title: Associations of repeated high alcohol use with unsafe driving behaviors, traffic offenses, and traffic crashes among young drivers: Findings from the New Zealand Drivers Study.
abstract: The objective of this study was to describe self-reported high alcohol use at each of the 3 licensing stages of graduated driver licensing and its relationship to drink-driving behaviors, intentional risky driving, aggressive driving, alcohol traffic offenses, non-alcohol traffic offenses, and traffic crashes.
  
  
  
  The New Zealand Drivers Study (NZDS) is a multistage, prospective cohort study of newly licensed drivers interviewed at all 3 stages of the graduated driver licensing system: learner (baseline), restricted (intermediate), and full license. At each stage, alcohol use was self-reported using the Alcohol Use Disorders Identification Test (AUDIT-C), with high alcohol use defined as a score of ≥4 for males and ≥3 for females. Sociodemographic and personality data were obtained at the baseline interview. Alcohol-related, intentional risky, and aggressive driving behaviors were self-reported following each license stage. Traffic crashes and offenses were identified from police records. Crashes were also self-reported.
  
  
  
  Twenty-six percent (n = 397) reported no high alcohol use, 22% at one license stage, 30% at 2 stages, and 22% at 3 stages. Poisson regression results (unadjusted and adjusted) showed that the number of stages where high alcohol use was reported was significantly associated with each of the outcomes. For most outcomes, and especially the alcohol-involved outcomes, the relative risk increased with the number of stages of high alcohol use.
  
  
  
  We found that high alcohol use was common among young newly licensed drivers and those who repeatedly reported high alcohol use were at a significantly higher risk of unsafe driving behaviors. Recently introduced zero blood alcohol concentration (BAC) should help to address this problem, but other strategies are required to target persistent offenders.
authors: a Department of Preventive and Social Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: Dorothy
authors: D
authors: Begg
authors: a Department of Preventive and Social Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: Rebecca
authors: R
authors: Brookland
authors: a Department of Preventive and Social Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: Jennie
authors: J
authors: Connor
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control; D001334:Automobile Driving; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008004:Licensure; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D011446:Prospective Studies; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Young drivers; crashes; high alcohol use; offenses; unsafe driving