Commentary on Kim et al. (2013): Drink driving in Hong Kong—a response


For those of us in Great Britain and Europe who have been concerned about how best to reduce the prevalence of drink driving and the injuries that result from it, the paper by Kim et al.[1] makes for fascinating reading. Clearly, random breath testing can have a significant impact upon certain categories of drink drivers. However, its application will not be universal.

In Great Britain, police often refer to the four fatal actions that are more likely to result in death or injury: failure to wear a seatbelt, non-compliance with the speed limit, driving while using a mobile phone and driving while impaired through drink, drugs or fatigue. Of these, the latter still remains the most significant issue with, even now, drink driving accounting for approximately 17% of road deaths.

Traditionally, tackling the incidence of drink driving has required a multiple approach: an acceptable drink drive limit, effective enforcement, hard-hitting and regular advertising and suitable levels of punishment. The combination of these has meant that, in surveys of drivers such as those conducted by the RAC (Royal Automobile Club) in Britain, drink driving has been clearly identified as a key priority for road safety.

In Great Britain, drivers can be breath tested by the police for three reasons. First, they may be committing a moving traffic offence. Secondly, a police officer may suspect that a driver is driving while under the influence of alcohol. Thirdly, the police have the power to breath test as a result of involvement in a road traffic accident. While these three reasons cover the bulk of eventualities on the roads, the question of the difference that random or targeted breath testing would also make has always remained.

This paper suggests that an additional power would make a difference for some groups of drivers: in particular, regular male drinkers.

In her work on the attitudes towards speed cameras, Claire Corbett concluded that drivers fell into one of four main categories: those who comply with the law, those who are deterred by a single offence, those who manipulate their driving in order to avoid conviction and those who defy the law in totality. It seems to me that, from the Hong Kong experience, we can argue that random breath testing would help to build up the cohort of drivers in the first two categories, leaving us with a small hard-core for whom enforcement is the only option.

What is, of course, intriguing about this research is the context in which it took place: an environment of heavy alcohol promotion. That is not, necessarily, the context of Europe as a whole, although the growing problem of weekend binge-drinking in the United Kingdom suggests that we should not overlook the experience of South East Asia.

One issue of concern, however, is the effect of budget reductions on both policing and public advertising. In Great Britain, the Department for Transport's advertising campaign has been reduced substantially since 2010, although the traditional Christmas drink-drive campaign was reinstated in 2012. Awareness-raising campaigns remain important if drivers are to be reminded of the legal consequences of drink-driving.

What the research also identifies is two groups for whom we need to develop a new approach: male binge drinkers and women for whom random breath testing made no difference. It is the latter group that is the more interesting. We know that alcohol consumption is rising among women. We also know that, in Great Britain at least, women's drinking habits are different from men's, with more emphasis on drinking at home among friends rather than in bars.

A key issue, therefore, will be to link the road safety implications of drink driving with the health aspects—the long-term damage that alcohol can cause. This will mean that we need to see road safety as part of the wider public health agenda, and not as something that stands on its own.

Declaration of interests

Robert Gifford is Director of the Gifford Partnership, an independent consultancy providing advice on public policy. From May 1994 to December 2012, he was Executive Director of the Parliamentary Advisory Council for Transport Safety.