a series of hearings. The Commission listened to victims of drunk driving crashes or to their families, as well as to enforcement officers, prosecutors, judges, and probation personnel. Educators, legislators, health leaders, the clergy, the media, and business executives also contributed their views on the problem and possible solutions. The information learned during these hearings and from testimony and papers submitted by world wide experts was all considered by the Commission in developing the recommendations contained in the Interim Report to the Nation. That report, dated December 13, 1982, was distributed to more than 4,000 individuals, organizations, and associations, including officials, governors, State legislators, police chiefs, motor vehicle administrators, health professionals, and corporate executives. Their comments and recommendations were solicited, and we were gratified by the response. More than 600 thoughtful responses were received by the Commission and were considered when preparing this Final Report to the Nation. Chronology of Commission Activities -April 14, 1982-President Reagan signed Executive Order No. 12358 establishing the Commission and appointed John A. Volpe as the Chairman. -May 18, 1982-White House Press Release distributed with the names of the individuals appointed to the Commission. -June 4, 1982-First Commission meeting. The Commission was briefed on the problem, available tools and resources, and State and local experiences. The Commission discussed actions to be taken and organizational approaches. -July 14, 1982-The Education and Prevention Committee, chaired by Dr. Morris Chafetz, held a working meeting in Washington, D.C., to establish a Committee agenda. - August 2 and 3, 1982-The Executive and Legislative Leadership Committee, chaired by Governor Frank White of Arkansas, held a meeting and a public hearing in Oklahoma City, Oklahoma. - August 9-11, 1982-The Enforcement and Adjudication Committee, chaired by Judge Sherman Finesilver, held a meeting and a public hearing in Denver, Colorado. -September 8, 1982-The Education and Prevention Committee held a public hearing in Boston, Massachusetts. -September 13, 1982-The Commission met in Scottsdale, Arizona, in conjunction with the annual meeting of the National Association of Governors' Highway Safety Representatives. The purpose of the meeting was to review Committee progress and to report on the results of the hearings held to date. -October 4, 1982-The Enforcement and Adjudication Committee held a public hearing in Chicago, Illinois, to receive comments on its draft findings. -October 8, 1982-The Education and Prevention Committee held a meeting in Washington, D.C., to prepare its draft recommendations. -October 25 and 26, 1982-The Commission held a public hearing in Baton Rouge, Louisiana. - November 4 and 5, 1982-The Commission held a public hearing in Detroit, Michigan. -November 8 and 9, 1982-The Executive and Legislative Leadership Committee held a public hearing in San Francisco, California. -November 29, 1982-The Commission held a public hearing in Washington, D.C., to obtain information from national organizations and associations on their plans to address the drunk driving problem. -November 30 and December 1, 1982-The Commission held a meeting in Washington, D.C.. to assess findings to date and to prepare its Interim Report. -December 13, 1982-The Commission presented a copy of its Interim Report to President Reagan and began distributing over 4,000 copies for review and comment. -May 18 and 19, 1983-The Commission held a meeting in San Antonio, Texas, to consider comments received on the Interim Report, to review recent events, and to consider changes to be incorporated in the Final Report. -September 26, 1983-The Commission held its final meeting in Atlanta, Georgia, to approve this Final Report and to establish a continuing National Body. The Commission's Recommendations In making its recommendation, the Commission acknowledges that driving under the influence is basically a State and local problem for which State and local solutions must be found. The Commission sees its report as a catalyst for such action and as a source of guidance for the States and localities as they develop effective, long-term programs to combat drunk driving. State and community officials have enthusiastically responded to the Commission's leadership in its Interim Report; this response must continue if we as a nation are to see a reduction in the deaths and injuries caused by drivers under the influence of alcohol. The Presidential Commission on Drunk Driving believes that any program adopted to respond to the drunk driving problem should include six (6) key elements: -First, drunk driving must be recognized as socially unacceptable. We must focus on bringing about changes in society's attitude of toleration toward drunkenness and drunk driving. The public must realize that the grave consequences of driving under the influence require each of us to take the personal responsibility for prevention in our own social circles. -Second, since attitudes about drinking and driving are largely shaped within the community, and because the primary administrative responsibility for our efforts to combat drunk driving rests with the groups and governments at that level, efforts