Distracted driving – It is time for public health to step in
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I will never forget my first professional encounter with mobile phones (cell phones) and distracted driving. Yes, my wife and I used to try to guess whether or not the driver in the car in front of us was using a mobile phone. But in 2001, my colleague Ben Kelley and I organized Public Health Rounds for a large group of Tufts medical students. We showed them early studies on mobile phones and driving: the well-known Ontario study of accidents and concurrent mobile phone use that used telephone records;1 and a study where the researchers examined driver behavior in a simulator.2
The Canadian study found a four-fold increase of two vehicle accidents during the time when drivers had been on the mobile phone. The simulator researchers collected split-image videos of the driver's eyes and the road ahead. When moving along a simulated highway, the driver's eyes would scan back and forth, side to side, presumably seeing hazards at the sides of the road. When the driver answered the phone, this scanning behavior ceased. Multi-tasking had overwhelmed the protective behavior. Importantly, the effect did not depend on the driver using a handheld telephone.
Our students were furious. Many refused to believe the studies. Most of them chose to defend their own use of telephones while driving by invoking exceptionalism. They said, ‘Yes, but I’m different. I can drive safely while using the phone’. As I paid more attention to this behavior, driving while using a mobile telephone, the refrain has become familiar to me. I seem to hear it almost every time that I ask a taxi driver to please end a telephone conversation.
Surely, mobile phones are not the only cause of distracted driving, as it appears that any multi-tasking can interfere with a driver's attention to driving, but they are a large problem. Police in the United Arab Emirates reported that a 3-day outage in 2011 of the local Blackberry cellular network resulted in a 40 per cent reduction in traffic accidents.3
It has always been a problem to keep powerful vehicles fully under control. To do so, society has built safer vehicles and designed safer roads. We have written laws to deter dangerous driving. Yet addictions have always challenged road safety efforts, because under the influence of drugs and alcohol, to which they may be addicted, drivers cannot choose to drive safely.
Now comes a new addiction: the compulsion to be in touch, to communicate immediately. E-mail, Facebook, Twitter, and many elements of new media appear to be addictive, as the users feel a compulsion to communicate immediately.7 Mobile phone use, particularly texting, has become a distraction that many people, particularly the young, cannot hold at bay.
The makers of telephones and other communications devices have made them faster and easier to use, and, of course, more attractive to look at.
The telephone companies (Internet service providers) have spread their signals to reach almost everyone, everywhere, with more and more information sent and received per second.
The makers of cars and trucks are creating a new image to sell their product. Buyers seem attracted by new in-vehicle environments that emphasize distractions and communication rather than the road ahead.8
Phone makers, service providers, and automakers could be developing technologies to keep the driver focused on the road, but if they are doing so at all, it is very slowly and less visibly. AT&T, a US-based telephone company, has recognized the hazard and has initiated a program called It Can Wait. It starts, not with a technology-based approach, but with a ‘pledge: never txt and drive’.9
This is where the public health community is needed. Let's take the lead and study the technologies, the laws, and the addictive behaviors so that we can develop an inclusive strategy to control distracted driving. Only a public health strategy is likely to weave government, commercial, community, and individual tools available in schools, workplaces, and neighborhoods, into a comprehensive approach to make people safer while on or near roads.
Alas, our record is mixed, when it comes to taking on powerful commercial interests. Conservative governments have often preferred public health strategies that target individual behavior rather than proximal causes controlled by powerful commercial interests. Lim and Chi4 say, ‘After all, the underlying culprit is human behavior rather than the communication devices’. But which human behaviors?
To eliminate distracted driving, public health can do more than focus on the distracted driver who causes damage, injury, and death. A primary prevention strategy will lead us beyond the behavior of individuals to the corporations in the communications and automobile industries and government regulators. Let us target them to change the driving environment within which drivers make choices.