History of Alchohol Programs

History of Youth Traffic Safety and Alcohol Programs

SADD. The single best known youth program is SADD, originally Students Against Driving Drunk. SADD was founded in 1981 as a high school-based program to reduce youth drinking and driving. Its original model included school assemblies, a student club (called a SADD chapter), alcohol-free activities, a 15-session curriculum for use in the sophomore year, and a Contract for Life between youth and parents in which youth who have been drinking and need a ride home agree to call parents and parents agree to provide the ride. SADD maintained national and state offices and provided program materials to school SADD chapters but did not control state or chapter activities. Consequently, state SADD organizations and local chapters operated in rather different ways with goals and activities adapted to local needs and opportunities. SADD's national goals have expanded beyond drinking and driving to other health and safety issues, as shown by its name change to Students Against Destructive Decisions.

SADD grew rapidly. By 1994 there were SADD chapters at an estimated 16,000 of the nation's high schools. Some state SADD organizations were well-organized with an effective state coordinator; others were not. In some states, SADD activities evolved under another name, sometimes with a continuing association with SADD, sometimes not: STAND in Colorado and SAFTYE in Washington are two examples.

State youth programs.

At the same time that SADD was expanding rapidly, state traffic safety activities directed at youth drinking and driving also grew, with assistance from federal funds. Each state receives federal funds each year for highway safety activities under Section 402 of the Highway Safety Act of 1966. States usually allocate some of these funds to youth programs. In addition, some states qualified for additional funds for several years in the 1980s and 1990s under the Section 408 and 410 alcohol incentive grant programs and used portions of these funds for youth programs.

A good view of how state impaired driving programs directed at youth grew, and what they included, can be found in a series of NHTSA assessments of how these federal funds were used (LaHeist, 1998). For these assessments, NHTSA selected one state from each of the 10 NHTSA regions. In each state, NHTSA traced how federal highway safety funds were used from 1980 to 1993. The information following, taken from these assessments, summarizes youth alcohol program activity across the 10 states and provides selected examples from each state.

Each of the 10 states developed and implemented a large number of youth impaired driving programs. Practically all were supported by federal funds. Programs usually began in a few areas and, if successful, spread statewide. One of the most popular was Project Graduation, which organizes alcohol-free prom and graduation celebrations at high schools and which was conducted extensively in each of the 10 states. SADD chapters were formed in most states. Several states developed media or other education programs for elementary and intermediate schools. All states conducted public education activities directed at youth drinking and driving. Many states integrated youth program activities into community traffic safety programs.

Refusal Skills

Colorado developed a "refusal skills" drug and alcohol education program which was part of the regular school curriculum by 1992. The first SADD chapter was formed in 1984. Colorado's SADD chapters reorganized in 1998 as STAND (Students Taking A New Direction) and have spread throughout the state. BACCHUS (Boost Alcohol Consciousness Concerning the Health of University Students) and GAMMA (Greeks Advocating Mature Management of Alcohol) chapters were active on every major college campus by 1994, promoting designated driver and Safe Spring Break programs and the National Collegiate Alcohol Awareness Week.

Connecticut began Project Graduation activities in 1986. Using the design and materials of Nationwide Insurance's "Prom Promise," 50 schools participated in 1994. A group of Middletown police officers, calling themselves the "Blue Crew," produced an award-winning rap video and poster on drinking and driving that was distributed to all Connecticut high schools and libraries. The NHTSA "Team Spirit" leadership program was introduced in 1994.

Kansas implemented a pilot drug and alcohol prevention program in Wichita schools in 1982 that reduced school suspensions for alcohol by more than 30 percent by 1985. Training conferences spread the program to other areas. Kansas established a Governor's Center for Teen Leadership in 1989 to promote drug- and alcohol-free lifestyles through education and training. SADD chapters grew from 3 in 1985 to over 200 by the early 1990s. Radio and television PSAs directed at youth drinking and driving were developed and aired.

Nevada conducted a Governor's Student Safety Program in 1980 for high school students and advisors. SADD in Nevada began in 1984. Friday Night Live programs provide youth with alcohol-free activities on weekends.

New Jersey youth activities began in 1979 as S.O.B.E.R. (Stay Off the Bottle, Enjoy the Road), a community-level public information campaign involving MADD, RID, SADD, PTAs, the Federation of Women's Clubs, and other civic organizations. The Teen Institute of the Garden State (TIGS) was begun in 1987 to train students in alcohol and drug prevention strategies and leadership skills. The Governor's Youth Advisory Task Force on Alcohol and Drug Prevention was established in 1993 to oversee youth activities.

New Mexico's youth drinking and driving activities began in 1984, when the first SADD chapters were started. An Albuquerque school-based drinking and driving education program was begun in 1985 and spread to six other school districts by 1987. The Traffic Safety Education and Enforcement Fund, legislated in 1990, funded youth public information campaigns. Teen courts and Friday Night Live programs were active in several communities.

