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Cell phones and choice architecture
  1. Brian D Johnston
  1. Correspondence to Dr Brian D Johnston, Harborview Medical Center, 325 Ninth Avenue, Box 359774, Seattle, WA 98104, USA; ipeditor{at}bmjgroup.com

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This summer, the New York Times ran a series of articles looking at the risks of distracted driving, especially as this relates to cell-phone use and text messaging while operating an automobile.1 The Times ran these pieces on their front page, generating considerable interest and spin-off coverage in other media.

While acknowledging the difficulties of studying risk associated with a transient exposure, the stories emphasized that, in the USA, cell-phone use is the most prevalent driver distraction and one that is especially common among the youngest (and, at baseline, riskiest) drivers. Citing data from simulator studies, the author reported that cell phone use increased the risk of crashes or near crashes anywhere from four- to eightfold, an impact comparable with driving with a blood alcohol level above the legal limit.2 In a salacious aside, the series revealed that in 2003, researchers at the US National Highway Traffic Safety Administration compiled research demonstrating the risks of distracted driving but withheld these findings when the agency came under pressure from Congress.3

The Times also included data collected by researchers at the Virginia Tech Transportation Institute. In an elegant design, their studies use longitudinal data from event recorders mounted in vehicle fleets. These naturalistic studies are the best indicator of what real drivers do in actual driving environments. Eye-glance analyses assessed where drivers were looking when performing cell-phone tasks and when crashes or near-miss events occurred. Whereas simulator studies suggest that talking on a cell phone, even in a hands-free mode, is as risky as dialing the phone, these, as yet unpublished, observational data suggest that it is tasks which draw the driver’s eyes away from the forward roadway that are associated with the highest risk. Texting increased the risk by greater than 20-fold.4

It is unclear why simulator-based studies suggest a higher risk of cell-phone-associated-crash than do these naturalistic observational studies. It is reasonable, however, to place more weight on the latter and to conclude that activities which require the driver’s eyes be off the roadway, such as dialing a call or texting, are clearly risky and should be discouraged. Unfortunately, legislation to ban cell-phone use while driving has a spotty record. Studies suggest that after passage of such laws, the initial decrement in use is followed by a slow return to baseline levels.5 Vigorous enforcement may be required but—as yet—is rarely practiced.

Technological fixes are an appealing alternative. One example is a car key that jams cell-phone reception and text messaging when the ignition is engaged.6 Another solution uses software to detect that a cell phone is in a moving motor vehicle.7 Non-emergent outbound calls are blocked, inbound calls are routed to voicemail, and inbound text messages are stored for delayed delivery. In both cases, it is not clear who would pay for this technology. Unless incentivized by insurance companies or offered to the concerned parents of newly licensed teen drivers, there may be no market for these clever devices.

Finally, there is a growing interest in using “behavioral economics” to encourage individuals to make better choices. This concept has been popularized by Thaler and Sunstein in their book Nudge and should have broad appeal and applicability in injury prevention.8 In essence, they argue that human decision-making is predictably irrational and that the context of our economic and social behavior (the “choice architecture”) is highly influential, playing a key role in determining outcomes. This choice architecture can often be structured to guide or nudge (rather than compel) people into making better choices. Because many aspects of the choice architecture surrounding cell-phone use are actively shaped by designers and policy makers, it makes good sense to use control of this context to try to achieve socially desirable goals without forcing anyone to do anything.

Examples of choice architecture amenable to intervention include:

Setting the default option in a set of choices

We know that hot-water heaters shipped preset at a lower temperature reduce the risk of household scalds. People are free to increase the temperature of their water, but most will not—so why not select this safer default option? In a similar manner, using available software, cell phones could be set to block texting when driving as a factory default.

Designing physical spaces to encourage desirable behavior

A series of convenient cell-phone pull-out areas, perhaps also with free wireless internet access, could be built into the roadway environment. This would structure a socially desirable alternative behavior for those who cannot wait to complete a phone call or text message while driving.

Offering “self-contracting” to support behavior change

Examples include automatic payroll deduction to enforce savings and self-imposed gambling bans for persons trying to break a habit. A simple example to reduce cell-phone use would be a driving sensor or signal-jamming key that drivers could opt to engage when ready to make a behavior change but which would then be hard to defeat if their will should falter in the driving environment.

Presenting or organizing information in a novel manner

Public health agencies use this technique to motivate the behavior of restaurant owners by posting health and sanitation “grades” in a conspicuous place. Cell-phone displays could include “distraction meters” showing the risk associated with talking, dialing, or texting. If you are sitting on a train, it might not matter to you, but a red bar on the display may be salient to a pedestrian or driver negotiating a traffic environment.

Supporting the development of social norms

Devices and environments can also be used to educate and reinforce desirable social norms. For example, a caller to the cell phone of an individual who is driving might hear the message “I’m driving just now and don’t want to jeopardize my safety and the safety of those around me by picking up the phone. Press 1 to ring through if this is an emergency …” Cleverly designed messages could be a form of social marketing to change behavior through the creation of new social norms.

No doubt, there are other “nudges” that could change behavior around cell-phone use while driving as well as many examples of choice architecture employed in injury prevention. The journal would be interested in publishing evaluations of these strategies and will also share successful or creative nudges through posts on our soon-to-debut blog. Watch our online site for details.

REFERENCES

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Footnotes

  • Competing interests None.

  • Provenance and Peer review Commissioned; not externally peer reviewed.

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