AIMS To test the hypotheses that stronger policy environments are associated with less impaired driving and that driving-oriented and drinking-oriented policy subgroups are independently associated with impaired driving. DESIGN State-level data on 29 policies in 50 states from 2001-2009 were used as lagged exposures in generalized linear regression models to predict self-reported impaired driving. SETTING Fifty United States and Washington, D.C. PARTICIPANTS A total of 1,292,245 adults (≥ 18 years old) biennially from 2002-2010. MEASURES Alcohol Policy Scale scores representing the alcohol policy environment were created by summing policies weighted by their efficacy and degree of implementation by state-year. Past-30-day alcohol-impaired driving from 2002-2010 was obtained from the Behavioral Risk Factor Surveillance System surveys. FINDINGS Higher Alcohol Policy Scale scores are strongly associated with lower state-level prevalence and individual-level risk of impaired driving. After accounting for driving-oriented policies, drinking-oriented policies had a robust independent association with reduced likelihood of impaired driving. Reduced binge drinking mediates the relationship between drinking-oriented policies and impaired driving, and driving-oriented policies reduce the likelihood of impaired driving among binge drinkers. CONCLUSIONS Efforts to reduce alcohol-impaired driving should focus on reducing excessive drinking in addition to preventing driving among those who are impaired.

中文翻译：

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美国的酒后驾车政策和酒后驾车：酒后驾车与酒后驾车的政策的影响。

目的为了检验以下假设：较强的政策环境与较少的驾驶障碍相关联，而以驾驶为导向和以饮酒为导向的政策子组独立地与障碍驾驶相关联。设计2001年至2009年期间50个州的29个政策的州级数据被用作广义线性回归模型中的滞后风险，以预测自我报告的驾驶不便。背景五十名美国和华盛顿特区的参与者从2002年至2010年，每两年有1,292,245名成人（≥18岁）。措施酒精政策量表得分代表了酒精政策环境，是通过对各项政策进行了加权综合得出的，这些政策按其效力和州的实施程度进行了加权。从行为危险因素监视系统调查中获得了2002-2010年过去30天的酒后驾驶障碍信息。研究结果较高的酒精政策量表分数与较低的州水平患病率和个人水平的驾驶障碍风险密切相关。在考虑了以驾驶为导向的政策之后，以酒为导向的政策具有强大的独立性，减少了驾驶不便的可能性。减少暴饮酒会调解以饮酒为导向的政策与不良驾驶之间的关系，而以驾驶为导向的政策则减少了狂饮者中驾驶受损的可能性。结论减少酒后驾驶的工作应着重于减少过量饮酒，以及在有残障的人中防止驾驶。以饮酒为导向的政策具有强大的独立性，减少了驾驶不便的可能性。减少暴饮酒会调解以饮酒为导向的政策与不良驾驶之间的关系，而以驾驶为导向的政策则减少了狂饮者中驾驶受损的可能性。结论减少酒后驾驶的工作应着重于减少过量饮酒，以及在有残障的人中防止驾驶。以饮酒为导向的政策具有强大的独立性，减少了驾驶不便的可能性。减少暴饮酒会调解以饮酒为导向的政策与驾驶不便之间的关系，而以驾驶为导向的政策则减少了在暴饮酒者中驾驶不便的可能性。结论减少酒后驾驶的工作应着重于减少过量饮酒，以及在有残障的人中防止驾驶。