title: Release from drinking-age restrictions is associated with increases in alcohol-related motor vehicle collisions among young drivers in Canada.
abstract: Alcohol-related motor vehicle collisions (MVCs) are a key concern in current international debates about the effectiveness of minimum legal drinking age (MLDA) laws, but the majority of this literature is based on natural experiments involving MLDA changes occurring 2-4 decades ago.
  
  
  
  A regression-discontinuity approach was used to estimate the relation between Canadian drinking-age laws and population-based alcohol-related MVCs (n=50,233) among drivers aged 15-23years in Canada.
  
  
  
  In comparison to male drivers slightly younger than the MLDA, those just older had immediate and abrupt increases in alcohol-related MVCs of 40.6% (95% CI 25.1%-56.6%; P<0.001) in Ontario; 90.2% (95% CI 7.3%-171.2%; P=0.033) in Manitoba; 21.6% (95% CI 8.5%-35.0%; P=0.001) in British Columbia; and 27.3% (95% CI 10.9%-44.5%; P=0.001) in Alberta; but also an unexpected significant decrease in the Northwest Territories of -102.2% (95% CI -120.7%-74.9%; P<0.001). For females, release from MLDA restrictions was associated with increases in alcohol-related MVCs in Ontario [34.2% (95% CI 0.9%-68.0%; P=0.044)] and Alberta [82.2% (95% CI 41.1%-125.1%; P<0.001)]. Nationally, in comparison to male drivers slightly younger than the legislated MLDA, male drivers just older had significant increases immediately following the MLDA in alcohol-related severe MVCs [27.0% (95% CI 12.6%-41.7%, P<0.001)] and alcohol-related fatal MVCs [53.4% (95% CI 2.4%-102.9%, P=0.04)].
  
  
  
  Release from Canadian drinking-age restrictions appears to be associated with immediate increases in alcohol-related fatal and non-fatal MVCs, especially among male drivers.
authors: Northern Medical Program, University of Northern British Columbia (UNBC), 3333 University Way, V2N 4Z9 Prince George, British Columbia, Canada; Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Health Sciences Building, M5T 3M7 Toronto, Ontario, Canada. Electronic address: Russ.Callaghan@UNBC.ca.
authors: Russell C
authors: RC
authors: Callaghan
authors: Northern Medical Program, University of Northern British Columbia (UNBC), 3333 University Way, V2N 4Z9 Prince George, British Columbia, Canada; Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), 250 College Street, M5T 1R8 Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Health Sciences Building, M5T 3M7 Toronto, Ontario, Canada.
authors: Jodi M
authors: JM
authors: Gatley
authors: Biostatistical Consulting Service, Centre for Addiction and Mental Health (CAMH), 250 College Street, M5T 1R8 Toronto, Ontario, Canada.
authors: Marcos
authors: M
authors: Sanches
authors: Department of Community Health Sciences, University of Northern British Columbia, 3333 University Way, V2N 4Z9 Prince George, British Columbia, Canada.
authors: Claire
authors: C
authors: Benny
authors: Department of Community Health and Epidemiology, Dalhousie University, 5790 University Ave., B3H 1V7 Halifax, Nova Scotia, Canada.
authors: Mark
authors: M
authors: Asbridge
mesh_terms: D000428:Alcohol Drinking / Q000331:legislation & jurisprudence* / Q000401:mortality*; D000434:Alcoholic Beverages / Q000009:adverse effects*; D001334:Automobile Driving; D002170:Canada / Q000453:epidemiology; D006801:Humans; D012737:Sex Factors
keywords: Accidents; Alcohol intoxication; Drinking age laws; Health policy; Traffic; Underage drinking