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INTRODUCTION. Strong laws with publicized strong enforcement are a proven countermeasure for changing driver behavior. This approach, for example, has led to.

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Strong laws with publicized strong enforcement are a proven countermeasure for changing driver behavior. This approach, for example, has led to increases in seat belt use Dinh-Zarr, Sleet, Shults, et al., 2001; Tison, Williams, 2010, decreases in alcohol-impaired driving Shults, Elder, Sleet, et al., 2001; Wells, Preusser, Williams, 1992, and ultimately reductions in crash deaths Farmer, Williams, 2006; Dinh-Zarr et al., 2001; Shults et al., 2001. As cell-phones began to proliferate in the late 1990s, a number of experimental studies found decrements in simulated or instrumented driving performance associated with phone use McCartt, Hellinga, Braitman, 2006, and a well-publicized epidemiological study found a fourfold increase in the risk of a property damage-only crash associated with a driver s phone conversation Redelmeier, Tibshirani, 1997. Bolstered by this research, concerns about the risks of drivers cellphone use led to the passage of laws limiting use. These laws are widespread in other countries and are increasingly common in the United States. This paper summarizes the research on the effectiveness of these laws in the United States.

On November 1, 2001, New York became the first state to implement a law prohibiting all drivers from talking on a hand-held cellphone while driving. Currently a total of 12 states and the District of Columbia have such laws. All of the laws allow emergency calls, most allow hand-held dialing, and some allow talking when stopped in traffic, at controlled intersections, or on the side of the road. The language in early hand-held cellphone laws in Connecticut effective October 1, 2005 and the District of Columbia effective July 1, 2004 covered text messaging, but Washington enacted the first law specifically banning all drivers from texting, effective January 1, 2008. Many states rapidly followed suit, and currently 41 states and the District of Columbia prohibit texting by all drivers. Beginning with New Jersey on January 8, 2002, 37 states and the District of Columbia have implemented laws targeting teenage drivers. These laws generally prohibit any use of an electronic device/telecommunications device/ cellphone, whether hands-free or hand-held; the laws may be based on age e.g., younger than 18 or license stage e.g., learner s permit or intermediate license. Only three states Arizona, Montana, and South Carolina have no laws limiting drivers cellphone use. Thus, currently there is a patchwork of laws limiting drivers cellphone use across the United States. Appendix A summarizes the history of the all-driver hand-held cellphone laws, all-driver texting laws, and teenage driver cellphone laws, including effective dates and key provisions.

Conducting rigorous evaluations of highway safety laws can be challenging. Ideally, information can be obtained to measure meaningful changes in the targeted behavior following implementation of the law and corresponding changes in crashes, injuries, or fatalities. For the link between a law and crash outcomes to be convincing, there should be strong evidence of an elevated crash or injury risk associated with the targeted behavior, and the crash measure should be consistent with this evidence.

However, the crash risk associated with using a cell-phone while driving is not well understood. Part of the challenge is that the contribution of phone use or other distractions to crashes is not fully or consistently recorded in databases of police-reported crashes e.g., National Safety Council, 2013. The chief problem is that drivers are unlikely to volunteer that they were using phones, especially if it is illegal, and there usually is no other evidence of phone use at the crash scene. In addition, reporting practices likely have changed as the issue of distraction has grown in prominence and as states have enacted laws limiting cellphone use and added codes for cellphone use to crash report forms.

Figure 1 plots the annual percentage of crash deaths coded as involving driver distraction during 1999–2012 in each of several states and nationally. These data come from the Fatality Analysis Reporting System FARS, a national census of crashes that occur on public roads and result in at least one death within 30 days. There are large, unexplained differences among the states and year-to-year anomalies within some states. For example, during 1997–2007, the proportion of crash deaths coded as involving distraction was 45–63 in New Mexico and 6–26 in California. Even after coding changes were implemented in 2010 to address some of the reporting problems, anomalies and inconsistencies have persisted. Thus, data on cellphone-related crashes in crash databases do not provide a solid basis for establishing the prevalence of cellphone-related crashes, supporting epidemiological research on the risks of cellphone use, or evaluating the effectiveness of cellphone bans.

Another challenge is that the findings from the few studies that have estimated crash risk associated with cellphone use are mixed. Two studies obtained cell-phone billing records to verify phone use of drivers involved in property damage-only crashes Redelmeier, Tibshirani, 1997 and in crashes serious enough to injure the drivers McEvoy, Stevenson, McCartt, et al., 2005. Using a case-crossover design, both studies found a fourfold increase in crash risk associated with phone conversations; the increased risk was similar for hands-free and hand-held phone use. Although the case-crossover designs accounted for possible driver differences, they assume the reasons for phone use are independent of crash risk, which may not be the case. Drivers with higher crash risk, who were more likely to get into the studies, may be affected by cellphone use differently than less risky drivers. Plus, the subjects may have had imperfect recall of whether or not they drove during control periods.

