A systematic review of factors associated with illegal drug driving

Questioning penalties and road safety Policies: Are they enough to deter risky motorcyclist Behavior?

Reducing risky behaviors and traffic violations is crucial for preventing road trauma among private and commercial motorcyclists. While legal interventions such as road rules and police enforcement have been somewhat effective, there is a gap in understanding how motorcyclists perceive these deterrents and the psycho-social factors influencing their effectiveness. This research aims to explore the interplay between motorcyclists' psycho-social predispositions and their responses to legal interventions. It also compares two distinct groups of riders - private and commercial motorcyclists - within the urban environment of Da Nang, Vietnam, providing a nuanced consideration of the influence of work-related impacts on risky behavior, which can enable targeted interventions. We propose a theoretical model integrating the Theory of Planned Behavior and Deterrence Theory to analyze how psycho-social and punitive factors influence riders' traffic violations. A total of 423 delivery riders and 411 private riders in Da Nang participated in the study. The results show that attitude, perceived behavioral control, and perceptions of deterrence significantly impact riders' intentions to engage in risky behaviors, with delivery riders being particularly responsive to law enforcement and penalties. To enhance policy effectiveness, interventions should employ tailored enforcement strategies that account for the unique motivations and perceptions of each rider group. For example, increasing the visibility and consistency of law enforcement could be particularly impactful for delivery riders, who are more sensitive to immediate deterrents. Policy adjustments should also focus on reshaping riders' attitudes toward safety and adjusting their perceived control over riding situations. By tailoring interventions to effectively influence each group's behavior, we can ultimately reduce traffic incidents.

Attitudes toward driving after cannabis use: a systematic review

BACKGROUND

Driving after cannabis use (DACU) is associated with increased risk of motor vehicle collisions. As cannabis legalization expands, DACU is emerging as a major public safety concern. Attitudes have a significant impact on behavioural decision making. As such, understanding the degree to which people have favorable or unfavorable evaluations of DACU is an important first step for informing prevention efforts. This systematic review summarizes existing evidence on attitudes toward DACU, their association with actual or intended DACU, and changes in attitudes following legalization of recreational cannabis.

METHODS

Four electronic databases (MEDLINE, EMBASE, PsycINFO, and TRID) were searched for studies that reported attitudes or changes in attitudes toward DACU published between their inception dates and February 26 2024. A total of 1,099 records were retrieved. Studies were analyzed using an inductive thematic synthesis approach.

RESULTS

Seventy studies from seven countries originating predominantly from the United States and Canada met inclusion criteria. Thematic analysis identified six themes. (I) Attitudes toward the safety and acceptability of DACU are mixed; participants in 35 studies predominantly expressed negative attitudes toward DACU (e.g., DACU is dangerous, affects driving ability, and increases crash risk). However, 20 studies reported opposing views. (II) Attitudes toward DACU vary by age, sex/gender, and cannabis use frequency; youth, men, and frequent cannabis users tended to view DACU more favorably than older participants, women, and occasional or non-users. (III) Attitudes toward DACU are associated with past DACU and intention to DACU. (IV) DACU is viewed more favorably than driving after drinking alcohol. (V) The relationship between legal status of recreational cannabis and attitudes toward DACU is unclear. (VI) Perceived risk of apprehension for DACU is low to moderate.

CONCLUSIONS

This review found that perceptions of DACU are primarily negative but mixed. Findings suggest that attitudes toward DACU are important targets for interventions to reduce this behaviour.

Does cognitive control mediate the relationship between peer presence and adolescent risk-taking? An ERP study

Peer presence influences risk-taking behavior, particularly in adolescence. Based on the dual system model, this event-related potential study examined whether and how the presence of a peer displayed a preference for risky behavior would increase adolescents' risk-taking by disrupting their cognitive control processes in either emotional or non-emotional contexts. A sample of 106 adolescents (17-19 years of age) completed two Stoop tasks and a Balloon Analog Risk Task under three peer presence conditions. Results revealed that compared to other conditions, the presence of a risk-averse peer caused adolescents to make safer decisions through improving their conflict monitoring (more negative N200-diff), whereas a risk-preference peer's presence led adolescents to more risky decisions through disrupting their conflict resolution (more positive N450-diff) but they were only observed on the Emotional Stroop task. These findings suggest that different peer presence contexts could increase or decrease adolescents' risk-taking behaviors by influencing their cognitive control under an emotional context rather than in a non-emotional context.

