Traffic Injury Prevention
ISSN: 1538-9588 (Print) 1538-957X (Online) Journal homepage: http://www.tandfonline.com/loi/gcpi20
General Motor Vehicle Drivers’ Knowledge and Practices Regarding Drink Driving in Yinchuan and Guangzhou, China Keqin Jia, Mark King, Judy Fleiter, Mary Sheehan, Wenjun Ma, Jing Lei & Jianzhen Zhang To cite this article: Keqin Jia, Mark King, Judy Fleiter, Mary Sheehan, Wenjun Ma, Jing Lei & Jianzhen Zhang (2015) General Motor Vehicle Drivers’ Knowledge and Practices Regarding Drink Driving in Yinchuan and Guangzhou, China, Traffic Injury Prevention, 16:7, 652-657, DOI: 10.1080/15389588.2014.1001509 To link to this article: http://dx.doi.org/10.1080/15389588.2014.1001509
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Accepted author version posted online: 08 Jan 2015.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=gcpi20 Download by: [University of Lethbridge]
Date: 05 November 2015, At: 20:19
Traffic Injury Prevention (2015) 16, 652–656 C Taylor & Francis Group, LLC Copyright ISSN: 1538-9588 print / 1538-957X online DOI: 10.1080/15389588.2014.1001509
General Motor Vehicle Drivers’ Knowledge and Practices Regarding Drink Driving in Yinchuan and Guangzhou, China KEQIN JIA1, MARK KING1, JUDY FLEITER1, MARY SHEEHAN1, WENJUN MA2, JING LEI3, and JIANZHEN ZHANG4 1
Centre for Accident Research and Road Safety–Queensland, Queensland University of Technology, Brisbane, Queensland, Australia Guangdong Institute of Public Health, Guangdong Province Centre for Disease Control and Prevention, Guangzhou, China 3 Yinchuan City Centre for Disease Control and Prevention of Ningxia Hui Autonomous Region, Yinchuan, China 4 School of Medicine, University of Queensland, Brisbane, Queensland, Australia
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
2
Received 3 September 2014, Accepted 18 December 2014
Objective: Drink driving contributes to significant levels of injury and economic loss in China but is not well researched. This study examined knowledge, drink-driving practices, and alcohol misuse problems among general drivers in Yinchuan. The objectives were to gain a better understanding of drink driving in Yinchuan, identify areas that need to be addressed, and compare the results with a similar study in Guangzhou. Methods: This was a cross-sectional study with a survey designed to collect information on participants’ demographic characteristics and their knowledge and practices in relation to drinking and driving. The survey was composed of questions on knowledge and practices in relation to drink driving and was administered to a convenience sample of 406 drivers. Alcohol misuse problems were assessed by using the Alcohol Use Disorders Identification Test (AUDIT). Results: Males accounted for the main proportion of drivers sampled from the general population (“general drivers”). A majority of general drivers in both cities knew that drunk driving had become a criminal offense in 2011; however, knowledge of 2 legal blood alcohol concentration (BAC) limits was quite low. Fewer drivers in Yinchuan (22.6%) than in Guangzhou (27.9) reported having been stopped by police conducting breath alcohol testing at least once in the last 12 months. The mean AUDIT score in Yinchuan (M = 8.2) was higher than that in Guangzhou (M = 7.4), and the proportion of Yinchuan drivers with medium or higher alcohol misuse problems (31.2%) was correspondingly higher than in Guangzhou (23.1%). In Yinchuan, males had a significantly higher AUDIT score than females (t = 3.454, P < .001), similar to Guangzhou. Multiple regression analyses were conducted on potential predictors of the AUDIT score (age, gender, monthly income, education level, years licensed, and age started drinking). There were significant individual contributions of gender (beta = 0.173, P = .09) and age at which drinking started (beta = 0.141, P = .033), but the overall model for Yinchuan was not significant, unlike Guangzhou. Conclusions: The results show that there are shortfalls in knowledge of the legislation and how to comply with it and deficiencies in police enforcement. In addition, there was evidence of drink driving and drink riding at high levels in both cities. Recommendations are made to address these issues. Keywords: China, general driver, road safety, drink driving, AUDIT
Introduction Alcohol-related driving is a significant public health issue, especially in low- and middle-income countries. According to Associate Editor Kathy Stewart oversaw the review of this article. Address correspondence to Keqin Jia, Centre for Accident Research and Road Safety–Queensland, Queensland University of Technology, K Block, 130 Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia. E-mail: g2.jia@student. qu.edu.au Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/gcpi.
