Challenging Dogma - Fall 2007

...Using the social and behavioral sciences to improve the practice of public health.

Wednesday, December 12, 2007

Why “Buzzed Driving” is not “Drunk Driving”: A Look at a Misleading Driving Under the Influence Campaign – Amber Solivan

Alcohol related motor vehicle accidents account for approximately 40% of all motor vehicle deaths. This is a prime public health concern as an additional 18,000 deaths would be prevented if drivers did not drive while intoxicated. Men that are involved in a motor vehicle accident are twice as likely as women to be intoxicated. Persons aged 21 to 34 comprise the highest percent of persons driving under the influence however men aged 18 to 21 reported driving under the influence more frequently than any other age group. Additionally 159 million people self-reported driving while intoxicated however only 1.4 million drivers were arrested for this offence (1,2).

The effects of alcohol on driving safety were not studied in the United States until the 1930’s. Initial observations were made in 1934 by Heise about how alcohol impairs driver judgment and overall safety; however, it was not until 1968 that the US Department of Transportation and National Highway Traffic Safety Administration (NHTSA) began reviewing alcohol-crash associations and initiating ways to try to prevent alcohol related vehicle crashes (3). Over time many different campaigns have been used to educate and prevent alcohol related car accidents and deaths. In 1992 the US Department of Transportation and the NHTSA began the most historic and well known anti-drunk driving campaign “Friends Don’t Let Friends Drive Drunk” (FDLFDD) (4). Although this campaign brought drunk driving levels to historic lows in the late 1990’s the incident of deaths from drivers with a BAC over the legal limit rose from 13,000 in 2004 to 15,000 in 2006 (3,5).

In response to the rise in drunk driving deaths the NHTSA commenced a new campaign in 2005, “Buzzed Driving is Drunk Driving” (Buzzed Driving). This campaign used public service announcements (PSA) on TV and radio as well as billboards. It is unclear exactly what the message was, but I believe the message is that if you feel “buzzed,” you are impaired and over the legal limit. Statistically significant data about the direct success of the campaign is not readily available however since 2005 there has been no change in the number of drunk driving accidents and there has been an increase in the number of drunk driving deaths. The campaign sought to build on the success of the FDLFDD campaign however it was a flawed public health intervention because of its failure to provide a clear and accurate message. The campaign also failed to account for social norms surrounding social drinking in the US population, especially among 21 to 34 year olds. Finally the campaign used properties of an inappropriate model.

Buzzed Driving Campaign Failed to Relate a Clear Message
An essential part of a public health campaign is that the target audience understands the message that is being conveyed. The Buzzed Driving is Drunk Driving campaign failed to relate a clear and strong message causing confusion and misleading the audience. The TV PSA used for this campaign consisted of two categories of people aged in their early twenties to their mid thirties. The first category is someone that is clearly over the legal limit and is shown moving with impaired motor skills, and acting uninhibited. The second category is someone that takes a few sips of a drink that is still half full and then picks up their car keys to drive home. The PSA is making the inference that the person taking that “last sip” from a partially full drink is “buzzed” and should not drive home, however because there are not multiple empty glasses shown and the drink that is being drank from is still half full the visual message being portrayed is that having any alcohol before driving is illegal, which is untrue.

When the NHTSA launched this campaign they sought to address the impaired driver with the message that if you have had enough to drink to feel “buzzed” or in any type of altered state than you are too impaired to drive (2). However neither the NHTSA nor any other organization has defined the feeling of a “buzz” for the population. The concept of a “buzz” is undefined but is a term used in popular culture to describe someone’s physical state in relation to impairment. Intoxication is measured by the amount of alcohol in your blood commonly referred to as a blood alcohol concentration or level (BAC). The BAC is a percent of alcohol in your blood stream measured by the weight of alcohol in a certain volume of blood at a certain point in time and reflects the amount of alcohol you consumed within 30 to 70 minutes (4). There is not a BAC to reflect a “buzz,” nor is there a certain level of impairment that coincides with a “buzz”. Research has shown that at a BAC of 0.02% an individual may experience a relaxed state and visual function may decline, while at a BAC of 0.05% the person may have exaggerated behavior and experience reduced coordination (4). However neither of these BACs and the resulting impairments was associated with a “buzz” in the campaign message. Therefore, the campaign is in essence leaving it up to the individual to determine their limits and their ability to drive, the campaign is not educating the audience. The audience already knows that drinking to intoxication can lead to impaired judgment possibly leading to motor vehicle accidents, arrest, or even death. They have been determining their own limits yet they have been choosing to drive with a “buzz”. Further these are consequences known by a rational population; however, someone who is impaired is not rational and therefore is unable to make these associations. If the issue being addressed by the campaign is actually “buzzed”= drunk than the social norm definition of “buzzed” needs to be changed by the PSA. If the issue being addressed by the campaign is actually “buzzed”= impaired and impaired=dangerous than the social norm of no drinking and driving must be changed by the PSA. Neither of these issues was addressed by the PSA.

