Skip to main content
Rural Health Information Hub

Decreasing Impaired and Distracted Driving to Prevent Traffic Accidents

In the U.S., people die each day in alcohol-impaired driving crashes. Approximately one-third of all traffic-related deaths are a result of alcohol. The use of legal and illegal drugs while driving has been linked to approximately 16% of crashes. In rural communities these numbers are higher, with 43% of all alcohol-related motor vehicle deaths occurring on a rural road.

Distracted driving includes activities that take a driver's attention and eyes off the road, such as talking on the phone, texting, eating, or drinking. In 2020, approximately 8% of all deaths on roads were due to distracted driving. Of all the deaths involving distracted driving, 46% happened on rural roads.

Another preventable cause of traffic crashes and deaths that occur more often on rural roads is drowsy driving, where the drivers are impaired because they were too tired to drive and fell asleep behind the wheel. Drinking alcohol, taking certain medications, and other factors such as type of job and work hours can impact a person's risk for drowsy driving.

Several evidence-based and promising strategies exist for decreasing alcohol- and drug-impaired driving and distracted driving. These include laws and enforcement, devices such as ignition interlocks, mass media and education campaigns, and sobriety checkpoints. Many rural communities are adapting these strategies to develop programs that provide alternatives for distracted and impaired driving. For example, several communities have been able to establish local cab and ride share programs to limit the number of people driving when impaired or drowsy. In addition, educational programs and driving simulators can improve driving skills and teach people about the risks of driving while impaired.

Alcohol- and Drug-Impaired Driving Laws and Enforcement

Alcohol-impaired driving laws make it illegal to drive with a blood alcohol content (BAC) over 0.08% in most U.S. states (in Utah, the limit is 0.05%). The Community Preventive Services Task Force (CPSTF) recommends BAC laws as evidence-based for preventing alcohol-related deaths from motor vehicle crashes. Other laws that aim to decrease the number of people driving under the influence of alcohol include zero tolerance laws for people under the age of 21 caught driving with any amount of alcohol in their system, and laws that make it illegal to drink before the age of 21. There is strong evidence that laws that set the legal age of drinking at 21, which are in effect nationwide, can help prevent people under this age from drinking and reduces risk of motor vehicle crashes related to alcohol use.

In every state, it is illegal to drive under the influence of drugs, including legal and illegal drugs, such as marijuana, opioids, and methamphetamines.

Ignition Interlocks

CPSTF recommends ignition interlock devices that can be installed in motor vehicles as a strategy to prevent people from driving while under the influence of alcohol and reduce rates of injury. These devices can measure alcohol content when a driver breathes into the device. If the BAC registers above a specified level, often set at 0.02%, it prevents the driver from starting the vehicle. Ignition interlocks are commonly used as an intervention for people convicted of driving under the influence of alcohol.

Mass Media and Education Campaigns

County Health Rankings & Roadmaps notes there is some evidence that mass media and educational campaigns are effective at preventing people from drinking and driving. These campaigns usually attempt to address the negative outcomes from driving under the influence. For example, school-based educational programs are effective at teaching youth not to ride with drivers who have been drinking.

Breath Testing/Sobriety Checkpoints

CPSTF and County Health Rankings & Roadmaps recommend sobriety checkpoint programs as an evidence-based practice to reduce alcohol-impaired driving and injuries. Sobriety checkpoints are places where police officers can stop drivers to examine whether they are driving after consuming alcohol. It is estimated that the use of these checkpoints could save several thousand lives each year. A main goal of sobriety checkpoint programs is to increase awareness of the risk of arrest from driving while impaired. Publicity of these checkpoints has been found to also stop drivers from driving while intoxicated. In the U.S., selective breath testing is used, where police must have a reason to administer a breath test for a driver that is pulled over. In several other countries, random breath testing is used, where all stopped drivers are given tests.

Distracted Driving Laws

There is some evidence that enacting distracted driving laws will reduce the number of crashes and deaths from driving while distracted. Almost every state in the U.S. has passed a law to address distracted driving, with many related to cellphone use and texting. For example, 48 states and several U.S. territories ban text messaging while driving, with the majority of these being primary enforcement laws.

Drowsy Driving Interventions

Aside from education about the dangers in driving when overly tired, experts suggest focusing on some of the following countermeasures:

  • Behavioral countermeasures such as encouraging drivers get adequate rest or consume caffeine before driving
  • Technology countermeasures to create safer vehicles to prevent crashes
  • Infrastructure countermeasures, for example changing roads to add rumble strips and signs
  • Educational countermeasures that highlight the risks of drowsy driving and prevention methods
  • Medical countermeasures for diagnosed sleep disorders that put people at risk for drowsy driving
  • Policy countermeasures to introduce state laws to prevent drowsy driving

Examples of Rural Programs that Focus on Decreasing Alcohol- or Drug-Impaired and Distracted Driving