research reported by the World Health Organization (WHO), Global Road Safety Partnership, and International Federation of Red Cross and Red Crescent Societies, 33–69% of drivers killed and 8–29% of drivers injured in low- and middleincome countries have illegal blood alcohol concentrations (BACs; Global Road Safety Partnership 2007). However, official Chinese statistics show that the proportion of fatalities related to drink driving ranged between 3 and 4.8% over a 10-year period (Traffic Management Bureau Under Ministry of Public Security 2012). It is considered that these figures reflect underreporting due to insufficient traffic police resources. Drink driving has been acknowledged as a public health concern (Hao et al. 2005, 2007; Li et al. 2011; Z.
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
Drink Driving in China
Fig. 1. Changes in percentage of road traffic crashes, fatalities, injuries, and economic loss caused by drink driving in China (Traffic Management Bureau Under Ministry of Public Security 2013). © Traffic Management Bureau Under Ministry of Public Security. Reproduced by permission of Traffic Management Bureau Under Ministry of Public Security. Permission to reuse must be obtained from the rightsholder.
Wang 2011; Zhang et al. 2014). Figure 1 shows the changes in percentage of road traffic crashes, fatalities, injuries, and economic loss caused by alcohol-related driving in China from 1995 to 2012 (Traffic Management Bureau Under Ministry of Public Security 2013). There is a slightly increasing trend for drink driving–related traffic crashes, fatalities, injuries, and economic loss between 2010 and 2012. On May 1, 2011, drunk driving was upgraded to become a criminal offense under China Criminal Law. That is, a driver with a BAC of 80 mg/100 ml or more while driving will be punished as a criminal offender. This “drunk driving” limit contrasts with a “drink driving” limit: a driver with a BAC between 20 and 80 mg/100 ml is convicted of drink driving, which is not a criminal offense. There were 414,359 drivers apprehended for alcohol-related driving in 2012, 49,384 of whom were drunk drivers (Research Institute of Highway, Ministry of Transport, P.R. China 2013). This means that 11.9% of alcohol-related driving offenses were drunk driving, so that the majority of offenses occurred at low blood alcohol concentrations. It is difficult to interpret the significance of this split because it will be influenced by enforcement practices as well as by the underlying incidence of drink driving in the population. The results are also compared with results for Guangzhou drivers obtained in an earlier study (Jia et al. 2013). Yinchuan is the capital of the Ningxia Hui Autonomous Region in China’s northwest with approximately 1.7 million people. There are 459,647 Hui (23.6%) in Yinchuan. The Hui form one of 56 ethnic groups in China and are predominantly Muslim. According to the Yinchuan Public Security Bureau record, there were 400,000 motor vehicles and 390,000 registered drivers in 2011 (Yinchuan Public Security Bureau 2011, 2012). Traffic crashes accounted for a substantial pro-
653 portion of mortality in Yinchuan between 2008 and 2010 (L. P. Wang et al. 2012). According to the local Public Security Bureau Traffic Police Team, in the first half of 2012 there were 499 traffic crashes, resulting in 73 fatalities, 588 injuries and a direct economic loss of 1,868,708 RMB (approximately US$233,588). In 2011 and 2012, local traffic police teams conducted 41 drink-driving enforcement operations and apprehended 46 drink-driving offenders and 376 drunk-driving offenders. In addition, there were 298 cases of dangerous driving in Yinchuan in 2012 and 99% of them were drunk-driving offenses (Kou and Jiang 2013). Though these statistics are drawn from varying time bases, the time periods overlap and the statistics build a consistent picture of an ongoing impaired driving problem. With the current rapid increase in motor vehicles and drivers, there is a need to better understand the factors that contribute to impaired driving in order to address it through education, legislation, and enforcement. However, there is limited information available on drivers’ knowledge and practices regarding drink driving in China. This study examines knowledge, drink driving practices, and alcohol misuse problems among drivers sampled from the general driving population (“general drivers”) in Yinchuan. In particular, the severity of alcohol misuse problems was measured by the Alcohol Use Disorders Identification Test (AUDIT), a short questionnaire that the WHO recommends to screen hazardous and harmful drinking (Babor and Grant 1989; Global Road Safety Partnership 2007; Saunders et al. 1993).
