Impact of the program life in traffic and new zero-tolerance drinking and driving law on the prevalence of driving after alcohol abuse in Brazilian capitals: An interrupted time series analysis.

Abstract

IntroductionDriving under the influence of alcohol is one of the main factors for morbidity and mortality from traffic accidents. In 2010 and 2013, the Program Life in Traffic was implemented in Brazil, including the international initiative "Road Safety in Ten Countries", which established actions to reduce one of the main risk factors for road traffic injuries, the driving under the influence of alcohol. In 2012, a new zero-tolerance drinking and driving law (new dry law) was implemented, establishing a zero-tolerance limit for the drivers' blood alcohol concentration, and increasing punitive measures. This study aimed at analyzing the impact of these measures on the prevalence of driving under the influence of alcohol abuse in Brazilian capitals.MethodsAn interrupted time series study was conducted using the models of autoregressive integrated moving average or seasonal autoregressive integrated moving average. The main outcome was the prevalence of driving after alcohol abuse in the adult population (≥ 18 years). The model's predictors were the interventions "Program Life in Traffic" and "New Dry Law". The former was implemented in the first quarter of 2011, initially in five capitals: Belo Horizonte, Campo Grande, Palmas, Teresina, and Curitiba, being expanded to the other capitals in the first quarter of 2013. The latter was implemented in the country on the first quarter of 2013. Data source for the study was the records of the surveillance system for risk and protection factors of chronic diseases through telephone survey (Vigitel) from 2007 to 2016.ResultsThe time intervals considered in the study were the quarters. Thirty-eight units were considered in the analysis, corresponding to time series points. It was found that after the implementation of the Program Life in Traffic, in the first quarter of 2011, there was a reduction in the prevalence in Belo Horizonte and Curitiba. Because the introduction of the New Dry Law and the Program Life in Traffic took place in similar periods in the other cities, there was a significant reduction in the outcome prevalence in the cities of Aracaju, Belo Horizonte, Boa Vista, Fortaleza, João Pessoa, Maceió, Manaus, Palmas, Porto Alegre, Recife, Teresina, Rio Branco, and Vitória following the law application.ConclusionThe present study identified an immediate impact of the Program Life in Traffic in two capitals (Belo Horizonte and Curitiba) and a joint impact of the New Dry Law in 13 capitals. The results of this study have implications for strengthening interventions aimed at reducing the burden of morbidity and mortality from traffic accidents in Brazil.