  • The Isanti County SafeCab Program in rural Isanti County, Minnesota, began in 2005 with the goal of reducing the number of deaths and injuries caused by alcohol-impaired driving and promoting positive traffic safety culture. The program offered rides home for people visiting bars and restaurants to reduce the number of people driving while intoxicated. The program also partnered with local communities including bar owners and servers to educate about drunk driving and worked to decrease the number of people being pulled over for alcohol-impaired driving.
  • The Court Referred Distracted Driving Program through Chautauqua Safety Village was established as an educational program for people who have received violations for distracted driving. Courts can refer people to the program's weekly classes. The Chautauqua Safety Village also offers distracted and impaired driving programming for high school students. The program uses a driving simulator and the One Simple Decision® program to educate about these risky driving behaviors. This program is offered in local schools or onsite at the Safety Village.
  • The Road Crew project operated in six rural counties in Wisconsin. It was funded through the National Highway Traffic Safety Administration and the Wisconsin Department of Transportation. The project goal was to reduce drunk driving in these areas and offered rides home for people who had consumed too much alcohol. Some communities engaged volunteer drivers to help with the project and others used existing cab services operating in the areas. Thousands of rides were given to potential drunk drivers through the project, and it is estimated that numerous alcohol-related crashes were prevented.
  • The Toward Zero Deaths program, in the rural community of Park Rapids, Minnesota, conducted a three-year traffic safety culture project to gain an understanding of community perceptions towards traffic safety, promote positive traffic safety messages, and reduce injuries. Some efforts focused on reducing behaviors such as driving while medicated or under the influence of alcohol. One accomplishment of the program was creating the Joyride Program to help people who were drinking get safely home from bars and restaurants. Prior to the program, the small town lacked any cab or rideshare services.
  • The Texas Department of Transportation created an annual campaign, Talk. Text. Crash., to educate about the dangers of distracted driving. The campaign includes paid media and social media, as well as educational content in the form of an interactive game about distracted driving.
  • Sleep Smart. Drive Smart. is a drowsy driving awareness education campaign in Utah through the Utah Department of Public Safety. The campaign presents information about how younger and older drivers are most impacted in drowsy driving crashes and how a lack of sleep can impair driving abilities. The campaign also teaches people how to identify signs of drowsiness and prevent people from driving while drowsy.
  • Teens in the Driver Seat is a Texas-based, peer-led educational program for high school students. The program operates in several states and has reached millions of adolescents. It focuses on delivering education, resources, and materials on the risks of driving under the influence of alcohol and other drugs, distracted driving, and the importance of using seat belts. The program also provides incentives for participation, including contests and cash prizes.

Implementation Considerations

Enforcement is essential to ensure that laws for reducing alcohol and drug-impaired and distracted driving have an impact. This can be a challenge in some areas where law enforcement agencies have limited staff, because it can take police officers away from other dedicated activities. Some rural areas have developed local strategies to address limited enforcement, for example creating a neighborhood watch near local bars and restaurants to incentivize community members to not drink and drive. Other areas have chosen to focus on problem-oriented policing which helps communities identify the most pressing issues and target prevention efforts.

When using ignition interlocks to reduce alcohol-impaired driving, some rural locations may experience challenges related to limited access to interlock providers who can install and service malfunctioning ignition interlocks. One suggestion is for states to mandate interlock providers serve rural areas when developing contracts for services. The Centers for Disease Control and Prevention (CDC) offers alcohol ignition interlock implementation considerations for states seeking to increase their use, particularly to decrease repeat cases of driving while intoxicated. While every state has implemented programs to manage the use of ignition interlocks, uptake remains low in many areas.

It can be difficult to address individual lifestyles and behaviors, such as texting while driving or driving under the influence of alcohol. Public media campaigns and education about the importance of laws can be helpful for spreading understanding about the importance of these issues. For example, the U.S. Department of Transportation has developed several campaigns with materials for communities to use to implement safety campaigns about distracted driving.

Resources to Learn More

America's Rural Roads: Beautiful and Deadly
Examines Fatality Analysis Reporting System (FARS) 2016-2020 data to determine who is dying from crashes on rural roads, where they are dying, and what behaviors put them at risk. Compares rural and urban data for road fatalities, crash and vehicle type, sex, race and ethnicity, age, use of seat belts, alcohol and drug use, speeding, and state maximum speed limits. Offers proven strategies to improve rural road safety.
Organization(s): Governors Highway Safety Association, State Farm
Date: 9/2022

Countermeasures That Work: A Highway Safety Countermeasure Guide for State Highway Safety Offices, Ninth Edition, 2017
Presents science-based safety measures and strategies, including promising programs aimed to address traffic safety problems such as alcohol and drug impaired driving, speeding and speed management, distracted driving, motorcycle safety, and bicycle safety.
Author(s): Richard, C.M., Magee, K., Bacon-Abdelmoteleb, P., & Brown, J.L.
Organization(s): National Highway Traffic Safety Administration
Date: 4/2018

Distracted Driving Topic Guide
Lists resources providing background information, training videos, laws by state, and related policies regarding distracted driving and strategies to prevent it from occurring.
Organization(s): National Rural Transit Assistance Program

Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem
Reviews programs, policies, and systems focused on preventing injuries and death due to alcohol-impaired driving. Identifies interventions most promising to implement for reducing alcohol-impaired injuries and deaths.
Organization(s): National Academies of Sciences, Engineering, and Medicine
Date: 2018