Objective: To estimate how frequently adults in the United States drive while impaired by alcohol.
Design: Telephone survey.
Setting: The 49 states (and the District of Columbia) that participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 1993.
Participants: A total of 102,263 noninstitutionalized adults aged 18 years or older.
Main outcome measures: The percentage of respondents who reported alcohol-impaired driving; number of episodes of alcohol-impaired driving per 1000 adult population; and total number of episodes of alcohol-impaired driving-each by age, sex, race, level of education, and state.
Results: Overall, 2.5% of adults reported an estimated 123 million episodes of alcohol-impaired driving in 1993. This corresponds to 655 episodes of alcohol-impaired driving for each 1000 adults (range among states per 1000 adults, 165-1550). Alcohol-impaired driving was most frequent among men aged 21 to 34 years (1739 episodes per 1000 adults) and was nearly as frequent among men aged 18 to 20 years (1623 episodes per 1000 adults), despite legislation in all states that prohibited the sale of alcohol to persons younger than age 21 years in 1993.
Conclusions: Alcohol-impaired driving is common even among underage persons. Strict enforcement of laws that discourage alcohol-impaired driving is needed along with community and patient education to reduce the prevalence of alcohol-impaired driving and prevent injuries and deaths from alcohol-related motor vehicle crashes. Data from the BRFSS, an ongoing source of national and state-specific data on the number of episodes of alcohol-impaired driving, are potentially useful for monitoring trends and evaluating the effect of future efforts to reduce alcohol-impaired driving.