Methods Participants Between July and August 2012, 406 general vehicle drivers (276 males and 126 females, 2 missing) aged 19–71 years (M = 37.8 years, SD = 9.8) with a current driver’s license or who currently drove with or without a license volunteered to complete a 15-min survey. Recruitment was conducted with the assistance of the Yinchuan City Centre for Disease Control and Prevention (CDC), Ningxia Hui Autonomous Region, China. Convenience sampling was used to recruit participants. Three trained research assistants from the CDC and the first author recruited participants from several sources: drivers attending training and publicity events coordinated by a local traffic police publicity team; drivers visiting Yinchuan CDC for physical examinations; drivers visiting a “4 S” shop (Sale, Spares, Service, and Survey); and private drivers and professional drivers from workplaces including Ningxia Museum, Ningxia Disabled Person’s Federation, Ningxia Education TV, and Yinchuan CDC. All of the drivers lived in Yinchuan. All were aged 18 years or older and were either licensed drivers or currently drove a motor vehicle without a current driver’s license. Detailed information on the demographic composition of licensed drivers in Yinchuan was not available but would not reflect actual driving because of variation in driving between individuals and because the sampling process captured unlicensed as well as licensed drivers. Some of the recruitment sites were more likely to be frequented by active drivers, so the sample probably reflects the population of active general drivers rather than licensed drivers as a whole.
654
Jia et al.
Table 1. AUDIT scores and alcohol misuse severity Alcohol problem severity
AUDIT score
Low Medium High level Need further diagnostic evaluation for alcohol dependence
0–7.9 8–15.9 16–19.9 20 or more
come (higher in Guangzhou); employment (more permanent employment in Guangzhou); licensing (higher in Yinchuan); and professional driver status (higher in Yinchuan). Details of the Guangzhou study have been published previously (Jia et al. 2013). Knowledge About Drinking and Driving
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
Procedure and Survey Measures A cross-sectional survey design was employed. A survey was developed to collect information on participants’ demographic characteristics and their knowledge and practices in relation to drinking and driving. Knowledge about drinking and driving was examined with 11 questions on the 2 legal limits, metabolism of alcohol, and how to stay under the legal limits. Drinking and driving behaviors and whether or not they had been penalized for drinking and driving were assessed with 9 questions. Alcohol misuse problem were assessed by using the AUDIT tool, which includes 10 questions and assesses hazardous drinking levels using the WHO cutoff scores (Table 1; Babor and Grant 1989; Saunders et al. 1993). Research assistants approached each potential participant and explained the context of the anonymous survey. When a participant consented to take part in the survey, he or she was told that all personal information would be kept confidential in line with ethical approval. When participants had completed the survey, they received a gift (a travel mug) valued at 15 RMB (about US$2.5).
