Seat Belt Laws Do Work

Troy Brown

April 25, 2012

April 25, 2012 — Primary seat belt laws, which permit police to stop motorists for not wearing seatbelts, are more effective at getting teens to wear seat belts than are secondary seat belt laws, which permit police to issue citations for not wearing seatbelts only if the driver is already stopped for another offense, according to a recent study.

The study was a joint effort between researchers at the Children's Hospital of Philadelphia (CHOP), and State Farm. Coauthors Felipe J. García-España, PhD, a researcher at CHOP's Center for Injury Research and Prevention, and Dennis Durbin, MD, MSCE, co-scientific director of the Center for Injury Research and Prevention, reported their results online in the American Journal of Public Health on April 19.

They conducted the study to examine the effect of primary and secondary seat belt laws on teen drivers as they advance through the stages of graduated driver licensing, and at teen passengers. Previous studies have suggested that more teens wear seat belts in states with primary seat belt laws than in states with secondary, or no, seat belt laws.

The study used data from the National Young Driver Survey (NYDS), which was conducted by a paper-and-pencil questionnaire completed by a nationally representative sample of 5665 9th-, 10th-, and 11th-grade public high school students in the United States. This study included only 3126 students who described themselves as drivers.

Drivers were categorized as Learner Permit ("I am only supposed to drive with an adult"), Provisional License ("I can drive on my own, but I am not supposed to drive under some conditions, like not late at night or not with passengers"), and Unrestricted License ("I can drive on my own with no conditions"). Students with a "hardship license," which is given in a few states to allow rural teens to drive to and from school, were put in the Learner Permit category.

Teens answered 2 questions about seat belt use: (1) "How often the following statement is true for you: 'I wear my seat belt when I drive' and (2) "How often do you wear your seat belt when you are a passenger?" Response options were "rarely or never," "sometimes or occasionally," and "often or always." Seat belt use was dichotomized for analysis (often/always versus less than often/always).

Seat belt law status (primary vs secondary) was determined by the type of law in effect in 2006; the NYDS survey was conducted in 17 primary enforcement law states and 17 secondary enforcement law states.

For the group as a whole, 81.5% (95% confidence interval [CI], 77.0% - 85.2%) of high school students who are drivers reported that they often/always wore a seat belt when driving versus 5.8% (95% CI, 4.3% - 7.8%) reported they rarely/never did.

Fewer teens wore seat belts as passengers; only 68.9% (95% CI, 64.5% - 72.9%) of teens reported that they often/always wore a seat belt as a passenger and 10.0% (95% CI, 8.0% - 12.44%) said they rarely/never did.

Secondary Law States

Driver seat belt use was lower in secondary law states (77.8%; 95% CI, 70.0% - 84.0%) than in primary law states (86.0%; 95% CI, 82.7% - 88.7%). Passenger seat belt use was lower than driver seat belt use for both secondary law states (64.9%; 95% CI, 57.4% - 71.7%) and primary law states (73.7%; 95% CI, 70.1% - 77.1%).

In secondary law states, driver safety belt use was lowest among teens with D/F grades (41.2%), teens who drive a pick-up truck (60.8%), and African-American teens (58.2%). Only students with a Learner Permit, students living in urban/suburban areas, students attending schools with a higher socioeconomic level, and students driving minivans had at least 84% reported use of seat belts when driving.

In secondary law states, passenger safety belt use was lowest among teens with D/F grades (32.9%), students who drive a pick-up truck (49.1%), and African-American teens (37%). Passenger seat belt use was at least 74% only in teens living in urban/suburban areas, attending schools with a higher socioeconomic level, and teens driving minivans.

Safety belt use was high for drivers with a learner permit in both primary (88.5%) and secondary (87.1%) law states. It stayed high through all driving stages in primary law states but declined in secondary law states. As passengers, drivers with a learner permit reported similar rates of use in primary (74.1%) and secondary (69.7%) law states.

Stricter Laws Effective

"The combined association of state law and driver license status with safety belt use was notable. We found that after controlling for socio-demographic and driving factors, provisional and unrestricted drivers residing in secondary, but not primary, law states were less likely than learner drivers to be restrained while driving," write the authors.

"Our findings indicate that the apparent reduction in safety belt use observed among teens, as they progress through the licensing process (from learner permit to provisional license to unrestricted license) might be mitigated in states with a primary provision," the authors write.

The authors have disclosed no relevant financial relationships.

Am J Public Health. Published online April 19, 2012. Abstract

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