must have a community focus. -Third, because attempts to deal with the problem involve a large number of governmental agencies and private groups, a systems approach must be employed to ensure that the activities of these groups are coordinated and interrelate smoothly to enhance their effectiveness. -Fourth, in order to ensure that our laws play their proper role in discouraging the largest possible number of potential drunk drivers, States and localities should take a general deterrence approach in developing short-term remedies to the problem, with the focus on increasing the perception of risk of arrest. -Fifth, to help develop personally responsible drinking and driving behavior, and to build a community consensus behind effective countermeasure programs, citizen support through grassroots groups must be encouraged. -Sixth, because drivers under the influence are responsible for this problem with its great resulting human cost, it is appropriate that offenders should defray the costs of enforcement, prosecution, adjudication, treatment, and education. The Commission recognizes that alcohol-related programs, especially those relating to enforcement and adjudication, can and should be made selffunding. Such a recommendation is included in this report. Furthermore, the Commission emphasizes the need for an adequate funding mechanism at the Federal level which would allocate monies to States and local communities, as well as to the private sector. This combined approach would ensure the timely and orderly implementation of the Commission's recommendations, resulting in a coordinated systems response to the national tragedy of alcohol-related crashes. We take note that federal incentive grants are currently available to States that adopt many of the Commission's recommendations, for example, enactment of a 21 year old minimum legal purchasing age for alcohol. The Commission further recommends that the Administration and the Congress consider not only general and traditional dedicated revenue sources, e.g., The Highway Trust Fund, but new dedicated funds as well. The Commission's recommendations are organized according to the major elements contained in the Commission's program for combating drunk driving. The recommendations presented under the following headings: Public Awareness Alcoholic Beverage Regulation Prosecution Adjudication Licensing Administration Education and Treatment are A word of caution. The Commission believes that, to achieve a lasting impact, no one element of this program can be enacted by itself; a coordinated, decade-long commitment to a multifaceted approach must be taken by every State and community. No one suggestion or recommendation and no single aspect of the system can produce the results the Nation desires. The Commission realizes that the long-term impact which we all desire can be achieved only through a long process, culminating in the only guarantee of permanent change: changes in individual attitude and behavior. To promote that change, the Commission's recommendations are: PUBLIC AWARENESS Drunk driving is one of a multitude of important social problems that vie for an American's attention. A welldesigned and sustained public awareness program, however, can keep the "driving-under-the-influence" issue before the public long after the initial wave of public interest has passed. Carefully planned and coordinated releases to the media can be used to inform the general public of new laws, increased law enforcement, and the success of efforts to reduce driving under the influence. The program should consist of the following elements: Recommendation-Public Information Campaign A media program should be developed and coordinated among appropriate agencies in each State, in cooperation with the private sector, to focus on alcohol use and abuse and their correlation to highway safety. Properly included should be information relating to new laws, fatalities and injuries, arrests, and current program activities. Specifically, the program should have the following aims: (1) To increase public awareness of the risks of a crash caused by drinking and driving; (2) To heighten the perceived risk of apprehen- (3) To encourage responsibility on the part of the (5) To foster awareness of the health benefits of Commentary Highly publicized law enforcement programs have proven effective in bringing about short-term reductions in alcohol-related crashes. Programs to inform the public about increased law enforcement activities should therefore be pursued as a means of preventing intoxicated drivers from getting behind the wheel of a motor vehicle. Other segments of the public awareness campaign should focus on the potential offender's social activity and environment. Since alcohol in sufficient quantities impairs a person's ability to judge his or her own ability to drive, friends, associates, and family members must be informed of appropriate intervention strategies that can deter an intoxicated person from driving. In some communities, social disapproval of drunk driving is expressed when local newspapers print the names of all persons arrested and or convicted of driving under the influence. Since no program of deterrence can be expected to achieve complete success, the public should be informed that the use of safety belts and