Intervention Review

Alcohol ignition interlock programmes for reducing drink driving recidivism

  1. Charlene Willis1,*,
  2. Sean Lybrand2,
  3. Nicholas Bellamy1

Editorial Group: Cochrane Injuries Group

Published Online: 19 JUL 2004

Assessed as up-to-date: 8 MAY 2004

DOI: 10.1002/14651858.CD004168.pub2


How to Cite

Willis C, Lybrand S, Bellamy N. Alcohol ignition interlock programmes for reducing drink driving recidivism. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004168. DOI: 10.1002/14651858.CD004168.pub2.

Author Information

  1. 1

    The University of Queensland, Centre of National Research on Disability and Rehabilitation Medicine, Brisbane, Queensland, Australia

  2. 2

    Merck, Sharp & Dohme (Australia) Pty Ltd, Health Outcomes, Granville, New South Wales, Australia

*Charlene Willis, Centre of National Research on Disability and Rehabilitation Medicine, The University of Queensland, Level 3, Mayne Medical School, Herston Road, Brisbane, Queensland, 4006, Australia. charlene@qimr.edu.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 JUL 2004

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

An ignition interlock device is part of a multi-dimensional programme aimed at reducing recidivism in convicted drink drivers. To operate a vehicle equipped with an ignition interlock device, the driver must first provide a breath specimen. If the breath alcohol concentration of the specimen exceeds the predetermined level, the vehicle will not start. As a measure to reduce circumvention of the device (i.e. someone else blows into the mouthpiece), random retests are required while the vehicle is running. Other components of the drink driving programme include information seminars for the driver and downloading data from the device's data logger, which logs all test attempts and records all passes, warnings and failures.

Objectives

To systematically assess the effectiveness of ignition interlock programmes on recidivism rates of drink drivers, by examining rates of recidivism while the ignition interlock device was installed in the vehicle and after removal of the device.

Search methods

We searched The Cochrane Injuries Group's Specialised register (Sept 2002), MEDLINE (1966 to August 2002), PubMed (to Aug 2002), EMBASE (1980 to Sept 2002), TRANSPORT (1988 to 2002 issue 06), CENTRAL (The Cochrane Library 2002, Issue 3), The Science Citation Index (1980 to Sept 2002)
National Research Register (2002, issue 3). We also searched the Internet using various search engines.

Selection criteria

Controlled trials in which offenders have been charged with drink driving and have either been sentenced to participate in an ignition interlock programme or the usual punishment (either licence suspension or some form of treatment programme). This study was not restricted by language or status of publication.

Data collection and analysis

One randomised controlled trial (RCT) and ten controlled trials were identified, and also three ongoing trials. Data regarding recidivism while the interlock is installed in the vehicle; after the interlock has been removed from the vehicle and total recidivism during the study were extracted and entered into analyses using RevMan.

Main results

The RCT showed that the interlock programme was effective while the device was installed in the vehicle; relative risk 0.36 (95% confidence interval 0.21 to 0.63). Controlled trials support this conclusion, with a general trend − in both first-time and repeat offenders − towards lower recidivism rates when the interlock device is installed. Neither the RCT nor the controlled trials provide evidence for any effectiveness of the programmes continuing once the device has been removed.

Authors' conclusions

In order to eliminate potential selection bias, more RCTs need to be conducted in this area so that effectiveness, as well as efficacy, can be ascertained. The interlock programme appears to be effective while the device is installed in the vehicle of the offender. Studies need to address ways of improving recidivism rates in the long term, as the major challenges are participation rates, compliance and durability.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Alcohol ignition interlocks may stop repeat drink driving offences, but only as long as they are still fitted

Convicted drink drivers are sometimes offered the choice of a standard punishment, or for an alcohol ignition interlock to be fitted to their car for a fixed period. To operate a vehicle equipped with an interlock, the driver must first give a breath specimen. If the breath alcohol concentration of the specimen is too high, the vehicle will not start. A number of studies have been conducted to see whether the interlock stops drink drivers from offending again. Most of these studies have not been of high quality. The interlock seems to reduce re-offending as long as it is still fitted to the vehicle, but there is no long-term benefit after it has been removed. However, more studies of good quality are needed to confirm these findings. The low percentage of offenders who choose to have an interlock fitted also makes it difficult to reach firm conclusions about their effectiveness.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

推動酒測發動鎖定裝置計劃以降低酒駕再犯率

酒測發動鎖定裝置是降低酒駕發生率多元計劃中重要的一環。要發動一輛安裝有酒測發動鎖定裝置的車輛時,駕駛人必須先吐氣採樣。如果吐氣採樣中,酒精濃度大於預設危險值,則車輛無法發動。為了避免舞弊行為(例如,有駕駛者以外的人吐氣入檢驗吹口),車輛進行中會有隨機測試。該項計劃還包括駕駛人資訊研討會,並且記錄下所有吹氣測試結果,包含通過、警告及失敗。

目標

藉由檢驗酒測發動裝置安裝前後之酒駕發生率,系統性的評估酒測發動鎖定裝置對於降低酒駕發生率的成效。

搜尋策略

搜尋包括考科藍實證醫學資料庫及相關電子資料庫及網路資料。

選擇標準

控制試驗中的違法者被以酒駕罪名起訴或被判決需參與酒測發動裝置計劃或一般懲罰(包括吊銷駕照或其他治療計劃)都在篩選標準內。本項研究不拘任何語言或版本。

資料收集與分析

共計有一項隨機控制試驗及十項控制試驗符於標準,此外另有三項試驗仍在進行中。收集的資料包括安裝酒駕測試裝置時、移除酒駕測試裝置後的酒駕率及總酒駕率。所有的資料皆使用RevMan進行分析。

主要結論

隨機控制試驗可發現安裝酒駕測試裝置時能有效降低酒駕發生率;相對風險0.36(95﹪信賴區間 0.21∼0.63)。控制試驗也支持這樣的結果,且可看出一項趨勢:無論酒駕初犯或累犯,安裝酒駕測試裝置時酒駕發生率都是較低的。隨機控制試驗及控制試驗皆無證據顯示移除酒駕測試裝置後仍能有效降低酒駕發生率。

作者結論

為了降低潛在性篩選誤差,需要再引用更多隨機控制試驗,以兼顧效力與效度。酒駕測試裝置計劃顯示車輛安裝酒駕測試裝置能降低酒駕率。未來的研究需要 投注在如何長期降低酒駕率,以及如何促進參與率、順從性及耐久性。

翻譯人

本摘要由高雄榮民總醫院畢勇賢翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

酒精測試裝置能降低酒駕累犯率,但只有在安裝時有效。酒駕者有時會被要求選擇接受一般懲罰或於車輛安裝酒駕測試裝置。當車輛安裝酒駕測試裝置時,駕駛必須先吐氣採樣。如果吐氣採樣中酒精濃度高於標準值,車輛將無法發動。有數個研究投注於測試酒精測試裝置是否能降低再犯率。不過這些研究的品質不夠理想。酒精測試裝置安裝於車輛時似乎能夠降低酒駕率,但是一但裝置移除後,長期效果有限。然而,仍需要更多優質研究來佐證這樣的發現。不過,僅有少數酒駕者願意選擇安裝酒駕測試裝置,使得達到定論的難度提高。