Background A vast literature has demonstrated that using mobile phones while driving increases the risk of road traffic crashes. In response, policy-makers have introduced bans and harsher penalties on using mobile phones while driving. Even though emerging evidence suggests that such measures may reduce mobile phone use and crashes, the literature has not been systematically reviewed and synthesised.

Objective To evaluate the impact of penalising mobile phone use while driving on road traffic fatalities, serious injuries and the prevalence of mobile phone use while driving.

Methods We employed a comprehensive search strategy using electronic databases, websites, handsearching and other sources to locate studies evaluating legislation on mobile phone use while driving. Randomised controlled trials, interrupted time series’, controlled before–after studies with control(s) not exposed to harsher sanctions and panel data designs were included if they measured the outcomes of fatalities, serious injuries or the prevalence of mobile phone use while driving. Eligible studies were critically appraised. Due to substantial heterogeneity, the results were synthesised narratively. The synthesis structured studies according to the type of legislation and outcome measure.

Results Of the 7420 studies retrieved, 32 were included. The evidence on the effects of penalising mobile phone use while driving was weak, and somewhat inconsistent, but pointed to a potential decrease in the prevalence of mobile phone use and fatalities for all-driver primary enforcement hand-held bans and texting bans.

Conclusions Preventing fatalities from risky driving practices may be helped by implementing harsher laws that penalise mobile phone use while driving.