Full text of DOI:10.1111/j.1467-842X.2001.tb00314.x

Brief Report
Measuring Risk
Drink and drug driving: what’s the skipper up to?
Mark Stevenson, Peter Palamara, Michelle Rooke,
Kate Richardson, Michael Baker and Jay Baumwol
Abstract
Objective: Since the introduction of
random breath testing (RBT) in Australia
there has been a significant reduction in
drink driving, as measured by alcohol-
related crashes. In contrast, the prevalence
of drug-related road fatalities is on the
increase. One strategy that targets drink-
and/or drug-driving is the promotion of a
designated driver or ‘skipper’.This paper
determines to what extent the ‘skipper’ is
driving alcohol or drug-free.
Injury Research Centre, Department of Public Health,
The University of Western Australia
ince random breath testing (RBT)
was introduced in Australia there
of ‘skippers’who are drinking alcohol or tak-
ing drugs and driving. The paper discusses
S
has been a significant reduction in these findings in relation to current public
1
serious motor-vehicle related crashes. A six-
year review following the introduction of
RBT in Western Australia found a 43%
health strategies.
Methods: A convenience sample of
university students from The University of
Western Australia completed a
reduction in night time, alcohol-related se- Methods
2
rious crashes. The success of RBT, in asso-
ciation with the 0.05% blood alcohol
concentrations and intensive public educa-
tion, has led to a change in cultural norms
with regard to drink-driving.
A convenience sample of 286 university
students from The University of Western
Australia participated in the study (response
rate = 96%). The students were selected to
represent the faculties of the university: sci-
ence; medicine and dentistry; arts; econom-
questionnaire that included questions on
drug and alcohol use while driving as the
designated ‘skipper’.
Results: The mean age of the 286
participants was 21 years. Among the
students who reported acting as the
designated ‘skipper’ during the past 12
months, 26% of the students drove, as the
designated ‘skipper,’ while feeling the effects
of alcohol. Similarly, 18% of students who
reported using drugs drove, as the ‘skipper’,
while feeling the effects of the drug.
Multivariate analysis identified that the
presence of random drug testing would act
as a deterrent for drug driving while the
designated ‘skipper’.
Although the prevalence of drink-driving
may be declining, there is evidence to sug- ics, commerce, education and law; and
gest that the drug-driving problem (in com-
bination with alcohol) is on the increase.3
engineering and mathematical science. Stu-
dents were given a brief introduction to the
study prior to the commencement of the lec-
4
Research from SouthAustralia found almost
one-quarter of non-fatally injured drivers ture.The questionnaire was administered at
tested positive for drugs. Cannabinoids were
the most frequently detected drugs after
alcohol. Similarly, in Western Australia, of
the 218 road fatalities in 1999, drugs (ex-
cluding alcohol) were detected in approxi-
mately 17% of the fatalities.5
this time. Lecturers gave the students 10
minutes to complete the instrument and they
were collected at the cessation of the lec-
tures. Each student completed, anonymously,
a questionnaire that included questions on
general health, drug (illicit drugs only) and
Conclusion: Although three-quarters of
designated ‘skippers’ do not drink and/or
drug drive, a sizeable proportion of young
drivers continue to place themselves and,
more importantly, their passengers and the
entire community at an elevated risk of
injury.
One strategy that targets drink- and/or alcohol use, drug and alcohol use while driv-
drug- driving is the promotion of a desig-
ing and as the designated skipper, and atti-
nated driver or ‘skipper’.Although this strat- tudes and beliefs about drug and alcohol
egy has been advocated since the driving and drug driving education. The
6
mid-1980s, only a few Australian studies
have evaluated the strategy.6,7 Research has
highlighted that designated driver campaigns
result in increased awareness and acceptance
questionnaire was piloted on a sample of stu-
dents prior to its administration.
The proportion of ‘skippers’ who drove
while under the influence of alcohol and/or
drugs was estimated from the sample. Both
univariate and multivariate statistics were
undertaken. The latter involved assessing
the independent contributions of variables
Implications: Campaigns that target the
responsibility of the ‘skipper’ and that are
included as part of drink-driving campaigns
would be beneficial. It is premature to be
making recommendations on random drug
testing for drivers.