Further misdirection of this campaign can be seen when researching the reactions of people after the campaign was launched. A popular legal blogger, Blonde Justice, made this statement on her blog, “The point of this ad campaign, I believe, is to draw the following line of thought: Buzzed Driving = Drunk Driving = Illegal...Therefore, Buzzed Driving = Illegal[…]It's a clear misstatement of the law…it is only illegal to drive while legally intoxicated.”(6) The Idaho Transportation Department misinterpreted the definition of impairment and interpreted the PSA similarly to the blogger as buzzed driving is illegal, they failed to clearly state the purpose of the campaign or interpret the word buzzed (7). A prominent news caster from ABC Laura Marquez, translated “impaired” as anyone with a BAC above 0.08% (8). Unfortunately this important message about impairment was lost on ineffective advertising and inconsistent messages. Different BACs lead to different levels of impairment, this important information was missing from the campaign and could have been used to strengthen or at least clarify its message.

Buzzed Driving Campaign Fails to Account for Social Norms
Consuming alcohol with friends and family is a social norm in this country and many other countries. The Buzzed Driving campaign makes the implication that consuming an alcoholic beverage and driving is equivalent to drunk driving. The NHTSA assumes that individuals at a social function where there is consumption of alcohol will perceive themselves as being at risk. This perception of individual risk contributes to the campaign’s failure to define “buzzed” for the audience and the audience’s failure to establish safer personal limits. Many people do not feel that they can or want to attend various social functions and not consume any alcohol because it is part of their social norm. Therefore because they do not desire not to drink they will most likely continue with the assumption that they know their limits and not pay close attention to how many drinks they have had. In the perceived threats theory an individual must feel that a particular behavior or action will be a threat to them. In this instance 159 million people drove under the influence and only 1.4 million were arrested in 2006 (1), even more people have at one point had a drink and driven and they have not had adverse consequences, therefore in this case the perception of danger must be changed for the behavior to change.

Social norms have a strong influence on how people behave. The relationship between social norms and drinking has been studied extensively. Multiple studies have been conducted and shown that people often overestimate the alcohol consumption of their peers which encourages an overall increase in their own alcohol consumption (9). The Buzzed Driving campaign does not address this social norm and is especially flawed due to the misleading visuals of the campaign. One PSA used depicts a man getting ready to leave a wedding. Among drinkers, it is a social norm to drink at a celebration, in this case a wedding where the social norm often includes a champagne toast. The misleading visuals of the PSA suggest that it is not safe to have a drink at a wedding and then drive home. The social norms would not agree with this deduction, as many people have had a drink and drove and not suffered consequences, and therefore this campaign fails.

In addition to effect of perceived alcohol consumption, research performed on college campuses across the country have shown that college students were more likely to drink and to drink to intoxication based upon the social event and celebration they were attending (10). Studies have also shown that the amount of drinking on campus can be decreased by distributing accurate information on the amount of alcohol that is actually consumed by the other students, which is frequently less than their peers expected (11). These social norms identified among college students may be applied to the social norms among the general population on a lesser scale where celebratory drinking is the practiced norm and as such individuals are not likely to feel the need or desire to deviate from this norm. Drunk driving statistics support this as 21 to 34 year olds that are still drinking to excess and driving which matches their college counterparts on these occasions.

Buzzed Driving Campaign Misuses of Models
The Buzzed Driving campaign used aspects of the health belief model (HBM) which incorrectly assumes that intention is a direct predictor of behavior. It also used the theory of planned behavior (TPB) which incorrectly focuses on rational and reasoned behavior by the individual. The HBM does not take into account influences on decisions such as learned behavior and perceptions surrounding drinking. The HBM also does not account for the social norms surrounding drinking previously discussed.

