Article Text

Download PDFPDF
Evaluating the effectiveness of implementing a more severe law on prevention of road traffic injury mortality in mainland China: an interrupted time series study based on national mortality surveillance
  1. Jiangmei Liu1,2,3,
  2. Xiaoqi Feng3,4,
  3. David Steel1,5,
  4. Maigeng Zhou2,
  5. Thomas Astell-Burt1,3
  1. 1 School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
  2. 2 National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
  3. 3 Population Wellbeing and Environment Research Lab (PowerLab), Sydney, New South Wales, Australia
  4. 4 School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
  5. 5 National Institute for Applied Statistical Research Australia (NIASRA), University of Wollongong, Wollongong, New South Wales, Australia
  1. Correspondence to Professor Thomas Astell-Burt, University of Wollongong, Wollongong, New South Wales, Australia; thomasab{at}


Background In China, road traffic injury (RTI) is the seventh-leading cause of death More than 1.5 million adults in China live with permanent disabilities due to road traffic accidents. In 2011, the Chinese government implemented a more severe law that increased the penalty points and fines for persons charged with drink-driving as a criminal offence.

Objectives This study evaluated the short-term and long-term effects of the drink-driving law. It also aimed to establish whether punishments of increased severity resulted in greater reductions in RTI mortality.

Methods RTI mortality data was obtained from the Disease Surveillance Points System. A two-level interrupted time series model was used to analyse daily and monthly road traffic mortality rates, accounting for the varying trends among counties.

Results The overall RTI mortality rate showed a decreasing trend from 2007 to 2015 in mainland China, especially after 2011, and similarly decreasing trends were noted among males and females and in urban and rural areas. After the Criminal Law and Road Traffic Law amendment was implemented in 2011, charging drink-driving as a criminal offence, the immediate daily RTI mortality rate reduced by 1.57% (RR=0.9843, 95% CI: 0.9444 to 1.0259), while the slope change significantly decreased by 0.04% (RR=0.9996, 95% CI: 0.9994 to 0.9997) compared with the period before the Law was revised. Stratified analysis showed that the effect size of the law was higher for males in urban and high socioeconomic circumstances (SEC) than females in rural and low and moderate SEC. Meanwhile, the increase in penalty points for dangerous driving behaviours showed no significant effects.

Conclusion Evidence was found that charging criminal responsibility for drink-driving is associated with reducing RTI deaths in China.

  • Policy
  • Public Health
  • Epidemiology
  • Time series
  • Mortality

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors Jiangmei Liu is responsible for the overall content as the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.