Background Alcohol is the main factor for road traffic crashes, contributing to high morbidity and mortality, especially in developing countries, such as Brazil.

Objective To estimate the prevalence and factors associated with drinking and driving (DD) in the Brazilian adult population. Methods: A cross-sectional study entitled ‘Surveillance of risk and protection factors for chronic diseases by telephone inquiry’ was conducted in 2016. This is a telephone survey using probabilistic samples of the adult population (>18 years) resident in the capitals of the 26 Brazilian states and federal district that make up the five macro-regions of Brazil. Initially, 5000 phone lines were systematically selected. Next, a selection was made of the adult resident to be interviewed using a structured questionnaire, previously validated. The analyzed outcome was direction after alcohol use in any quantity in the last 30 days, according to self-report. Poisson regression was used to analyze the factors associated with DD using complex sample routines.

Results A total of 53 210 adults were interviewed. The prevalence of DD was 7.31% (95.0% CI: 6.86 to 7.78). Living in the central-western macro-region of Brazil (Adjusted Prevalence Ratio [aPR]: 1.78; 95.0% CI: 1.70 to 1.98), age between 25 and 34 years (aPR: 1.25; 95.0% CI: 1.03 to 1.50), male sex (aPR: 1.51; 95.0% CI: 1.44 to 1.62), high schooling – incomplete or complete higher education – (aPR: 1.67; 95.0% CI: 1.37 to 2.02), binge drinking in the last 30 days (aPR: 4.45; 95.0% CI: 3.92 to 5.04) and antecedent of fine in the last 12 months (aPR: 1.70; 95.0% CI: 1.40 to 1.90) were factors associated with the outcome.

Conclusion The study estimated a high prevalence of DD in Brazil and important determinants.

Policy implications The results can contribute to subsidize traffic safety interventions and public policies aimed at reducing the prevalence of DD in Brazilian capitals.