Table A2 (see online supplement) presents the results of questions on knowledge about drink driving and related legislation. The majority (93.1%) of the Yinchuan sample knew that drunk driving had become a criminal offense in May 2011. Knowledge of the legal limit for drink driving (34.2%) was higher than for Guangzhou’s drivers (19.2%) and knowledge of the drunk-driving limit (19.2%) was very close to that of Guangzhou’s drivers (21.2%). Both samples from Yinchuan and Guangzhou had very little knowledge about how many drinks (sprits, wine, and beer) would keep their BAC under the legal limit. Fewer Yinchuan drivers (15.8%) knew that alcohol consumption on an empty stomach could register a higher blood alcohol concentration compared to Guangzhou drivers (54.4%). Drivers in the 2 cities had a very similar proportion (less than 20%) who reported allowing people younger than 18 years to purchase alcohol. Information about the risks of drink driving was received by 76.4% drivers in Yinchuan and 63.3% of drivers in Guangzhou, mainly through television, the Internet, newspapers, and radio, in that order. Drinking and Driving Practices
Statistical Analysis Means for continuous variables were compared using parametric t tests and one-way analyses of variance. Bivariate correlations between continuous variables utilized Pearson’s product moment correlation. All analyses were evaluated at a significance level of α = .05. Standard multiple regression was used to explore the relationship between AUDIT scores and 6 independent variables: age, gender, monthly income, education level, years licensed, and age started drinking. Analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 21.0 (PASW Statistics for Windows, version 18.0; Chicago, IL). The study was approved by the Queensland University of Technology Human Research Ethics Committee.
Results Sociodemographic Characteristics As Table A1 (see online supplement) shows, a total of 406 general motor vehicles drivers were recruited for the project, including 278 (68.5%) males and 126 (31%) females. For comparison purposes, the results of the earlier study in Guangzhou are also presented. The distributions for Yinchuan and Guangzhou were similar for most characteristics, with the exception of occupation (a greater proportion of the Yinchuan sample worked in professional, technical occupations); marital status (more were married in Yinchuan); education (in Yinchuan, there were more with a bachelor’s degree or higher and fewer with only primary school education); in-
Table A3 (see online supplement) presents Yinchuan and Guangzhou general drivers’ drinking and driving practices. Both Yinchuan and Guangzhou samples reported more drink riding on a bicycle than drink driving in a motor vehicle (Yinchuan 28.8% vs. 10.8%; Guangzhou 22.2% vs. 14.8%). In the last 12 months, about 83.3% of drivers in Yinchuan and 81% in Guangzhou reported no drink driving. The range for those who did report drink driving was between 10 and 15% in the 2 samples. In the last 12 months, about 14% in both samples had ridden a bicycle on a public road after drinking and were over the legal BAC. Drink riding (being a passenger of a drink driver) was reported by 27.2% of Yinchuan drivers and 17.7% in Guangzhou in the previous 12 months. There were very low rates (1% in Yinchuan and 1.2% in Guangzhou) of being apprehended for drink/drunk driving in the last 3 years. Being stopped by police for breath alcohol testing in the last 12 months was reported by 22.6% in Yinchuan and 27.9% in Guangzhou. Around 40% in both samples said that they often or always kept track of their drinks if they were driving. Very few reported being jailed for drink/drunk driving or experiencing license sanctions. Alcohol Use (AUDIT) and Its Relationships with Drivers’ Sociodemographic Characteristics AUDIT scores were used to examine alcohol misuse. The mean AUDIT score in Yinchuan was M = 8.2, SD = 4.9, and in Guangzhou it was M = 7.4, SD = 5.4. Table 2 presents the AUDIT score distribution. The proportion of Yinchuan drivers with medium or higher alcohol misuse (31.2%) was higher than that for the Guangzhou drivers (23.1%).