Substance use and driver fatality in Norway: An expanded case-control study

OBJECTIVE

Using alcohol or psychoactive drugs before driving a motor vehicle may increase the risk of crash involvement, injury, and death. This is better documented for alcohol than for drugs. The aim of this study was to expand a previous case-control study on substance use and driver fatality by doubling the number of cases and controls, and hence improve the statistical power and enable the analysis of combined substance use.

METHODS

We collected data on alcohol and drug use from all 1197 drivers of cars and vans who were fatally injured in road traffic crashes in Norway between 2005 and 2020 ('cases') by analyzing blood samples or reviewing other information on substance use. We also collected data on alcohol and drug use among 17,219 drivers in random road traffic ('controls') by analyzing oral fluid samples. Substance use was converted to dichotomous variables (no use/use). We used unconditional logistic regression to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) of driver fatality for mutually exclusive substance groups, adjusted for sex, age, geographic region, urban centrality class, and time interval of the week.

RESULTS

Compared to no substance use, the aOR (95% CI) for driver fatality was for alcohol 91 (61-137), stimulants (primarily amphetamines) aOR 22 (9-56), benzodiazepines and z-hypnotics (BZDs) aOR 4.0 (2.7-5.9), tetrahydrocannabinol (THC) aOR 3.4 (1.7-6.7), and opioids aOR 1.4 (0.4-4.9). The aOR for any polysubstance use was 168 (96-297). The combinations of BZDs with stimulants or THC were associated with markedly higher aORs for driver fatality than the use of single substance groups.

CONCLUSIONS

Alcohol and polysubstance use are the most important predictors of fatal injury, followed by stimulants.

The association between single and dual use of cannabis and alcohol and driving under the influence and riding with an impaired driver in a large sample of Canadian adolescents

OBJECTIVE

Dual use of cannabis and alcohol has increased in adolescents, but limited research has examined how it relates to impaired driving or riding with an impaired driver (IDR) compared to single substance use. This study aimed to examine the odds of alcohol- and/or cannabis-IDR among adolescents based on their use of alcohol and/or cannabis, and whether associations differed by gender and age.

METHODS

Cross-sectional survey data were used from a sample of 69,621 students attending 182 Canadian secondary schools in the 2021/22 school year. Multilevel logistic regression estimated the odds of exclusive alcohol-IDR, exclusive cannabis-IDR, and both alcohol and cannabis IDR (alcohol-cannabis-IDR). Substance use interactions with gender and age were tested.

RESULTS

Overall, 14.7% of participants reported IDR; 7.5% reported exclusive alcohol-IDR, 3.2% reported exclusive cannabis-IDR, 4.0% reported alcohol-cannabis-IDR, and 7.4% were unsure if they had experienced IDR. The prevalence of IDR varied across substance use groups, 8.0% among nonuse, 21.9% among alcohol-only use, 35.9% among cannabis-only use, and 49.6% among dual use groups. Gender diverse, older, and students with lower socioeconomic status exhibited a higher likelihood of reporting alcohol-cannabis-IDR. Dual use was significantly associated with 9.5 times higher odds of alcohol-cannabis-IDR compared to alcohol-only use, and 3.0 times higher odds compared to cannabis-only use. Dual use was also associated with an increased likelihood of either alcohol- or cannabis-IDR.

CONCLUSIONS

This study highlights that all students, regardless of substance use, are at risk of IDR, but students engaged in dual use of alcohol and cannabis face an elevated risk compared to both peers who do not use substances and those who use only a single substance. These findings emphasize the importance of targeted interventions that address the risks associated with IDR.

