Background Non-standard motorcycle helmet use is a public health concern that adds burden to the existing disproportionate scales of morbidity and mortality related to motorcycle collisions.

Objective This ecological study aimed to explore the determinants of non-standard motorcycle helmet use.

Methods Secondary data on the prevalence of wearing motorcycle helmets and the use of non-standard motorcycle helmets from twelve countries were collected from published literature. The relationship between non-standard helmet use and factors like the country’s level of economic development (Gross National Income per capita) and level of law enforcement were explored using bar graphs, scatter plots, and box plots. A multivariate regression model was developed to analyze the correlation.

Results The mean prevalence of using all helmets while riding motorcycles in the median country was 83%, but almost half of them (46.4%) were using non-standard motorcycle helmets. The study found that non-standard helmet use is not linearly dependent on cost or the economic development of a country. An inverse correlation was observed between the level of law enforcement and the use of non-standard motorcycle helmets. The implementation of universal helmet laws is useful in increasing the use of motorcycle helmets, but they alone don’t ensure that the helmets being used meet recommended standards.

Conclusion A multi-pronged approach engaging various stakeholders of the health system including policymakers, law enforcement agencies, and manufacturers is required to efficiently curb the use of non-standard helmets to improve health outcomes and road safety for motorcycle riders. The study’s findings can inform policies and programs aimed at reducing the prevalence of non-standard helmet use and promoting the use of recommended standard helmets.