Drink Driving in China
655
Table 2. Distribution of AUDIT scores for general drivers and drink-driving offenders AUDIT score
Level of severity
Yinchuan Number
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
N/A — Low 0–7.9 Medium 8–15.9 High level 16–19.9 Need further diagnostic 20 or evaluation more
Number
35.2 33.5 27.8 3.2 0.2
154 158 74 16 4
37.9 38.9 18.2 3.9 1.0
Table 3. Gender and AUDIT t test, Yinchuan and Guangzhou (excludes nondrinkers)
Yinchuan Male Female Guangzhou Male Female
Mean
n
AUDIT Mean
Novice driver (
ISSN: 1538-9588 (Print) 1538-957X (Online) Journal homepage: http://www.tandfonline.com/loi/gcpi20
General Motor Vehicle Drivers’ Knowledge and Practices Regarding Drink Driving in Yinchuan and Guangzhou, China Keqin Jia, Mark King, Judy Fleiter, Mary Sheehan, Wenjun Ma, Jing Lei & Jianzhen Zhang To cite this article: Keqin Jia, Mark King, Judy Fleiter, Mary Sheehan, Wenjun Ma, Jing Lei & Jianzhen Zhang (2015) General Motor Vehicle Drivers’ Knowledge and Practices Regarding Drink Driving in Yinchuan and Guangzhou, China, Traffic Injury Prevention, 16:7, 652-657, DOI: 10.1080/15389588.2014.1001509 To link to this article: http://dx.doi.org/10.1080/15389588.2014.1001509
View supplementary material
Accepted author version posted online: 08 Jan 2015.
Submit your article to this journal
Article views: 129
View related articles
View Crossmark data
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=gcpi20 Download by: [University of Lethbridge]
Date: 05 November 2015, At: 20:19
Traffic Injury Prevention (2015) 16, 652–656 C Taylor & Francis Group, LLC Copyright ISSN: 1538-9588 print / 1538-957X online DOI: 10.1080/15389588.2014.1001509
General Motor Vehicle Drivers’ Knowledge and Practices Regarding Drink Driving in Yinchuan and Guangzhou, China KEQIN JIA1, MARK KING1, JUDY FLEITER1, MARY SHEEHAN1, WENJUN MA2, JING LEI3, and JIANZHEN ZHANG4 1
Centre for Accident Research and Road Safety–Queensland, Queensland University of Technology, Brisbane, Queensland, Australia Guangdong Institute of Public Health, Guangdong Province Centre for Disease Control and Prevention, Guangzhou, China 3 Yinchuan City Centre for Disease Control and Prevention of Ningxia Hui Autonomous Region, Yinchuan, China 4 School of Medicine, University of Queensland, Brisbane, Queensland, Australia
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
2
Received 3 September 2014, Accepted 18 December 2014
Objective: Drink driving contributes to significant levels of injury and economic loss in China but is not well researched. This study examined knowledge, drink-driving practices, and alcohol misuse problems among general drivers in Yinchuan. The objectives were to gain a better understanding of drink driving in Yinchuan, identify areas that need to be addressed, and compare the results with a similar study in Guangzhou. Methods: This was a cross-sectional study with a survey designed to collect information on participants’ demographic characteristics and their knowledge and practices in relation to drinking and driving. The survey was composed of questions on knowledge and practices in relation to drink driving and was administered to a convenience sample of 406 drivers. Alcohol misuse problems were assessed by using the Alcohol Use Disorders Identification Test (AUDIT). Results: Males accounted for the main proportion of drivers sampled from the general population (“general drivers”). A majority of general drivers in both cities knew that drunk driving had become a criminal offense in 2011; however, knowledge of 2 legal blood alcohol concentration (BAC) limits was quite low. Fewer drivers in Yinchuan (22.6%) than in Guangzhou (27.9) reported having been stopped by police conducting breath alcohol testing at least once in the last 12 months. The mean AUDIT score in Yinchuan (M = 8.2) was higher than that in Guangzhou (M = 7.4), and the proportion of Yinchuan drivers with medium or higher alcohol misuse problems (31.2%) was correspondingly higher than in Guangzhou (23.1%). In Yinchuan, males had a significantly higher AUDIT score than females (t = 3.454, P < .001), similar to Guangzhou. Multiple regression analyses were conducted on potential predictors of the AUDIT score (age, gender, monthly income, education level, years licensed, and age started drinking). There were significant individual contributions of gender (beta = 0.173, P = .09) and age at which drinking started (beta = 0.141, P = .033), but the overall model for Yinchuan was not significant, unlike Guangzhou. Conclusions: The results show that there are shortfalls in knowledge of the legislation and how to comply with it and deficiencies in police enforcement. In addition, there was evidence of drink driving and drink riding at high levels in both cities. Recommendations are made to address these issues. Keywords: China, general driver, road safety, drink driving, AUDIT
Introduction Alcohol-related driving is a significant public health issue, especially in low- and middle-income countries. According to Associate Editor Kathy Stewart oversaw the review of this article. Address correspondence to Keqin Jia, Centre for Accident Research and Road Safety–Queensland, Queensland University of Technology, K Block, 130 Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia. E-mail: g2.jia@student. qu.edu.au Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/gcpi.