North Carolina formed the Governor's Youth Advocacy and Involvement Office in 1983 to organize youth groups and educate them about drinking and driving. SADD grew rapidly, to 325 chapters by 1990. Youth Safety Councils were formed in all state high schools to address drinking and driving and other issues. Many communities conducted Project Graduation activities annually. The college community of Chapel Hill instituted a Drive-A-Teen program to provide rides as an alternative to driving after drinking.

Ohio conducted over 1,300 high school programs on drinking and driving from 1986 through 1991. There were 670 SADD chapters by 1994 with a full-time state SADD coordinator. Project Graduation was conducted in 500 high schools by 1991; BACCHUS was active in 37 colleges by 1990. A "None for Under 21" campaign in 1994 promoted Ohio's zero tolerance law. Cops in Shops programs help enforce MLDA 21.

Pennsylvania held Youth Traffic Safety Council conferences in 1980 featuring drinking and driving. Forty school districts participated in an alcohol and drug education project in 1982-83. Ten regional youth traffic safety conferences were held in 1987. SADD had 400 chapters by 1989. An active network of community traffic safety programs conducts local public education and other program activities directed at youth.

Washington conducts youth drinking and driving activities through SAFTYE (Stopping Automobile Fatalities Through Youth Efforts), which began in 1974 and expanded substantially when a youth program coordinator was hired in 1985. By 1986, SAFTYE was active in over 120 high schools statewide. It conducted public education campaigns and held annual student conferences.

NHTSA's Report
NHTSA's Report to Congress on Youth Alcohol Traffic Safety (1995) provides a similar brief summary of each state's federally-funded youth traffic safety activities during fiscal year 1994. The report tabulates activities in several broad categories and notes which states conducted activities in each. The categories and the number of states active within each are:

Public information and education: 41 states
Leadership training, conferences, and task forces: 33
MLDA 21
enforcement, court programs, server training, problem identification: 32
School, college, and workplace programs: 31
Community activities: 8
Family programs: 5
Graduated driver licensing and zero tolerance legislation and implementation: 4

MADD's Rating the States.

The Rating the States assessments compiled by Mothers Against Drunk Driving (MADD) provide an interesting, although subjective, measure of the strength of state youth programs (Mothers Against Drunk Driving, 1991, 1993, 1996, and 1999). In these assessments, a panel of MADD members and national drinking and driving experts collected information on each state's drunk driving laws and activities. The panel assigned each state and the nation as a whole a "report card" grade from A to F in each of about 10 categories. The categories differed slightly from year to year, but always included Youth Legislation, Prevention, and Education (in 1991 the category included only prevention and education, with youth legislation included elsewhere).

For the nation as a whole,

Youth received the highest grade of all categories in each of the last three assessments: B- in 1993, tied with three others; B+ in 1996 along with one other; B+ in 1999 by itself. In 1991, Youth received the second highest grade of B, trailing one category and tied with none.

The MADD assessments are not evaluations in any sense. They subjectively compare the relative strengths of various drunk driving program components - law enforcement, legislation, public information, youth programs, etc. - against MADD's goals in each. The youth component contains legislation (zero tolerance) and enforcement (of MLDA 21 laws) as well as prevention and education programs. Nevertheless, when youth programs consistently receive top grades, it's clear that MADD's panel considers youth drinking and driving activities to be extensive and effective.

Community programs.

Community traffic safety programs, or CTSPs, also developed and spread in the 1980s. These were organized and operated locally, sometimes with state assistance. Most conducted some youth impaired driving activities, as noted in some of the previous state program summaries. Two CTSP groups have been described and evaluated in some detail and are discussed in the following section.

Section 410.

Section 410 of the 1991 Intermodal Surface Transportation Efficiency Act (ISTEA) provided grants for impaired driving countermeasures to qualifying states. To qualify, a state must meet a specified number of criteria: for example, in 1992, states qualified by meeting four out of five criteria. Over the years, the number of available criteria and the number required to be met for qualification changed somewhat. But one criterion directed at youth remained the same. To meet it, a state must issue distinctive driver licenses to persons under 21 and must conduct programs directed at youth drinking and driving, including a program for alcohol retailers and servers, a strategy to enforce the MLDA 21, and an underage drinking prevention program that involved youth participation.

In 1992, 19 states qualified for grants by meeting four out of five criteria. In 1997, 38 states qualified by meeting five out of seven criteria. In each year, 1992 through 1997, every qualifying state met the youth criterion. No other single criterion was met this frequently. For example, in 1997 all 38 qualifying states met the youth criterion, while the next most frequently used criterion was met by 31 states (Leaf and Preusser, 1998). This observation provides additional evidence that each state took substantial actions directed at youth drinking and driving.

State expenditures on youth programs. States have spent a substantial amount of both federal and state funds on youth drinking and driving prevention activities over the past 20 years. Information on these expenditures for the fiscal years 1993-1995 are provided in NHTSA's Report to Congress (1995). Congress appropriated $8 million for each fiscal year 1994 and 1995, and $9.2 million for fiscal year 1996, to be used by the states for youth drinking and driving prevention. NHTSA reports that in fiscal year 1993, before this additional appropriation, states spent $10.0 million of federal funds on youth drinking and driving (using a combination of Section 402, 408, and 410 funds). With the additional appropriation, the total rose to $21.1 million in fiscal year 1994 and to $21.7 million in fiscal year 1995.

