Three points are removed from a driving record for every 12 consecutive months in which a person is not under suspension or revocation or has not committed any violation that results in the assignment of points or the suspension or revocation of the driving privilege. Once a driving record is reduced to zero and remains at zero points for 12 consecutive months, any further accumulation of points is treated as the first accumulation of points.
The legal purchase and possession age for beverages containing alcohol in New York State is 21. Under the state's "zero tolerance" law, it is a violation for a person under 21 to drive with any BAC that can be measured (.02 to .07). After a finding of violation is determined at a DMV hearing, the driver license will be suspended for six months. The driver then must pay a $100 suspension termination fee and a $125 civil penalty to be re-licensed. For a second Zero Tolerance violation, the driver license will be revoked for at least one year or until the driver reaches 21, whichever is longer.
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A reexamination of, or modification to, existing policies and laws could provide opportunities for reducing the incidence of alcohol-impaired driving crashes. Interventions discussed in this section include changes to blood alcohol concentration (BAC) laws, zero tolerance laws, graduated licensing laws, and child endangerment laws.
Laws limiting permissible BAC among operators of motor vehicles are important interventions for reducing alcohol-impaired driving and related injuries and fatalities. Currently, in each state in the United States, drivers 21 years of age and older are prohibited from driving with a BAC that exceeds 0.08%, which is the limit proscribed in state per se laws for alcohol-impaired drivers (APIS, 2016).1 In December 2018, however, Utah will be the first state to lower its BAC per se law to 0.05%. Commercial drivers cannot exceed a BAC of 0.04%,2 and drivers under the age of 21 are restricted to a BAC varying from 0.00% to 0.02% (Fell et al., 2016; so-called zero tolerance laws, discussed later in this chapter), depending on the state where they are licensed to drive. Any individual, regardless of age or type of license, who drives with a BAC in excess of that proscribed by state law can be subject to punishments, including fines, license revocation, vehicle impoundment or restrictions, mandatory treatment, or arrest.
The following section provides information about how BAC affects the human body and an overview of the history and context of BAC laws in the United States and internationally. The section also reviews relevant scientific evidence, including laboratory and epidemiological studies of crash risk at measured BAC levels of less than 0.08%, to determine the point at which alcohol impairment occurs. Potential barriers to adopting laws lowering BAC limits and information on overcoming those barriers are also discussed. Based on its review of the evidence on the effectiveness of 0.05% BAC laws, the committee ends the section with a recommendation to state governments to lower the BAC limit set by state laws from 0.08% to 0.05%. Based on recent literature reviews and estimates by the committee and others, adoption of 0.05% per se laws nationally could save more than 1,500 lives annually (Fell and Scherer, 2017).
Despite these early developments, decades passed before alcohol-impaired driving began to be seen as an important public health issue (Fell and Voas, 2006). In the 1970s, the National Highway Traffic Safety Administration (NHTSA) was officially established and began advocating for stricter laws and penalties for alcohol-impaired driving; soon after, Mothers Against Drunk Driving (MADD) was founded in 1980 (Fell and Voas, 2006). The efforts of these two organizations influenced the passage of many laws, including zero tolerance laws, which prohibit underage drivers from operating a vehicle after consuming any alcohol (Fell and Voas, 2006). The minimum legal drinking age of 21, which prohibits those under 21 years of age from purchasing or publicly consuming alcohol, was adopted by all states by 1988 (APIS, n.d.). Despite these successes, enacting nationwide laws focused on lowering BAC levels has been challenging.
The effectiveness of lowering the per se laws from 0.08% to 0.05% will be supported by legislation that currently applies to 0.08% per se laws, including, but not limited to, use of sobriety checkpoints, administrative license revocation, and penalties for refusing preliminary breath tests or blood tests that are equal to or greater than penalties for alcohol-impaired driving offenses. This means that the same laws and sanctions that currently apply to 0.08% per se laws could remain in place but would be enforceable at the 0.05% BAC limit. Effectiveness will also be enhanced by efforts to publicize 0.05% per se laws through mass media campaigns, by strong and sustained enforcement efforts, and through the implementation and enforcement of laws and policies to prevent illegal alcohol sales to underage or intoxicated persons (e.g., underage compliance checks with alcohol licensees, dram shop liability laws). Incentives from the federal government could include incentive grants to states or, if necessary, the threat of losing highway funding, as was done with the passage of the 0.08% per se laws. Countries with a 0.05% BAC limit implement the law through either administrative sanctions (a traffic citation with sanctions that may include insurance company notification, license suspension, and/or fines) or criminal offenses with various sanctions for drivers with a BAC between 0.05% and 0.079%. The committee offers this recommendation with the understanding that alcohol impairment and increased crash risk begin at BAC levels well below 0.08%. The primary intent of this recommendation is to reduce serious injuries and fatalities caused by alcohol-related crashes, as well as to align with other developed nations and their impaired-driver laws.