research reported by the World Health Organization (WHO), Global Road Safety Partnership, and International Federation of Red Cross and Red Crescent Societies, 33–69% of drivers killed and 8–29% of drivers injured in low- and middleincome countries have illegal blood alcohol concentrations (BACs; Global Road Safety Partnership 2007). However, official Chinese statistics show that the proportion of fatalities related to drink driving ranged between 3 and 4.8% over a 10-year period (Traffic Management Bureau Under Ministry of Public Security 2012). It is considered that these figures reflect underreporting due to insufficient traffic police resources. Drink driving has been acknowledged as a public health concern (Hao et al. 2005, 2007; Li et al. 2011; Z.
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
Drink Driving in China
Fig. 1. Changes in percentage of road traffic crashes, fatalities, injuries, and economic loss caused by drink driving in China (Traffic Management Bureau Under Ministry of Public Security 2013). © Traffic Management Bureau Under Ministry of Public Security. Reproduced by permission of Traffic Management Bureau Under Ministry of Public Security. Permission to reuse must be obtained from the rightsholder.
Wang 2011; Zhang et al. 2014). Figure 1 shows the changes in percentage of road traffic crashes, fatalities, injuries, and economic loss caused by alcohol-related driving in China from 1995 to 2012 (Traffic Management Bureau Under Ministry of Public Security 2013). There is a slightly increasing trend for drink driving–related traffic crashes, fatalities, injuries, and economic loss between 2010 and 2012. On May 1, 2011, drunk driving was upgraded to become a criminal offense under China Criminal Law. That is, a driver with a BAC of 80 mg/100 ml or more while driving will be punished as a criminal offender. This “drunk driving” limit contrasts with a “drink driving” limit: a driver with a BAC between 20 and 80 mg/100 ml is convicted of drink driving, which is not a criminal offense. There were 414,359 drivers apprehended for alcohol-related driving in 2012, 49,384 of whom were drunk drivers (Research Institute of Highway, Ministry of Transport, P.R. China 2013). This means that 11.9% of alcohol-related driving offenses were drunk driving, so that the majority of offenses occurred at low blood alcohol concentrations. It is difficult to interpret the significance of this split because it will be influenced by enforcement practices as well as by the underlying incidence of drink driving in the population. The results are also compared with results for Guangzhou drivers obtained in an earlier study (Jia et al. 2013). Yinchuan is the capital of the Ningxia Hui Autonomous Region in China’s northwest with approximately 1.7 million people. There are 459,647 Hui (23.6%) in Yinchuan. The Hui form one of 56 ethnic groups in China and are predominantly Muslim. According to the Yinchuan Public Security Bureau record, there were 400,000 motor vehicles and 390,000 registered drivers in 2011 (Yinchuan Public Security Bureau 2011, 2012). Traffic crashes accounted for a substantial pro-
653 portion of mortality in Yinchuan between 2008 and 2010 (L. P. Wang et al. 2012). According to the local Public Security Bureau Traffic Police Team, in the first half of 2012 there were 499 traffic crashes, resulting in 73 fatalities, 588 injuries and a direct economic loss of 1,868,708 RMB (approximately US$233,588). In 2011 and 2012, local traffic police teams conducted 41 drink-driving enforcement operations and apprehended 46 drink-driving offenders and 376 drunk-driving offenders. In addition, there were 298 cases of dangerous driving in Yinchuan in 2012 and 99% of them were drunk-driving offenses (Kou and Jiang 2013). Though these statistics are drawn from varying time bases, the time periods overlap and the statistics build a consistent picture of an ongoing impaired driving problem. With the current rapid increase in motor vehicles and drivers, there is a need to better understand the factors that contribute to impaired driving in order to address it through education, legislation, and enforcement. However, there is limited information available on drivers’ knowledge and practices regarding drink driving in China. This study examines knowledge, drink driving practices, and alcohol misuse problems among drivers sampled from the general driving population (“general drivers”) in Yinchuan. In particular, the severity of alcohol misuse problems was measured by the Alcohol Use Disorders Identification Test (AUDIT), a short questionnaire that the WHO recommends to screen hazardous and harmful drinking (Babor and Grant 1989; Global Road Safety Partnership 2007; Saunders et al. 1993).