Driving Under the Influence of Alcohol, Cannabis, and Delta-8 THC: Perceived Likelihood, Risk Perceptions, and Behaviors

Driving under the influence (DUI) of alcohol or cannabis poses public health risks. Little is known about DUI of Delta-8 THC, a newer cannabis product. Using 2022 survey data among 189 U.S. adults ages 18-25 (58.73% male, 59.26% non-Hispanic White), multivariable logistic regression examined substance-specific (alcohol, cannabis, Delta-8) DUI perceived likelihood and risk in relation to past-year DUI among those with past-year use of each. Overall, 72.49% reported past-year alcohol use, 50.53% cannabis, and 22.46% Delta-8. Among those reporting past-year use of each respective substance, 33.58% reported DUI of alcohol, 32.63% cannabis, and 57.14% Delta-8. On average, participants had the same DUI perceived likelihood ("somewhat unlikely") across substances and perceived alcohol DUI as riskiest. Higher alcohol DUI perceived likelihood and lower perceived risk were associated with alcohol-related DUI. Greater cannabis-related perceived likelihood (but not risk) was associated with cannabis-related DUI. Neither Delta-8 DUI perceived likelihood nor risk were associated with Delta-8 DUI. In sum, perceived DUI likelihood for alcohol, cannabis, or Delta-8 tended to be similar. Among those with past-year use of each, the proportion of DUI was highest for Delta-8. Interventions should target DUI-related perceived likelihood and promote protective behavioral strategies that reduce substance-specific DUI risk.

Do crashed drivers need more drug testing? A retrospective analysis of blood samples from hospitalised post-crash drivers in New Zealand

Driving under the influence of alcohol and other drugs is a prominent safety concern in New Zealand and across the world. While alcohol testing is routinely performed for drivers involved in hospitalisation crashes, testing for other drugs is often not undertaken. The present study refers to 530 traffic crashes that occurred from October 2019 to January 2020 on New Zealand roads. The blood samples from 550 drivers who were injured in a crash and were admitted to a hospital (66% of all drivers involved in these crashes), previously tested for drugs and/or alcohol, were retested for a wider range of drugs. Alcohol above the applicable limit was found to be present in 38% of hospitalised drivers, while other drugs of interest were found in 47% of hospitalised drivers. Binary logistic regression was used to predict the presence of drugs of interest for a crashed driver using previous offence data. A driver having at least one prior drink and drug driving offence is 61% more likely to be positive for a drug of interest when involved in a crash. Similarly, a driver having at least one prior non-traffic drug offence is 4.7 times more likely to be positive for at least a drug of interest when involved in a crash. While the presence of a drug or drugs cannot be presumed to have played a role in the occurrence of the crash, this study has provided a unique and comprehensive picture of the presence of various drugs present in New Zealand drivers' blood. It is recommended to consider standardising drug testing on all blood specimens taken in relation to a serious injury or fatal crash. This procedure is not only of interest for information purposes but may importantly inform appropriate charging decisions.

Drug driving: a secondary analysis of factors associated with driving under the influence of cannabis in Jamaica

OBJECTIVES

To determine cannabis use patterns, the predictive sociodemographic correlates of driving under the influence of cannabis (DUIC) and the association between risk perception and cannabis dependence among vehicle drivers in Jamaica.

DESIGN

Secondary data analysis.

SETTING

Used the Jamaica National Drug Prevalence Survey 2016 dataset.

PARTICIPANTS

1060 vehicle drivers extracted from the population sample of 4623.

PRIMARY AND SECONDARY OUTCOME MEASURES

Analysis used Pearson's χ2 test and logistic regression. ORs and 95% CIs were recorded. A p<0.05 was considered statistically significant.

RESULTS

More than 10% of Jamaican drivers admitted to DUIC in the past year. Approximately 43.3% of drivers who currently use cannabis reported DUIC only. Evidently, 86.8% of drivers who DUIC were heavy cannabis users. Approximately 30% of drivers with moderate to high-risk perception of smoking cannabis sometimes or often were dependent on cannabis. Notwithstanding, drivers with no to low-risk perception of smoking cannabis sometimes or often were significantly likelier to be dependent (p<0.001 and p<0.001, respectively). Logistic regression highlighted male drivers (OR 4.14, 95% CI 1.59 to 14.20, p=0.009) that were 34 years and under (OR 2.97, 95% CI 1.71 to 5.29, p<0.001) and were the head of the household (OR 2.22, 95% CI 1.10 to 4.75, p=0.031) and operated a machine as part of their job (OR 1.87, 95% CI 1.09 to 3.24, p=0.023) were more likely to DUIC, while those who were married (OR 0.42, 95% CI 0.22 to 0.74, p=0.004) and had achieved a tertiary-level education (OR 0.26, 95% CI 0.06 to 0.76, p=0.031) were less likely.

CONCLUSIONS

Two in five Jamaican drivers, who currently smoke cannabis, drive under its influence, with over 85% engaging in heavy use. Public health implications necessitate policy-makers consider mobile roadside drug testing and amending drug-driving laws to meet international standards.