8
of the designated driver strategy. However,
there is a paucity of research that has deter-
mined to what extent the ‘skipper’is driving
alcohol or drug free. This paper documents
the characteristics as well as the proportion to the risk of driving under the influence of
(Aust N Z J Public Health 2001; 25: 511-3)
Correspondence to:
Submitted: August 2001
Mark Stevenson, Injury Research Centre, Department of Public Health, The University of
Western Australia, 35 Stirling Highway, Crawley, WA 6009. Fax: (08) 9380 1199;
e-mail: marks@dph.uwa.edu.au
Revision requested: September 2001
Accepted: October 2001
2
001 VOL. 25 NO. 6
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511

Stevenson et al.
Brief Report
alcohol or drugs while a designated ‘skipper’. This was conducted
using unconditional logistic regression on STATA software.9
Table 1: Predictors of drink- or drug-driving among
designated ‘skippers’.a
Variable
Odds ratio
95% CI
Model 1: Drink-driving
Results
“
I am likely to be caught by
More than half the respondents were female (51%, n=146) with
the mean age of 21 years for both males and females. Thirty per
cent of the respondents came from the Faculty of Engineering
and Mathematical Science, 28% from Medicine and Dentistry,
police if I drive over the
legal blood alcohol limit”
Agree
1.00
0.86
2.10
—
Unsure
0.30-2.45
1.03-4.31
Disagree
1
6% from Arts, 16% from Science and 10% from Economics,
Model 2: Drug-driving
Commerce, Education and Law. Ninety-two per cent of the re-
spondents drove a motor vehicle and 4% rode a motorcycle on a
regular basis.
“I would not drive if there
was random drug testing
on the roads”
Almost half (47%, n=133) of the respondents reported having
a drink containing alcohol approximately once a week, with 15%
Disagree
Unsure
Agree
1.00
0.19
0.16
—
0.03-1.03
0.05-0.49
(n=42) of the respondents drinking most days of the week. Eleven
per cent (n=31) of the respondents did not drink alcoholic bever-
ages. There was a significant association between gender and al-
cohol consumption with a higher proportion of males consuming
Notes:
(a) Models are adjusted for sex.
Model 1: -2 log Likelihood 222.7.
Model 2: -2 log Likelihood 113.9.
2
alcoholic beverages on a regular basis (χ =19.7, df=5, p=0.001).
The respondents were asked to report the frequency of drug
use over the past 12 months. Cannabis was the most frequently
used drug with 37% (n=103) reporting having used cannabis in
the preceding 12 months. Of those who reported using cannabis,
designated ‘skipper’ while feeling the effects of both alcohol and
drugs, combined. Significantly more males (22%, n=11) reported
2
this behaviour compared with females (6%, n=6) (χ =4.60, df=1,
1
7% (n=18) reported regular use (more than once a week).
p=0.032).
Ecstasy use was reported by 21% (n=58) of the respondents, while
amphetamine (speed) and dexamphetamine (dexies) use was re-
ported by 13% (n=35) and 15% (n=40) of respondents, respec-
tively.The use of LSD or hallucinogens was reported by 9% (n=23)
of respondents while cocaine and heroin use was low: 2% (n=6)
and 1% (n=4), respectively.
As might be expected, 95% of respondents reported that driving
under the influence of alcohol would increase their likelihood of
crashing. The responses were more varied in relation to the effects
of cannabis on the risk of crashing. Ten per cent of respondents
believed cannabis reduced the risk of crashing while a further 8%
of respondents were unsure. Forty-two per cent of the designated
‘skippers’ who reported feeling the effects of alcohol did not be-
lieve they would be caught by police if over the legal blood alcohol
concentration (BAC) and a further 15% were unsure.