Methods Participants Between July and August 2012, 406 general vehicle drivers (276 males and 126 females, 2 missing) aged 19–71 years (M = 37.8 years, SD = 9.8) with a current driver’s license or who currently drove with or without a license volunteered to complete a 15-min survey. Recruitment was conducted with the assistance of the Yinchuan City Centre for Disease Control and Prevention (CDC), Ningxia Hui Autonomous Region, China. Convenience sampling was used to recruit participants. Three trained research assistants from the CDC and the first author recruited participants from several sources: drivers attending training and publicity events coordinated by a local traffic police publicity team; drivers visiting Yinchuan CDC for physical examinations; drivers visiting a “4 S” shop (Sale, Spares, Service, and Survey); and private drivers and professional drivers from workplaces including Ningxia Museum, Ningxia Disabled Person’s Federation, Ningxia Education TV, and Yinchuan CDC. All of the drivers lived in Yinchuan. All were aged 18 years or older and were either licensed drivers or currently drove a motor vehicle without a current driver’s license. Detailed information on the demographic composition of licensed drivers in Yinchuan was not available but would not reflect actual driving because of variation in driving between individuals and because the sampling process captured unlicensed as well as licensed drivers. Some of the recruitment sites were more likely to be frequented by active drivers, so the sample probably reflects the population of active general drivers rather than licensed drivers as a whole.
654
Jia et al.
Table 1. AUDIT scores and alcohol misuse severity Alcohol problem severity
AUDIT score
Low Medium High level Need further diagnostic evaluation for alcohol dependence
0–7.9 8–15.9 16–19.9 20 or more
come (higher in Guangzhou); employment (more permanent employment in Guangzhou); licensing (higher in Yinchuan); and professional driver status (higher in Yinchuan). Details of the Guangzhou study have been published previously (Jia et al. 2013). Knowledge About Drinking and Driving
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
Procedure and Survey Measures A cross-sectional survey design was employed. A survey was developed to collect information on participants’ demographic characteristics and their knowledge and practices in relation to drinking and driving. Knowledge about drinking and driving was examined with 11 questions on the 2 legal limits, metabolism of alcohol, and how to stay under the legal limits. Drinking and driving behaviors and whether or not they had been penalized for drinking and driving were assessed with 9 questions. Alcohol misuse problem were assessed by using the AUDIT tool, which includes 10 questions and assesses hazardous drinking levels using the WHO cutoff scores (Table 1; Babor and Grant 1989; Saunders et al. 1993). Research assistants approached each potential participant and explained the context of the anonymous survey. When a participant consented to take part in the survey, he or she was told that all personal information would be kept confidential in line with ethical approval. When participants had completed the survey, they received a gift (a travel mug) valued at 15 RMB (about US$2.5).