Studies of zero tolerance and graduated licensure laws have found that the creation of high-visibility enforcement programs targeting young drivers (Johnson, 2016), increasing or strengthening existing state licensing restrictions (Williams et al., 2016), further restricting the hours when young drivers can operate a motor vehicle (Curry et al., 2017; Shults and Williams, 2016), or promoting awareness of license restrictions to parents of teens (Naz and Scott-Parker, 2017) could increase the effectiveness of existing laws. More research is needed to identify how new drivers over the age of 18 fare without GDL restrictions and whether driving restrictions should be compulsory for all novice drivers. Research is also needed into further limiting alcohol-impaired driving among teens and new drivers, and strategies for preventing passengers from riding with those drivers.
Racial profiling and financial profitability could undermine the success of sobriety checkpoint programs in detecting alcohol-impaired drivers and reducing resulting crashes and fatalities. To minimize the risk of racial profiling, Bergen et al. (2014a) encourage systematic selection and standardized methodology to select vehicles and drivers for breath testing so driver selection is not left to the discretion of individual law enforcement officers. See Chapter 2 for a discussion on the importance of health equity considerations specific to the implementation of interventions to reduce alcohol-impaired driving.
Low-staff, weekly sobriety checkpoint programs can be effective at reducing alcohol-impaired driving in small rural communities (Lacey et al., 2006) and well-publicized, highly visible sobriety checkpoints have been credited with reducing injuries from alcohol-impaired driving in American Indian/Alaska Native reservations (Piontkowski et al., 2015). Box 4-1 describes a successful motor vehicle injury prevention program implemented in a tribal community in Arizona that combined sobriety checkpoints with culturally appropriate social marketing methods, emphasizing the importance of publicity and high visibility for sobriety checkpoints to be effective. In addition to benefiting rural populations, sobriety checkpoints have also been effective at reducing alcohol-related crashes in high-risk populations including men and young people 21 to 34 years (Bergen et al., 2014a).
When low-staff checkpoints were integrated into West Virginia's statewide comprehensive program to reduce traffic crashes, the state saw a 17.3 percent reduction in alcohol-related driving fatalities the following year and an 8.1 percent decrease the year after that (Neil, 2006). West Virginia continues to conduct low-staff checkpoints as indicated by its 2017 Highway Safety Plan (Tomblin et al., 2016).
Evidence indicates that publicized sobriety checkpoints are effective at decreasing alcohol-impaired driving and resulting crashes and fatalities. As described in this section, two systematic reviews conducted by the Community Preventive Services Task Force (Bergen et al., 2014a; Shults, 2001) and a meta-analysis conducted by Erke et al. (2009) found that publicized sobriety checkpoint programs with selective or random breath testing were effective at decreasing alcohol-impaired driving and resulting crashes and fatalities in rural and urban areas as well as at city, county, state, and national levels. More recently, Lenk et al. (2016) found that states that conduct sobriety checkpoints at least monthly had a 40.6 percent lower rate of alcohol-impaired driving. In addition, NHTSA has supported the effectiveness of sobriety checkpoints in its Countermeasures That Work. Results from studies of sobriety checkpoint programs in several states also indicate that they are effective when paired with publicity and advertising efforts (Beck and Moser, 2004; Fell et al., 2005, 2008; Zwicker et al., 2007a,b) or enforcement of speeding laws (Hingson et al., 1996). Evidence also suggests that sobriety checkpoints are effective among specific, often high-risk, populations including small rural communities (Lacey et al., 2006), American Indian/Alaska Native reservations (Piontkowski et al., 2015), and for men and young people 21 to 34 years of age (Bergen et al., 2014a). In addition, there is some evidence to suggest that sobriety checkpoints are cost-effective; however, results from these studies indicate that the cost-effectiveness of sobriety checkpoints depends on several factors related to their implementation. Updated studies with more rigorous methods are needed to more accurately and confidently assess the cost-effectiveness of sobriety checkpoints. Based on its review of a strong body of evidence supporting the effectiveness of sobriety checkpoints at decreasing alcohol-impaired driving in a variety of geographical environments and for a range of specific populations, the committee recommends: be457b7860
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