Correspondence

Alcohol-Related Automobile Crashes

N Engl J Med 1995; 332:893March 30, 1995

Article

To the Editor:

One way to reduce alcohol-related crashes, the subject of the Special Article by Brewer et al. (Aug. 25 issue),1 is to reduce consumption by raising the price of alcoholic beverages. There is a strong relation between total alcohol consumption in a population and deaths from vehicular crashes; for every percent decrease in alcohol consumption, there is an approximately equal reduction in the number of deaths from vehicular crashes.2 The price of alcoholic beverages has not increased as rapidly as inflation, so the current cost is relatively low. So-called sin taxes are unpopular, but imposing a tax on alcohol might lower the rates of alcohol-related injury and disease while increasing revenues, which could be used for health-related projects.

Albert B. Lowenfels, M.D.
New York Medical College, Valhalla, NY 10595

2 References

1
Brewer RD, Morris PD, Cole TB, Watkins S, Patetta MJ, Popkin C. The risk of dying in alcohol-related automobile crashes among habitual drunk drivers. N Engl J Med 1994;331:513-517
Full Text | Web of Science | Medline

2
Lowenfels AB, Wynn PS. One less for the road: international trends in alcohol consumption and vehicular fatalities. Ann Epidemiol 1992;2:249-256
CrossRef | Medline

Author/Editor Response

The authors reply:

To the Editor: We agree with Dr. Lowenfels that strategies to combat drinking and driving must reach beyond drivers who have already been arrested. We also agree that raising state and federal excise taxes to reduce the availability of alcohol is a promising approach.1 Nevertheless, our results emphasize the need for aggressive intervention directed at people who have been arrested for driving while impaired. Since a substantial proportion of such people may be alcoholics, it is critical that legal sanctions against drinking and driving be linked with programs to identify and treat alcoholic drivers.

Robert D. Brewer, M.D., M.S.P.H.
Centers for Disease Control and Prevention, Atlanta, GA 30341

Peter D. Morris, M.D., M.P.H.
Thomas B. Cole, M.D., M.P.H.
North Carolina Department of Environment, Health, and Natural Resources, Raleigh, NC 27611

1 References