police controls to reinforce the general deterrent effect (in other words: increasing the perceived likelihood to get checked for alcohol); * expand how DUI is sanctioned (e.g. penalty combined with close monitoring of alcohol use in case of recidivists) * keep the time gap between the offence and sanctioning as short as possible in order to increase the deterring effect of the sanction; * lower the alcohol limit for young and/or novice drivers (usually less than 2 years of driving experience). * expand the driver rehabilitation programmes for alcohol traffic offenders (e.g. mandatory driver rehabilitation programmes for specific target groups, implementation of a driver rehabilitation program in case of a provisional driver licence withdrawal, spread programmes over a longer period and treat non-addicts and addicts in separate programmes); * expand the alcohol interlock programmes combined with counselling and close monitoring (e.g. mandatory programmes for recidivists); * keep on addressing the topic “don’t drink and drive” in education, sensitisation and campaigns aiming at reducing the social acceptability of DUI; * further intensify the cooperation between various sectors and different policy areas (e.g. education, health, enforcement); including both federal and regional policy levels, as certain policy areas are regionalized. 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