Alcohol-involved road safety trends and strategies: insights from U.S. road safety monitoring (2015-2024).

Persistent risky behaviours continue to undermine progress reducing traffic fatalities in the United States. Despite the implementation of programmatic interventions combined with increasing awareness, alcohol-impaired driving remains a contributing factor, accounting for nearly 32% of crash deaths in 2022. This study analyzed longitudinal trends in self-reported alcohol-involved driving behaviours, attitudes, and injury outcomes from 2015 to 2024 using Road Safety Monitoring survey data, supported by national fatality statistics from the Fatality Analysis Reporting System. The objective was to identify demographic and behavioural predictors of high-risk outcomes and track patterns over time, especially during periods of disruption. The application of logistic regression models to the survey data showed males were 2.1 times more likely to engage in impaired driving than females and drivers with multiple traffic tickets were more than tenfold likely to do so. The percentage of individuals reporting driving over the legal alcohol limit among those who consumed any level of alcohol in the past 12 months (19,173 out of 26,639 in total) increased from 8.83% in 2015 to 23.99% in 2024. Meanwhile, ride-share use to avoid impaired driving rose from 18.7% in 2016 to 46.4% in 2024. Results indicate a troubling pattern: self-reported alcohol-impaired driving increased significantly between 2015 and 2021 and remained elevated in subsequent years. High levels of public concern about alcohol- and cannabis-impaired driving, along with rising traffic-related injuries, underscore the urgent need for targeted prevention strategies that align with Vision Zero and Safe System goals by addressing the behaviours and groups most at risk.