Driving under the influence of cannabis versus alcohol: A mixed-methods study examining perceptions and related risk behaviors among US and Israeli adults

BACKGROUND

Despite the dangers of driving under the influence (DUI), little is known about DUI substance-specific risk perceptions or risk factors for riding with drunk/drugged drivers (RDD).

METHODS

In this sequential exploratory mixed-methods study, we conducted: 1) multivariable analyses of cross-sectional survey data from 2222 US and Israeli adults to identify correlates of perceived cannabis- vs. alcohol-related DUI risks (linear regression) and past-month RDD involving alcohol-only, cannabis-only, or both (alcohol-cannabis) (multinomial logistic regression); and 2) deductive-inductive thematic analyses of qualitative interview data from 84 participants to identify themes elaborating on survey findings regarding DUI-related risk perceptions.

RESULTS

54.0 % reported past-month alcohol use, 16.7 % cannabis use, 4.2 % alcohol-only RDD, 5.5 % cannabis-only RDD, and 7.9 % alcohol-cannabis RDD. Being from the US, not having children at home, and cannabis non-use correlated with lower perceived cannabis vs. alcohol DUI risk. Lower perceived cannabis vs. alcohol DUI risk correlated with cannabis-only and alcohol-cannabis (vs. no) RDD, and with alcohol-cannabis (vs. cannabis-only) RDD. Alcohol use correlated with alcohol-only (vs. no) RDD and alcohol-cannabis (vs. cannabis-only) RDD. Cannabis use correlated with cannabis-only and alcohol-cannabis (vs. no) RDD, and with alcohol-cannabis (vs. alcohol-only) RDD. Being from the US correlated with alcohol-only (vs. alcohol-cannabis and none) RDD and cannabis-only (vs. alcohol-cannabis) RDD; being from Israel correlated with alcohol-cannabis (vs. no) RDD. Qualitative data indicated most participants perceived greater risk of DUI of alcohol vs. cannabis and desired more effective DUI-related prevention and regulatory efforts.

CONCLUSIONS

Prevention interventions targeting DUI- and RDD-related risk perceptions are needed, particularly for high-risk populations.

Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map

Background

Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy-relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms.

Objectives

This evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps.

Search Methods

We comprehensively searched for eligible English-language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020.

Selection Criteria

The conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population-level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer-term consequences (health, safety, and socioeconomic outcomes) of these laws.

Data Collection and Analysis

Both dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2.

Main Results

The EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws-including CBDLs, IHLs, and DCLs-are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid-related harms (3), and alcohol-related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality.

Authors’ Conclusions

More primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer-term-and arguably more salient-health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions.

Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia

INTRODUCTION

Self-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood.

METHODS

We followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors.

RESULTS

Adolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes.

DISCUSSION

Our findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.

Drunk driving: a secondary analysis of factors associated with driving under the influence of alcohol in Jamaica

OBJECTIVES

To determine the prevalence of alcohol use patterns, sociodemographic factors and risk of alcohol dependence among vehicle drivers in Jamaica.

DESIGN

A secondary data analysis.

SETTING

This study was conducted using the Jamaica National Drug Prevalence Survey 2016 dataset.

PARTICIPANTS

This included 1060 vehicle drivers derived from the population sample of 4623. The participants from each household were randomly selected as the respondent for the survey.

PRIMARY AND SECONDARY OUTCOME MEASURES

Alcohol use and dependence were measured using the Alcohol Use Disorders Identification Test questionnaire. Driving under the influence of alcohol (DUIA) was assessed by questions regarding its use in the past 12 months. The analysis involved the use of Pearson's χ2 test and logistic regression.

RESULTS

75% of Jamaicans reported lifetime alcohol use. Approximately 65% of drivers indicated that they currently drink alcohol. 18% of drivers who currently drink alcohol admitted to DUIA. Reportedly, 54.5% of these drivers were alcohol binge drinkers, with 41.5% also driving under the influence of cannabis. The bivariate analysis demonstrated that DUIA was higher among Christian participants and those who worked in non-machine operator jobs (p=0.002 and p=0.008, respectively). Vehicle drivers altogether and drivers who drive under the influence of alcohol had significant associations with hazardous drinking (p=0.011 and p<0.001, respectively). Logistic regressions highlighted drivers 34 years and under (p=0.012), male drivers (p=0.002) and the head of the household (p=0.050) were 1.82, 3.30 and 1.86 times more likely, respectively, to report driving under the influence of alcohol in the past year.

