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Motor Vehicle Injury – Alcohol-Impaired Driving: Publicized Sobriety Checkpoint Programs

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What the CPSTF Found

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). The review was conducted on behalf of the CPSTF by scientists from CDC’s Division of Unintentional Injury Prevention with input from a team of specialists in systematic review methods and experts in research, practice and policy related to motor vehicle injury prevention. This finding updates and replaces the 2000 Task Force finding on Sobriety Checkpoints pdf icon [PDF – 378 KB]

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). Evidence was combined because some of the studies from the updated search period evaluated sobriety checkpoint programs conducted during the period covered by the 2000 review.

Of the 16 included studies, seven reported cost and benefit findings on actual operation of the sobriety checkpoints alone, eight reported costs or cost-effectiveness information on media advertising and publicity alone, and one reported costs for both operations and media. 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

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are 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.

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.

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