Among those drivers who drove a motor vehicle (92%, n=264),
8
5% (n=221) had reported acting as the designated ‘skipper’
sometime during the past 12 months. There was no association
between the frequency of reporting being the designated ‘skip-
A number of multivariate models were undertaken. The first
model identified only one factor that predicted the likelihood of
drink driving while the designated ‘skipper’ (seeTable 1). ‘Skip-
pers’ who felt they were unlikely to be caught by police while
over the legal BAC were twice as likely to drive (OR=2.1, 95%
CI 1.02-4.31) while feeling the effects of alcohol compared with
‘skippers’ who thought they would be caught.
2
per’ and the gender of the driver (χ =0.69, df=1, p=0.406).
Twenty six per cent (n=57) of drivers, when nominated as the
designated ‘skipper’, reported driving while feeling the effects of
alcohol in the past 12 months.
Eighteen per cent (n=39) of designated ‘skippers’ drove in the
past 12 months while feeling the effects of illicit drugs namely,
cannabis, ecstasy or amphetamines. Overall, approximately 21%
of cannabis users (n=19) and 21% of ecstasy users (n=11) drove,
as the ‘skipper’, while feeling the effects of these drugs. Twenty
nine per cent (n=9) of amphetamine users did the same.
Among the designated ‘skippers’, significantly more male driv-
ers (38%, n=38) compared with female drivers (17%, n=19)
The second model determined what factors predicted drug driv-
ing while the designated ‘skipper’. Designated ‘skippers’felt the
presence of random drug testing would reduce their likelihood of
driving under the influence of drugs by approximately 84%
(OR=0.16, 95% CI 0.05-0.49) (see Table 1). This is relative to
designated ‘skippers’ who would drive in the presence of random
drug testing.
2
reported driving while feeling the effects of alcohol (χ =11.8,
df=1, p=0.001) (see Figure 1). In contrast, more female drivers
compared with male drivers drove as the ‘skipper’ while feeling
the effects of ecstasy or amphetamines; however, the absolute num-
bers are small.
Discussion
Almost two-thirds (62%) of the respondents in this study
reported consuming an alcoholic beverage at least once a week
while only 6% of respondents reported using cannabis at the same
frequency. Cannabis is the most frequently used illicit drug, with
Among the designated ‘skippers’ who reported drinking alco-
hol and/or taking drugs, 14% indicated they had driven as the
512
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2001 VOL. 25 NO. 6

Measuring Risk
Drink and drug driving
Figure 1: Use of
alcohol/drugs while
the designated
1
00
9
0
‘skipper’.
80
70
6
0
Male
50
Female
40
30
20
10
0
Yes
Alcohol
No
Yes
Cannabis
Use of Alcohol/drugs
No
Yes
Ecstasy
No
Yes
No
Ampehetamines
approximately one-third of respondents having used cannabis in
the past 12 months. Interestingly, 21% of respondents had used
ecstasy in the past 12 months. The reported levels of alcohol and
drug use in this study are higher than other Western Australian2
Although three-quarters of designated ‘skippers’ do not drink-
and/or drug-drive, a sizeable proportion of young drivers con-
tinue to place themselves and, more importantly, their passengers
and the entire community at an elevated risk of injury due to drink-
driving. The findings suggest that campaigns that target the
responsibility of the ‘skipper’ and that are included as part of
drink-driving campaigns should be advocated.
4
and interstate studies. The elevated levels in this study could be
attributed to greater homogeneity of the participants, reflecting
the sampling process adopted.
We measured responses to driving while feeling the effects of
substances. This is preferable compared with other approaches
that measure impairment by the presence of the drug. Using this
approach we found that a significant proportion of designated
Random drug testing of drivers was perceived to be a deterrent
among respondents in this study. However, until such time as
reliable population-based estimates of the prevalence of drug-
driving are obtained as well as further research to investigate the
risks associated with drug driving, it is premature to make
recommendations on random drug testing for drivers.
‘skippers’ are not alcohol (26%) or drug (predominantly canna-
bis) free (18%). These findings are of concern, particularly the
fact that more than one-quarter of ‘skippers’drink and drive. The
risks associated with drinking alcohol and driving are well docu-
mented; for example, a driver’s risk of crashing increases six times
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