CONCLUSIONS

The prevalence of alcohol use among Jamaica's population and vehicle drivers is high. That one in five drivers, who currently consume alcohol, also admits to driving under the influence suggests the urgent need for mitigation strategies and legislative action as part of a preventative effort to reduce drunk driving.

Sharing roads with automated vehicles: A questionnaire investigation from drivers', cyclists' and pedestrians' perspectives

Despite the promised benefits, the introduction of Automated Vehicles (AVs) on roads will be confronted by many challenges, including public readiness to use those vehicles and share the roads with them. The risk profile of road users is a key determinant of their safety on roads. However, the relation of such risk profiles to road users' perception of AVs is less known. This study aims to address the above research gap by conducting a cross-sectional survey to investigate the acceptance of Fully Automated Vehicles (FAVs) among different non-AV-user groups (i.e., pedestrians, cyclists, and conventional vehicle drivers). A total of 1205 road users in Queensland (Australia) took part in the study, comprising 456 pedestrians, 339 cyclists, and 410 drivers. The Theory of Planned Behaviour (TPB) is used as the theoretical model to examine road users' intention towards sharing roads with FAVs. The risk profile of the participants derives from established behavioural scales and individual characteristics are also included in the acceptance model. The study results show that pedestrians reported lowest intention in terms of sharing roads with FAVs among the three groups. Drivers and cyclists in a lower risk profile group were more likely to report higher intention to share roads with FAVs than those in a higher risk profile group. As age increased, pedestrians were less likely to accept sharing roads with FAVs. Drivers who had more exposure time on roads were more likely to accept sharing roads with FAVs. Male drivers reported higher intention towards sharing roads than female drivers. Overall, the study provides new insights into public perceptions of FAVs, specifically from the non-AV-user perspective. It sheds light on the obstacles that future AVs may encounter and the types of road users that AV manufacturers and policymakers should consider closely. Specifically, groups such as older pedestrians and road users who engage in more risky behaviours might resist or delay the integration of AVs.

Did the cannabis recreational use law affect traffic crash outcomes in Toronto? Building evidence for the adequate number of authorised cannabis stores' thresholds

INTRODUCTION

In the past decade, a group of studies has begun to explore the association between cannabis recreational use policies and traffic crashes. After these policies are set in place, several factors may affect cannabis consumption, including the number of cannabis stores (NCS) per capita. This study examines the association between the enactment of Canada's Cannabis Act (CCA) (18 October 2018) and the NCS (allowed to function from 1 April 2019) with traffic injuries in Toronto.

METHODS

We explored the association of the CCA and the NCS with traffic crashes. We applied two methods: hybrid difference-in-difference (DID) and hybrid-fuzzy DID. We used generalised linear models using CCA and the NCS per capita as the main variables of interest. We adjusted for precipitation, temperature and snow. Information is gathered from Toronto Police Service, Alcohol and Gaming Commission of Ontario, and Environment Canada. The period of analysis was from 1 January 2016 to 31 December 2019.

RESULTS

Regardless of the outcome, neither the CCA nor the NCS is associated with concomitant changes in the outcomes. In hybrid DID models, the CCA is associated with non-significant decreases of 9% (incidence rate ratio 0.91, 95% confidence interval 0.74,1.11) in traffic crashes and in the hybrid-fuzzy DID models, the NCS are associated with nonsignificant decreases of 3% (95% confidence interval - 9%, 4%) in the same outcome.

DISCUSSION AND CONCLUSIONS

This study observes that more research is needed to better understand the short-term effects (April to December 2019) of NCS in Toronto on road safety outcomes.

