Drinking and driving in university students: An international study of 23 countries

Alcohol-impaired driving is a major problem in many countries. We assessed drinking and driving and associated attitudes and legislative practices in 8282 male and 10 816 female students at universities in 23 countries. The age-adjusted prevalence of drinking and driving was 20% in men, and 7% in women. There was wide variation between countries, with the highest levels in men and women from the USA and men from South American and Mediterranean countries. Rates correlated significantly with national surveys of drinking and driving, and with national road traffic accident death rates. Drinking and driving was more prevalent in country samples in which the legal blood alcohol threshold was higher. Attitudes to drinking and driving and other aspects of hazardous driving were strongly associated with drinking and driving both within and between countries. A multi-level approach involving changes in blood alcohol laws and efforts to shift the attitudes of individuals who drink and drive is suggested by the current results.