child restraints can reduce the death and injury toll in motor vehicle crashes by 50 percent. In addition, the public should be informed that compliance with the existing speed limit mitigates the result of a crash. References • "A Descriptive Review of Selected Mass Media Cam paigns on Highway Safety," DOT-HS-805–954. "A Public Communications Manual for Highway Safety Planners," DOT-HS-805-794. • Deterring the Drinking Driver, Ross, Lexington Books, 1981. Recommendation-Administration Each State should identify a single coordinating agency for public information and education programs to minimize or prevent issuance of contradictory messages that confuse the public and endanger long-term continuity of combined efforts. Commentary The public has shown an increasing readiness to take action to prevent driving under the influence. If these energies are to be effectively mobilized, people must be given clear messages about how they can prevent such behavior and reduce their own risk of death or injury at the hands of a person driving under the influence. A coordinating agency could coordinate messages, eliminate duplication, and highlight significant media events. Also, many people are confused about the amount of alcohol which can cause impairment. Coordinated efforts and coordinated messages within each State, and among the States, can reduce such confusion. PUBLIC EDUCATION Public education programs complement public awareness programs by inducing long-term changes in attitudes and behavior toward alcohol abuse. The ultimate goal of public education on the drunk driving issue is to make drunk driving and intoxication itself socially unacceptable. Over the long term, the need to retain the social approval of one's peers may be a more powerful incentive to avoid intoxication and drunk driving than fear of arrest or involvement in a crash. The change in social attitudes toward smoking during the past decade and the subsequent decline in smoking are an example of how powerfully such social reinforcement can affect behavior. To be effective, educational programs to promote new social norms should be tailored to the audience and should promote positive actions to be taken to prevent alcohol abuse or driving under the influence. Programs to promote long-term behavior changes should include: Recommendation-Media and Influentials Editorial boards and media trade associations should encourage their associates and members to communicate with the public regularly about alcohol use and abuse and highway safety. Television and radio program managers and film makers should portray alcohol use and abuse and highway safety in a responsible manner, and, where appropriate, use program content to communicate with the public about the problem of driving under the influence. The clergy in each community should periodically remind their congregations about their responsibility for highway safety, particularly in regard to alcohol use and abuse. Medical schools and associations should give a high priority to alcohol use and abuse issues in their curricula and organizational agendas. Physicians should be encouraged to educate their patients. Commentary Community-wide encouragement and reinforcement of changed social norms are a must if real progress is to be made in DUI statistics. Education through the media and through influential citizens has a strong impact, particularly if the messages are uniform and the efforts are coordinated to maximize the public's exposure to preventive education. Recommendation-Youth Programs The best hope for prevention lies in teaching people how to prevent drunk driving among those in their own social circles-family, friends, neighbors, and coworkers. Young people must be a primary focus, both because they are at greatest risk for involvement in motor vehicle crashes and because their driving and drinking habits are still in the formative stages. Programs must include a variety of curricular and extracurricular educational activities: (1) Curricula concerning alcohol, drugs and other impairments on the body and their relationship to highway safety should be included as part of general school curricula promoting values clarification and decisionmaking skills. Training for teachers and school counselors is an essential ingredient. (2) Extracurricular programs in junior and senior high schools and in colleges should be publicized and encouraged. (3) Driver education programs should include information on the effects of alcohol, drugs, and other impairments on the body. (4) Athletic clubs and other youth organizations should establish programs for members and their peers concerning the use and abuse of alcohol, drugs, and other impairments on the body. Commentary Alcohol education has been shown to have a significant impact on young people's knowledge and attitudes about alcohol abuse. When alcohol education is incorporated in the curriculum as a part of general life skills training, alcohol loses its lustre as a magical potion. The record indicates that young people have responded to educational programs designed to illustrate the danger of alcohol misuse, particularly when programs begin early in the educational process. Studies have shown that children as young as five can distinguish between the effects of alcoholic and non-alcoholic