What contributes to drug driving? An exploratory investigation into the influence of problematic substance use, roadside testing and alternative transport options

Despite a strong reliance on enforcement approaches to prevent drug driving in Australia, this behaviour is still prevalent. The objective of this study was to investigate the influence of problematic drug use (i.e., showing indications of addiction), exposure to roadside drug testing, the use of detection avoidance strategies, and perceptions relating to alternative transport options on drug driving among illicit drug users. A total of 1,541 licensed drivers from the states of Queensland, New South Wales, and Victoria completed an online survey. The survey collected demographic and problematic substance use information, as well as items assessing drug driving behaviour. Cannabis was reported to be the most commonly used drug (36.0%); the most common drug of problematic use (27.9%), and the drug most often taken prior to driving (43.5%). Observing police operating Roadside Drug Tests (RDT) was more common among the participants than being tested by RDT (35.7% vs 23%). The results indicated a significant association between being a drug driver and observing or being tested by RDT. The drug drivers were significantly more likely to report using a range of strategies to avoid police detection than the non-drug drivers. Similarly, the drug drivers reported that it was more difficult for them to use various alternative transport options than the non-drug drivers. Decision tree analyses found that significant predictors of self-reported drug driving were problematic drug use, holding a provisional or probationary licence, earning a low- or middle-income, and using detection avoidance strategies like remaining watchful for police vehicles and taking back streets. The findings of this study suggest that ongoing improvements to drug driving enforcement will need to be complemented by health-based approaches designed to reduce drug abuse and dependence, and improvements to public transport, in order to achieve a sustainable reduction in drug driving.

Risk Factors Associated With Driving After Marijuana Use Among US College Students During the COVID-19 Pandemic

PURPOSE

To assess the sociodemographic and behavioral risk factors associated with driving after marijuana use among US college students.

METHODS

A secondary analysis used the fall 2020 and spring 2021 American College Health Association- National College Health Assessment III and the dataset was restricted to college students ≥18 years of age who reported recent driving and marijuana use. Associations between risk factors and driving after marijuana use were estimated using multivariable logistic regression.

RESULTS

A total of 29.9% (n = 4,947) of the respondents reported driving after marijuana use. Males (adjusted odds ratio [AOR]: 1.64, 95% confidence interval [CI]: 1.48-1.82), non-Hispanic Black (AOR: 1.32, 95% CI: 1.02-1.71), sexual minorities (AOR: 1.19, 95% CI: 1.07-1.31), individuals with an alcohol or substance use disorder (AOR: 1.44, 95% CI: 1.08-1.91), anxiety (AOR: 1.20, 95% CI: 1.06-1.36), higher suicidality (AOR: 1.18, 95% CI: 1.07-1.31), and those who also drank and drove (AOR: 3.18, 95% CI: 2.84-3.57) had a higher risk of driving after marijuana use.

DISCUSSION

Future research should focus on increasing awareness of driving after marijuana use and prevention programs and/or strategies on college campuses regarding driving after marijuana use for these groups to reduce this risky behavior.

A study of self-reported personal cannabis use and state legal status and associations with engagement in and perceptions of cannabis-impaired driving

Objective: The objectives of the current study were to (1) characterize predictors of perceived risk of driving within 2 h of cannabis use and driving after cannabis use in a sample of adults who have used cannabis in the past year and (2) determine whether the influence of these predictors vary by state legalizations status.Methods: Data for this study were from online surveys. Study participants from Colorado, Iowa, and Illinois were included if they reported being between 25 and 40 years old and had a history of cannabis use. Outcome variables included (1) days of cannabis use per month, (2) reported driving within 2 h of cannabis use (vs. not driving within 2 h as reference), (3) proportion of driving after cannabis use days per month (days of driving a car within 2 h of cannabis use per month/days of cannabis use per month), and (4) perception of safety of driving after cannabis use. Potential predictors included age of first use of cannabis, gender, education status, and state of residence. The SAS GLMSELECT Procedure was used for the analysis.Results: Increased age of first use of cannabis was associated with decreased days of cannabis use per month (B = -0.51 days/month per year), a reduction in the proportion of driving after cannabis use days per month (B = -0.02 per month), and decreased perception of safety of driving after cannabis use (B = -0.06 per year). Female gender was also associated with less use (B = -2.3 days per month), a lower proportion of driving following use (B = -0.06 days driving/days used), and decreased perception of safety (B = -0.29). In addition, residents of Colorado reported using the most days, had the highest likelihood of driving within 2 h of use, and had the most positive perceptions of being able to safely drive after cannabis use.Conclusions: The delay in onset of cannabis use may mitigate its use among adults and driving after cannabis use. This has important implications for driver safety. Intervention programs for reducing cannabis's effects on driving should focus on individuals with early onset of use, male drivers, and drivers in states where cannabis for adult recreational use is legalized.