Table A2 (see online supplement) presents the results of questions on knowledge about drink driving and related legislation. The majority (93.1%) of the Yinchuan sample knew that drunk driving had become a criminal offense in May 2011. Knowledge of the legal limit for drink driving (34.2%) was higher than for Guangzhou’s drivers (19.2%) and knowledge of the drunk-driving limit (19.2%) was very close to that of Guangzhou’s drivers (21.2%). Both samples from Yinchuan and Guangzhou had very little knowledge about how many drinks (sprits, wine, and beer) would keep their BAC under the legal limit. Fewer Yinchuan drivers (15.8%) knew that alcohol consumption on an empty stomach could register a higher blood alcohol concentration compared to Guangzhou drivers (54.4%). Drivers in the 2 cities had a very similar proportion (less than 20%) who reported allowing people younger than 18 years to purchase alcohol. Information about the risks of drink driving was received by 76.4% drivers in Yinchuan and 63.3% of drivers in Guangzhou, mainly through television, the Internet, newspapers, and radio, in that order. Drinking and Driving Practices
Statistical Analysis Means for continuous variables were compared using parametric t tests and one-way analyses of variance. Bivariate correlations between continuous variables utilized Pearson’s product moment correlation. All analyses were evaluated at a significance level of α = .05. Standard multiple regression was used to explore the relationship between AUDIT scores and 6 independent variables: age, gender, monthly income, education level, years licensed, and age started drinking. Analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 21.0 (PASW Statistics for Windows, version 18.0; Chicago, IL). The study was approved by the Queensland University of Technology Human Research Ethics Committee.
Results Sociodemographic Characteristics As Table A1 (see online supplement) shows, a total of 406 general motor vehicles drivers were recruited for the project, including 278 (68.5%) males and 126 (31%) females. For comparison purposes, the results of the earlier study in Guangzhou are also presented. The distributions for Yinchuan and Guangzhou were similar for most characteristics, with the exception of occupation (a greater proportion of the Yinchuan sample worked in professional, technical occupations); marital status (more were married in Yinchuan); education (in Yinchuan, there were more with a bachelor’s degree or higher and fewer with only primary school education); in-
Table A3 (see online supplement) presents Yinchuan and Guangzhou general drivers’ drinking and driving practices. Both Yinchuan and Guangzhou samples reported more drink riding on a bicycle than drink driving in a motor vehicle (Yinchuan 28.8% vs. 10.8%; Guangzhou 22.2% vs. 14.8%). In the last 12 months, about 83.3% of drivers in Yinchuan and 81% in Guangzhou reported no drink driving. The range for those who did report drink driving was between 10 and 15% in the 2 samples. In the last 12 months, about 14% in both samples had ridden a bicycle on a public road after drinking and were over the legal BAC. Drink riding (being a passenger of a drink driver) was reported by 27.2% of Yinchuan drivers and 17.7% in Guangzhou in the previous 12 months. There were very low rates (1% in Yinchuan and 1.2% in Guangzhou) of being apprehended for drink/drunk driving in the last 3 years. Being stopped by police for breath alcohol testing in the last 12 months was reported by 22.6% in Yinchuan and 27.9% in Guangzhou. Around 40% in both samples said that they often or always kept track of their drinks if they were driving. Very few reported being jailed for drink/drunk driving or experiencing license sanctions. Alcohol Use (AUDIT) and Its Relationships with Drivers’ Sociodemographic Characteristics AUDIT scores were used to examine alcohol misuse. The mean AUDIT score in Yinchuan was M = 8.2, SD = 4.9, and in Guangzhou it was M = 7.4, SD = 5.4. Table 2 presents the AUDIT score distribution. The proportion of Yinchuan drivers with medium or higher alcohol misuse (31.2%) was higher than that for the Guangzhou drivers (23.1%).
Drink Driving in China
655
Table 2. Distribution of AUDIT scores for general drivers and drink-driving offenders AUDIT score
Level of severity
Yinchuan Number
Downloaded by [University of Lethbridge] at 20:19 05 November 2015
N/A — Low 0–7.9 Medium 8–15.9 High level 16–19.9 Need further diagnostic 20 or evaluation more
Number
35.2 33.5 27.8 3.2 0.2
154 158 74 16 4
37.9 38.9 18.2 3.9 1.0
Table 3. Gender and AUDIT t test, Yinchuan and Guangzhou (excludes nondrinkers)
Yinchuan Male Female Guangzhou Male Female
Mean
n
AUDIT Mean
Novice driver (