The principles the campaign uses from the HBM fail to account for the social influences and norms that surround individuals. Social influences include those influences and norms felt by society and by one’s peer group. As stated previously it is well documented that persons who perceive their peers as drinking heavily will they themselves drink heavily (12). Additionally it has been found that norms predict drinking; however, drinking does not predict the perceived norms (12). Therefore if the perceived norm is changed the behavior will change. The behavior will not change the norm.

The principles the campaign uses from TPB assumes that those who have been consuming alcohol will rationally consider their decisions. This model assumes a high level of rational thought by the individual which is contradictory to being under the influence of alcohol. Research performed by the NHTSA indicated that judgment becomes impaired with a BAC as low as 0.02%. The campaign takes for granted that an individual who is “buzzed” would be able to understand their level of impairment. This level of rational thought may be a reason that the FDLFDD campaign was so successful; the responsibility was in the hands of someone who was thinking rationally and not in that of the impaired.

The Buzzed Driving campaign potentially holds an important message to all drivers; although the intended message is unclear, it potentially holds that driving when you feel any effect of alcohol is impairment and is dangerous. The NHTSA was very successful in bringing to light the dangers of drunk driving; however the NHTSA’s “Buzzed Driving is Drunk Driving” campaign is a flawed public health intervention because it failed to convey a clear and therefore compelling message. This unclear message was compounded by the neglect to account for social norms surrounding drinking at social occasions. The campaign was also flawed because it used aspects of inappropriate behavioral models that lead to its lack of efficacy. It is unclear whether the NHTSA was trying to change the social norm of consuming any alcohol and then driving. This lack of clarity in message further negates the merits of this campaign.


1. Centers for Disease Control and Prevention. Impaired Driving. Atlanta, GA.
2. National Highway Traffic Safety Administration. Traffic Safety Facts: 2006 Traffic Safety Annual Assessment – Alcohol Related Fatalities. Washington, DC: NHTSA’s National Center for Statistics and Analysis, August 2007.
3. US Department of Transportation. National Highway/Traffic Safety Administration. Alcohol and Highway Safety 2001: A Review of the State of Knowledge, 2001.
4. Ad Council. Drunk Driving Prevention.
5. National Highway Traffic Safety Administration. The ABCs of BAC: A Guide to Understanding Blood Alcohol Concentration and Alcohol Impairment. Washington, DC, 2005.
6. Blonde Justice. Buzzed Driving is…Legal. No location, 2005.
7. Idaho Transportation Department. ITD reminds drivers that "buzzed" driving is drunk driving this St. Patrick's Day. Boise, Id: Office of Highway Operations and Safety, 2007.
8. Marquez, Laura. Buzzed Driving is Drunken Driving. ABC, December 28, 2005.
9. Dunnagan, T., Haynes, G., Linkenbach, J, Summers, H. Support for Social Norms Programming to Reduce Alcohol Consumption in Pregnant Women. Addiction Research and Theory,August 2007; 15(4):383-396.
10. Glindermann, K., Wiegand, D., Geller, E. Celebratory Drinking and Intoxication. Environment and Behavior, 2007; 39(3): 352-366.
11. The Higher Ed Center. The Social Norms Approach: Theory, Research and Annotated Bibliography: What is the Effect of Correcting Misperceptions? Successful Interventions Utilizing the Social Norms Approach. August 2004.
12. Neighbors, C., Dillard, A.J., Lewis, M.A., Bergstrom, R.L., and Neil, T.A. Normative Misperceptions and Temporal Precedence of Perceived Norms and Drinking. Journal of Studies on Alcohol, 2006, 67(2): 290-299.

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  • At December 13, 2007 at 7:19 AM , Anonymous Meg Gavaghan said...

    Amber -- Really interesting comparison between the two campaigns...I agree that the social aspect of drinking is certainly an influence on whether or not a person chooses to consume. Great job!

  • At December 18, 2007 at 8:51 AM , Anonymous Nicole M said...

    It’s surprising to realize that only 1.5 million out of the 145 million drunk drivers are arrested each year, which is a scary statistic! Nice job in shedding some light on the current interventions and critiquing them!


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