[Decision-making process and evaluation of public health interventions]

Objectif

Nous proposons un cadre méthodologique destiné aux experts impliqués dans l'appui à la décision concernant les interventions de santé publique.

Méthodes

Le cadre méthodologique comprend quatre éléments : 1) une série de neuf questions, formulées en termes non techniques, pertinentes pour juger de l'utilité d'une intervention, considérée à un moment donné dans un contexte donné ; 2) une traduction de ces questions en concepts liés à l'évaluation des interventions (définition de l'intervention, de sa cible et de son objectif, efficacités potentielle et réelle, sécurité, efficience et équité) ; 3) une organisation logique des informations nécessaires pour répondre aux questions ; 4) un algorithme permettant de traduire les informations disponibles en recommandations sur l'utilité réelle de l'intervention dans le contexte où les questions ont été posées.

Résultats

Chaque étape est illustrée par des questions posées sur des interventions de sécurité routière, le dépistage, la transfusion sanguine et des mesures proposées pendant la pandémie de COVID-19.

Conclusion

La décision peut être facilitée si les experts fournissent aux décideurs un résumé formel des forces et faiblesses des connaissances, fondé sur une analyse de toutes les facettes de l'utilité potentielle d'une intervention.

Understanding sexual activity while driving as a form of distracted driving

Sexual activity while driving has been reported in emerging research. Sexual activity while driving is a form of distracted driving because it includes an individual (the driver) who deviates resources from the primary task (driving) towards a secondary task (sexual activity). However, most of our current knowledge about the range of sexual activities while driving is based on self-reported data or media reports. Thus, an in-depth understanding of sexual activities while driving and their interactions with non-sexual driving behaviours and vehicle control is missing. Additionally, there is limited information on the context of where sexual activities while driving occurs and the influence of factors such as the environment, the vehicle, interactions with other road users, and other in-vehicle distractions. To cover this gap, a content analysis of sexually explicit media (SEM) was conducted on a sample of 270 videos depicting real driving. We conducted descriptive analyses and used decision tree analysis to explore the association between sexual activities while driving and their interactions with non-sexual driving behaviours and vehicle control. The videos portrayed a naturalistic driving situation of a driver of a moving vehicle engaging in sexual activity. The results show that when engaging in sexual activity, drivers do not present safe vehicle control. Sexual activity imposes additional cognitive, physical, and visual demands on the driver, thereby decreasing safety. Similar to other distractions, drivers engaging in sexual activity while driving appear to mitigate risks. Concerning the potential for legal sanctions, it appears that drivers may attempt to conceal sexual activity by reducing their visible nudity and minimising interactions with other road users. Finally, mobile phones and cameras appear to interact with sexual activities while driving, by imposing potential restrictions on the range of sexual activities. Implications for policymakers and practitioners are discussed.

Illicit Drug Use among Commercial 'Boda Boda' Motorcyclists in Uganda

Background: Illicit drug use is a global public health problem with grave health and socio-economic consequences. Related intoxication has been associated with accidental injuries and fatalities. In Uganda, 67% of road traffic accidents are attributed to motorcyclists. Methods: This study assessed the prevalence and determinants of illicit drug use among commercial motorcyclists in Uganda, using a cross-sectional survey research design. We interviewed 785 commercial motorcyclists in the divisions of Nakawa, Rubaga, Makindye, and Kawempe of Kampala district. We used an on-spot saliva drug test kit to screen and detect the presence of illicit drugs. Data were analyzed using frequency distributions, cross tabulations and multi variable logistic regression. Results: Findings show that 11% of the cyclists used illicit drugs. The use of illicit drugs was associated with division of operation, religiosity, and whether a cyclist resided with a family. The odds of use of illicit drugs were higher among cyclists from Nakawa division compared to cyclists from Kawempe. Cyclists who went to places of worship on a weekly basis compared to those who were less frequent, and cyclists who lived with their families compared to those who did not, had reduced odds of use of illicit drugs. There are variations in the distribution of cyclists that use illicit drugs in Kampala. Religious commitment and residence with families had a mitigating influence on illicit drug use among commercial cyclists. Conclusion: Illicit drug use prevention, treatment, and harm reduction programs among cyclists should collaborate with faith-based organizations and other key stakeholders, and promote stable family relations.