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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

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 252 KB].

The updated systematic review included 15 studies.

  • Fourteen studies evaluated programs conducted in the United States with selective breath testing.
    • Crash fatalities thought to involve alcohol decreased by a median of 8.9% (10 studies).
    • One study reported a relative decrease of 14% in the ratio of alcohol-involved drivers to non-alcohol-involved drivers in fatal crashes.
    • One study reported a relative decrease of 18.8% in the number of fatal and non-fatal crashes thought to involve alcohol (1 study).
    • The number of drivers with a BAC level above the legal limit had relative decreases of 28% and 64% (2 studies).
    • The percentage of people in intervention communities who had seen or heard messages about drinking and driving or sobriety checkpoints increased by 3.4% to 31.9% (5 studies).

One study evaluated a program conducted in New Zealand with random breath testing.

  • The number of serious and fatal nighttime crashes, which serve as a proxy for alcohol-involved fatal crashes, showed a relative decrease of 22.1%.

Summary of Economic Evidence

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 252 KB].

The economic review included 16 studies (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, 7 reported cost and benefit findings on actual operation of the sobriety checkpoints alone, 8 reported costs or cost-effectiveness information on media advertising and publicity alone, and 1 reported costs for both operations and media. Monetary values are reported in 2011 U.S. dollars. The Consumer Price Index and Purchasing Power Parities from the World Bank were used to convert international currencies.

  • Cost-benefit estimates of sobriety checkpoint programs:
    • Benefit-to-cost ratios for selective breath testing checkpoint interventions were 6:1 and 23:1 (2 studies).
    • Benefit-to-cost ratios for random breath testing checkpoint interventions were 2:1, 14:1, and 57:1 (3 studies).
      • The study with the highest ratio considered both fatal and serious injury crashes averted over a 3-year period. The other 2 studies used nonfatal crashes over 9 months and nighttime fatal and nonfatal crashes over 2 years.
  • Cost-effectiveness estimates for 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 programs that set up a small number of checkpoints over a brief time period.

Evidence Gaps

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

  • 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 technological advances, electronic recording and reporting is feasible, and process measures are needed to better assess 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 research should account for changes in the environment, such as 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 increase their effectiveness.

Study Characteristics

  • Fourteen studies evaluated selective breath testing checkpoint programs in the United States and 1 study evaluated a random breath testing program in New Zealand.
  • Programs studied in this review were implemented at 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 (NHTSA) or followed NHTSA guidelines for conducting sobriety checkpoints.
  • All evaluated programs involved a series of checkpoints conducted over time, typically 1 to 3 years.

Publications

Bergen G, Pitan A, Qu S, et al. Publicized sobriety checkpoint programs: a Community Guide systematic review. American Journal of Preventive Medicine. 2014;46(5):529-39.
Community Preventive Services Task Force. Publicized sobriety checkpoint programs to reduce alcohol-impaired driving. Recommendation of the Community Preventive Services Task Force. American Journal of Preventive Medicine. 2014;46(5):540-1.

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