Young and Schreiner 2009 examined the call records of OnStar hands-free mobile phone customers and airbag deployments. Airbag deployment crash rates were not significantly different during periods when drivers were using the OnStar phone system compared with periods of non-use. As with the case-crossover studies, the reasons for phone use may not have been independent from crash risk, and the distribution of driving conditions for OnStar and non-calling minutes was unknown. The analysis did not account for periods when drivers may have been using their portable cellphones. It also was unclear if drivers who placed calls through the OnStar system while driving were different from those who did not.

The risk of cellphone use also has been examined in naturalistic studies that continuously videotape drivers and monitor their driving. Klauer, Dingus, Neale, et al. 2006 collected 1 year of data from 109 drivers and found that the risk of an at-fault crash or near-crash was 1.3 times as high when drivers were talking on hand-held phones and 2.8 times as high when drivers were dialing compared with just driving; the latter difference was significant. However, nearly 9 times as many near-crashes as actual crashes were observed, and only 17 of the crashes were reported to police Dingus, Klauer, Neale, et al., 2006. Based on a re-analysis of these data and an analysis of data from 42 newly licensed teenagers, the risk of an at-fault crash or near-crash among teenagers was significantly increased with dialing or reaching for a phone and with texting compared with just driving Klauer, Guo, Simons-Morton, et al., 2014. Among adult drivers, only dialing was associated with increased risk; texting was not assessed. Using near-crashes in addition to crashes to estimate risk may result in more conservative risk estimates than when using crashes alone Guo, Klauer, Hankey, et al., 2010.

Fitch, Soccolich, Guo, et al. 2013 collected 1 month of data from 204 drivers who reported using phones daily while driving. The estimated risk of a crash, near-crash, or crash-relevant conflict was 21–27 lower when drivers were talking on a portable hand-held or hands-free cellphone compared with just driving, but these estimates were not significant. Risk was nearly twice as high when drivers engaged in visual/manual tasks such as dialing, texting, or reaching for a phone. Most of the 342 events were crash-relevant conflicts, and only 6 were crashes, including 2 curb strikes. It is unknown how well less severe crash surrogates such as crash-relevant conflicts predict actual crashes, especially serious ones.

Bhargava and Pathania 2013 examined patterns of cellphone use while driving and police-reported crashes around a common transition from peak to off-peak cellphone plan pricing at 9 p.m. Calls that were switched between towers were assumed to be made by drivers. Weekday rates of calls switching towers during 9– p.m. per traffic counts during 11 days in California in 2005 were 7.2 percentage points higher than the hour before, a significant increase. However, this uptick in cellphone use did not correspond with significant changes in crash counts in California and 8 other states between 9– p.m. and the hour before during 2002–05 compared with changes between these time periods in 1995–98 when cellphone use was scarce. Some calls would have been made by passengers including mass transit riders, and treating all such calls as being made by drivers could be a problem if the relative cellphone behavior of drivers and passengers or the passenger occupancy rate varies by time of day.

On the issue of texting while driving, even less is known. There are no studies estimating actual crash risk associated with texting. Three naturalistic studies estimated the risk associated with texting, producing widely divergent estimates of risk. In a study of drivers who frequently used their phones while driving, the risk of a crash, near-crash, or crash-relevant conflict was about two times higher when drivers were texting compared with just driving or driving without using a phone Fitch et al., 2013. In a study of drivers of large trucks, the odds of a lane drift, traffic conflict, near-crash, or crash were 23 times as high when drivers were texting compared with just driving Olson, Hanowski, Hickman, et al., 2009. In both studies, actual crashes represented less than 2 of the incidents. It is unknown how less severe incidents relate to actual crashes or whether the results from either study generalize to the general population of drivers. A study of newly licensed teenagers found the risk of an at-fault crash or near-crash was 4 times as high when sending or receiving text messages compared with just driving Klauer et al., 2014. The sample included 31 crashes and 136 near-crashes.

The deleterious effects of cellphone use and texting on simulated or instrumented driving performance are well-established Caird, Johnston, Willness, et al., 2013; Caird, Willness, Steel, et al., 2008; McCartt, Hellinga, Bratiman, 2006. However, the absence of a thorough understanding of the crash risks associated with cellphone use and texting while driving has important implications for evaluating laws limiting drivers cellphone use. Formulating careful hypotheses about the magnitude or direction of the effects of cellphone or texting bans and selecting appropriate crash outcome measures are challenging.

The current review focuses on studies published in peer-reviewed journals or as technical reports. Studies were identified through online databases e.g. the National Academy of Science s Transportation Research Information Services TRIS database, ScienceDirect, Google Scholar, PubMed using key word variants of mobile phone, cell phone, texting, legislation, and ban, and combinations of these keywords. Backward referencing was used to identify additional studies. Most of the studies identified were conducted in the United States, but there also were several studies of the effects of cellphone bans on driver behavior in other countries e.g., Hussain, Al-Shakarchi, Mahmoudi, et al. 2006; Johal, Napier, Britt-Compton 2005; Rajalin, Summala, Pöysti, et al. 2005. However, evaluations of the effects of cell-phone laws on crashes were confined to U.S. studies. Therefore, this review is restricted to evaluations of U.S. cellphone legislation.

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