beverages. In addition, since young males represent a disproportionately high risk category for motor vehicle crashes, alcohol education should emphasize the reasons males are more susceptible, e.g., careless driving at high risk hours as a means of demonstrating masculinity, or expressing anger or aggression. These concepts should be reinforced in driver education programs. Such educational programs should also discuss drugs and other impairments on the body that can cause highway crashes. References "Effectiveness and Efficiency of Traffic Safety Programs in Alcohol Safety," DOT-HS-806-141, March 1982. "Teenage Driving After Using Marijuana or Driving and Traffic Accident Involvement," Journal of Safety Research, National Safety Council, Spring 1982, Vol. 13, No. 1. PRIVATE SECTOR If new social norms are to evolve as a primary means of preventing drunk driving, then prevention activities should be focused on natural social settings, particularly the work place and local organizations. Social ties among people in these environments will help strengthen each person's sense of responsibility to preserve the lives and safety of people near and dear to them. Private sector support of drunk driving prevention programs should be sought in all industries, since all of us are affected by the results of drunk driving. Those industries which deal with alcohol or motor vehicles, however, should be especially involved in prevention. The motor vehicle is a part of the equation that results in alcoholrelated crashes. Hence, it is important that those engaged in selling, insuring, and maintaining motor vehicles cooperate in public information and education programs. Alcohol's pharmacological effects also put a great burden of responsibility on producers, distributors, servers, and purveyors of alcoholic beverages to prevent misuse of these beverages and to prevent dangerous actions on the part of people who misuses alcohol. Recommendation—General Outreach Corporations and industry trade associations, labor organizations, civic, fraternal, and social organizations should: (1) Develop and disseminate to employees and/ or members policy statements regarding the use and abuse of alcohol and alcohol's relationship to highway-related deaths and injuries, and implement these policies at company-sponsored events. (2) Implement educational programs directed toward their employees and customers concerning the problems caused by driving under the influence and the solutions available. (3) Implement employee assistance programs to deal with employees' alcoholism problems. (4) Become active advocates and participants in local or State endeavors to reduce driving under the influence. Commentary Alcohol can affect judgment and tends to inhibit recall of recently learned information. Combined, these effects make an intoxicated person a poor judge of his or her own fitness to drive. Hence, the burden of responsibility for the public safety falls not only on the intoxicated person but on the social network, the support group in which he or she moves. Drinking to excess should be made unacceptable at group events, and group members should be made aware of specific means to prevent those who do drink excessively from endangering themselves and others. Alternatives by way of non-alcoholic beverages should be available at company parties and large social gatherings. Employee assistance programs and other programs, such as taxi programs which provide free rides home for employees under the influence, assist employees to overcome problems and to establish behavioral norms. Reference "Expanding DWI Public Information Outreach Through Intermediary Groups,” Preliminary Draft, NHTSA Contract DTHN-22-81-C05093. Recommendation-Motor Vehicle Motor vehicle manufacturers and dealers should include in their owners' manuals, advertising programs, showrooms, and local sales efforts information on the hazards of combining alcohol use and driving and the benefits in reducing death and injury of using safety belts and child restraints and adhering to the 55 mph speed limit. Insurance companies should include in their policy billings, advertising and sales materials, and agent information kits, information on the hazards of combining alcohol use and driving and the benefits in reducing death and injury of using safety belts and child restraints and adhering to the 55 mph speed limit. Gasoline stations and motor vehicle repair shops should display signs informing their customers of the law and their responsibility relating to the hazards of combining alcohol use and driving and the benefits in reducing death and injury of using safety belts and child restraints and adhering to the 55 mph speed limit. Commentary It is important that those who are engaged in selling. insuring, and maintaining motor vehicles cooperate in informing the public about driving under the influence. Innovative programs and research currently being carried out by some companies should be continued and expanded. The public should be provided with specific information on how to avoid excessive drinking when driving. The public should be kept informed about safety belts and child restraints and encouraged to use these restraints themselves and to urge their passengers to use them. Similarly, the public should continue to be informed about |