Motor Vehicle Injury Alcohol-Impaired Driving: Publicized Sobriety Checkpoint Programs
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends publicized sobriety checkpoint programs based on strong evidence of effectiveness in reducing alcohol-impaired driving.
The full CPSTF Finding and Rationale Statement and supporting documents for Reducing Alcohol-impaired Driving: Publicized Sobriety Checkpoint Programs are available in The Community Guide Collection on CDC Stacks.
Intervention
Publicized sobriety checkpoint programs are a form of high visibility enforcement where law enforcement officers stop drivers systematically to assess their degree of alcohol impairment. Media efforts to publicize the enforcement activity are an integral part of these programs. The program goal is to reduce alcohol-impaired driving by increasing the public’s perceived risk of arrest while also arresting alcohol-impaired drivers identified at checkpoints.
There are two types of sobriety checkpoints:
- Selective Breath Testing (SBT) — police must have reason to suspect that a stopped driver is intoxicated before a breath test can be requested. SBT is used in the United States.
- Random Breath Testing (RBT) — all stopped drivers are given breath tests for blood alcohol concentration (BAC) levels. RBT is used in Australia and several European countries.
About The Systematic Review
The CPSTF finding is based on evidence from a Community Guide systematic review published in 2001 (Shults et al., 23 studies, search period January 1980 to June 2000) combined with more recent evidence (15 studies, search period July 2000 to March 2012). This finding updates and replaces the 2000 Task Force finding on Sobriety Checkpoints.
Study Characteristics
- Fourteen studies evaluated SBT checkpoint programs in the U.S. and one evaluated an RBT program in New Zealand.
- Programs studied in this review were implemented at the city, county, state, and national levels, and were conducted in rural, urban, and mixed rural and urban areas.
- Most of the evaluated programs either were funded by the National Highway Traffic Safety Administration or followed NHTSA guidelines for conducting sobriety checkpoints.
- All evaluated programs involved a series of checkpoints conducted over time, typically 1 to 3 years.
Summary of Results
The following results are from studies identified during the updated search period.
Fourteen studies evaluated programs conducted in the United States.
- Crash fatalities thought to involve alcohol: median relative decrease of 8.9% associated with selective breath testing checkpoints (inter-quartile interval [IQI]: 16.5% to 3.5%; 10 studies)
- Ratio of alcohol-involved drivers to non-alcohol-involved drivers in fatal crashes: relative decrease of 14% (1 study)
- Fatal and non-fatal crashes thought to involve alcohol: relative decrease of 18.8% (1 study)
- Drivers with a BAC level above the legal limit: relative decreases of 28% and 64% (2 studies)
- Public awareness of checkpoints: the relative increase in the percentage of people from the intervention community who had seen or heard messages about drinking and driving or sobriety checkpoints ranged from 3.4% to 31.9% (5 studies)
One study evaluated a program conducted in New Zealand.
- Serious and fatal nighttime crashes, which serve as a proxy for alcohol-involved fatal crashes: relative decrease of 22.1% associated with random breath testing checkpoints (1 study)
Summary of Economic Evidence
Sixteen studies were included in the economic review (4 from the 2000 review and 12 from the updated search period). All monetary values are reported in 2011 U.S. dollars using the Consumer Price Index and Purchasing Power Parities from the World Bank for international currencies.
- Cost-benefit estimates of sobriety checkpoint programs:
- Benefit-to-cost ratios for selective breath testing checkpoint interventions: 6:1 and 23:1 (2 studies)
- Benefit-to-cost ratios for random breath testing checkpoint interventions: 2:1 to 57:1 (3 studies)
- Cost-effectiveness estimates of sobriety checkpoint programs:
- $5,787 per alcohol-involved motor vehicle crash averted (1 study)
- $35,146 to $40,168 per percentage point reduction in nighttime drivers with BAC 0.08g/dl (1 study)
- $1,723 per percentage point reduction in self-reported driving after drinking (1 study)
- Costs of media advertising and publicity ranged from $1 to $82 per 100 persons (9 studies).
- Estimated cost-effectiveness of media advertising and publicity ranged from $29 to $257 per additional 100 persons who became aware of the sobriety checkpoint program (5 studies).
Applicability
Results should be applicable to various settings, jurisdictions, and populations. They may not, however, be applicable to implementations that consist of a small number of checkpoints conducted over a brief time period.
Evidence Gaps
Prior to and during the literature review and data analysis, the review team and the Community Preventive Services Task Force attempted to address several evidence gaps identified in the 2000 review related to levels of enforcement and publicity. Too few studies included the details necessary to fully address these gaps, however, and several additional gaps were identified.
- More research is needed on the differing configurations of checkpoints (e.g., low staffing versus regular staffing, intermittent blitzes versus continuous) to judge their impact on effectiveness.
- More evaluations need to document useful process measures, such as the numbers of checkpoints conducted, vehicles stopped, or breath tests administered. With the technological advances in recent decades, electronic recording and reporting of this type of information is feasible, and these types of process measures are needed to assess more thoroughly the effectiveness of sobriety checkpoints at varying levels of enforcement.
- More information is needed about procedures and costs, including the use of technology (e.g., instruments such as passive alcohol sensors), staff needed, costs of checkpoint operations, and costs and quantities of different types of publicity used.
- Future publicized sobriety checkpoint programs should accommodate contextual changes such as potential shifts in alcohol-impaired driving patterns, new technologies to help identify alcohol-impaired drivers, and the rapid growth and diversification of media outlets. Working with law enforcement to understand and evaluate such changes, researchers could provide valuable information on the design of checkpoint programs to maintain and potentially increase their effectiveness.
Implementation Considerations and Resources
- As of April 2014, there are legal restrictions against using checkpoints in 12 states: Alaska, Idaho, Iowa, Michigan, Minnesota, Montana, Oregon, Rhode Island, Texas, Washington, Wisconsin, Wyoming. These states have decided that checkpoints are illegal under either the state law or constitution, not authorized by state law, or illegal under the state’s interpretation of the federal constitution.
- An integral part of publicized sobriety checkpoint programs is the use of media, either paid ads or news stories (i.e. “earned” media), to publicize the program and increase the population’s perceived risk of arrest for alcohol-impaired driving.
- Six of the included studies reported increases ranging from 4% to 32% in the percent of people from a targeted community who had seen or heard messages about drinking and driving or checkpoints following implementation.
- Securing the necessary law enforcement staff to implement sobriety checkpoints may present a challenge to implementation. Law enforcement agencies are often understaffed and their attention and resources are divided.
- Sobriety checkpoints are typically conducted during times when alcohol-impaired drivers are most likely to be on the roads, such as weekend evenings, and staff overtime is often required.
- Sobriety checkpoints are harder and potentially more dangerous to implement during adverse weather conditions as checkpoints require law enforcement personnel to stand outside.
- Law enforcement may be less supportive of sobriety checkpoints because they can result in fewer arrests of impaired drivers compared to other forms of high visibility enforcement, such as saturation patrols.
- The National Highway Traffic Safety Administration published Saturation Patrols & Sobriety Checkpoints: A How-to Guide for Planning and Publicizing Impaired Driving Enforcement Effects. This guide recommends selecting a site for conducting checkpoints by identifying locations that have a high incidence of impaired driving-related crashes or fatalities and are safe for both law enforcement and motor vehicle occupants.
Crosswalks
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.