Section 410 spending.

Leaf and Preusser (1998) track Section 410 spending on youth drinking and driving for the six fiscal years 1992-1997. During these years, a total of $93.3 million in Section 410 funds was awarded to states. Approximately 15 percent, or $14.7 million, was used for youth activities: $3.4 million for enforcing laws, $3.2 million for school and workplace programs, $1.3 million for youth leadership development, $1.1 million for family-based programs, $0.8 million for public education directed to youth, $0.6 million for community youth program activities, and $4.3 million for other activities.

Effects of Youth Programs

The volume and variety of youth drinking and driving program activity is barely suggested by the preceding information. Unfortunately, most of these activities have not been evaluated, so the evidence of their effects is meager. This section reviews what's available.

SADD.

Two studies attempted to evaluate SADD's activities and effects. Klitzner et al (1994) examined SADD programs in two schools (one each in California and New Mexico). They concluded that neither school implemented the model SADD program well, student participation in SADD was low, and comparisons with similar schools without SADD chapters showed no evidence for SADD effects on any drinking and driving measure.

Leaf and Preusser (1995)

examined six schools with strong SADD programs (in Arizona, Ohio, and Wisconsin), matched with similar schools with no similar program. They found that students in the SADD schools were exposed to more information about drinking, drugs, and driving while impaired and were more likely to hold attitudes opposed to drinking and driving. Self-reported drinking and driving behavior was slightly, though not consistently, lower in SADD schools.

Community programs.

Two studies show that well-organized community traffic safety programs can reduce youth drinking and driving. The first is the Massachusetts Saving Lives program discussed and evaluated by Hingson et al. (1996). The program operated in six Massachusetts communities beginning in 1989 and conducted many activities addressing all aspects of traffic safety. An evaluation compared results in these communities with five similar communities and with the rest of the state. The evaluation found that the proportion of 16-19 year olds reporting driving after drinking in the previous month dropped from 19 percent in 1988 to 9 percent in 1993 in program cities, a 40 percent decline relative to the rest of the state.

CMCA

Communities Mobilizing for Change on Alcohol (CMCA) was directed very specifically at reducing youth access to alcohol and youth drinking (Wagenaar et al., 2000). It was conducted in seven Minnesota and Wisconsin communities with eight others serving as controls. Local CMCA organizations implemented many changes in community policies, procedures, and practices regarding alcohol service, backed up with extensive media and community support. The evaluation found that merchants in CMCA communities increased age identification checking and reduced sales to minors. The proportion of 18-20 year olds who drank in the past 30 days decreased 7 percent compared to the control communities.

Other evaluation evidence.

As part of a guide to reducing youth alcohol use, Stewart (1999) reviews the evidence supporting the effectiveness of 36 different strategies. The three strategies directed specifically at driving all involve legislation and enforcement, and all "can be very effective": zero tolerance laws, sobriety checkpoints, and vigorous overall impaired driving law enforcement. The remaining strategies are directed at alcohol use in one way or another. The only strategies that have been proven effective also involve laws and enforcement: enforcement against retailers selling alcohol to youth, better laws prohibiting alcohol possession by youth, increased alcohol taxes, media campaigns supporting enforcement, and school policies regarding alcohol use. All other strategies, including the youth program activities discussed above, either have not been evaluated or evaluations have not found consistent effects. For example:

Prevention curricula (in schools or youth clubs):

Evaluations have found weak and inconsistent effects on alcohol use. Alcohol-free activities for youth: have not been specifically evaluated. Keg registration laws (so that beer keg purchasers may be identified): have not been specifically evaluated.
Conclusions Clearly, states and communities conducted extensive youth drinking and driving programs in the past two decades. Other organizations concerned with traffic safety - insurance companies, automobile manufacturers, MADD, AAA, and many others - did the same through public education and specific program activities.

But there is little evidence of the effects produced by these activities. The CMCA and Massachusetts Saving Lives results show that community programs can be successful. But these two examples were well-organized and well-funded and certainly may not be representative of many other community programs. The SADD evaluations show that effective SADD chapters certainly affect students' knowledge and attitudes and may affect behavior. Again, it is not clear how many SADD chapters operate at this level. When states evaluate the effects of their overall youth impaired driving programs they typically examine the bottom-line measures of youth crashes or fatalities without attempting to disaggregate the effects of specific program components.

The conclusion:

with the exception of Massachusetts Saving Lives, there is no direct proof that any of the myriad youth traffic safety program activities not involving laws and enforcement had any direct effect on youth drinking and driving. But there also is no proof that they did not. The accumulation of information, education, skills, role models, and the like provided by these programs may have been the crucial force in the youth attitude, behavior, and crash changes documented in Chapter III. We simply do not know.