Background Motorcyclists constitute the largest proportion of vehicle users on Indian roads. They are also vulnerable to road traffic crashes, injuries and deaths. Helmet-use can reduce the risk of injuries among them. Helmet-use rates can be determined by different methodologies.

Objectives To compare observed and self-reported helmet-use rates among motorcyclists in Hyderabad city, India.

Methods To determine helmet-use rates observations were recorded for motorcycle drivers (n=68 229) and pillion riders (n=21 777). By a different methodology, roadside interviews were conducted with motorcycle drivers (n=606) where they were asked if they ‘always wear a helmet’ and observations were also recorded for them.

Results In observational study, 22.6% of motorcycle drivers and 1.1% pillion riders were found wearing helmets. In roadside interview, 64.6% of the respondents reported to always use helmet, much higher than the observed rate of 29.3% in the same group. ‘It can save my life’ (99.2%) was common reason for always using helmets. Reasons for not always using helmets included not having one (27.4%), depending on where they drive (25.1%) and forgetting it sometimes (23.7%). In purchasing helmet, quality (66.0%), certification (15.2%) and brand/company name (7.7%) were given more importance than price (4.6%), style/look (2.6%) and colour (1.8%). Only 2.3% were stopped by police in the past three months to check helmet-use.

Significance Discrepancy between observed and self-reported helmet-use rates suggest that observational studies can provide more valid helmet-use rates than those that are self-reported. Increased enforcement might be an effective strategy to increase helmet-use among drivers who are aware of its importance.