Health Education &
Behavior
http://heb.sagepub.com/
A Focus Group Study on Decision Processes of Young Drivers: Reasons
That May Support a Decision to Drink and Drive
Charles E. Basch, Ingrid M. DeCicco and James L. Malfetti
Health Educ Behav 1989 16: 389
DOI: 10.1177/109019818901600307
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A Focus Group Study on Decision Processes of
Young Drivers: Reasons That May Support a
Decision to Drink and Drive
Charles E. Basch, PhD
Ingrid M. DeCicco, EdD
James L. Malfetti, EdD
This article explores reasons that may support a decision by young drivers to drink
and drive. Forty focus group discussions on driving and traffic safety were conducted
with 316 volunteers 18 to 22 years of age in 10 cities in the United States and two
cities in Canada. The audiotaped discussions identified some factors that may influence young peoples’ decisions to drink and drive, such as inappropriate knowledge
about alcohol and driving, lack of decision making skills, and the tendency to ignore
the increased risk of drinking and driving. While some respondents drove intoxicated
because they were unaware of the dangers, others rationalized their drinking and driving behavior. Improved understanding about the nature and extent of the factors influencing young drivers’ decisions to drink and drive is essential to planning effective
health education programs.
INTRODUCTION
The descriptive epidemiology of injuries and deaths of young people from alcoholrelated motor vehicles crashes is well known. 1-4 A variety of solutions to the problem
Editors’ Note. This article differs from the others in this issue in that it is an exploratory investigation of how young people view drinking and driving. Ultimately, to succeed in modifying
the drinking/driving behavior of youth, it is essential to develop a clearer understanding of how
they regard the issue. While the findings are qualitative rather that quantitative, they provide a rich
source for hypotheses and suggest directions for further research using more quantitative methods.
This study was supported by a grant from the AAA Foundation for Traffic Safety. The authors
are responsible for the views expressed.
Charles E. Basch is an Associate Professor, and James L. Malfetti is a Professor with
the Department of Health Education, Teachers College, Columbia University.
Ingrid M. DeCicco is an Associate Professor with the Department of Health and
Physical Education, Bronx Community College (at the time of this study, Dr. DeCicco
was a doctoral candidate at Teachers College).
Address reprint requests to Charles E. Basch, PhD, Department of Health Education, Division of Health Services, Sciences, and Education, Teachers College, Columbia
University, P.O. Box 114, New York, NY 10027.
389
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390
has been suggested, including changing aspects of the law, licensing, enforcement,
education, and alcohol serving policies.’-’ Few studies have used qualitative research
methods such as focus group interviews to explore decisions to drink and drive among
young drivers. The need for more exploratory research of this type in health education
has been stressed by Basch and others. 8-10 The purpose of this preliminary study was
to identify feelings and opinions of small groups of youth about drinking and driving
that warrant further research and to consider implications of the findings for health
education. This study was part of a larger study on perceptions, attitudes, and behavl
iors of drivers.
METHODS AND PROCEDURES
Settings and Subjects
The subjects for the study were recruited by local American Automobile Association (AAA) and Canadian Automobile Association (CAA) clubs, in combination with
the AAA Foundation for Traffic Safety. The cooperating sites included Norfolk, VA;
Tulsa, OK; Los Angeles, CA; Sacremento, CA; Garden City and West Point, NY;
Phoenix, AZ; Seattle, WA; St. Louis, MO; Des Moines, IA; Hamilton, Ontario, Canada;
Edmonton, Alberta, Canada. A broadly representative cross section of licensed
drivers 18 io 22 years of age comprised the convenience sample, which consisted of
158 females and 158 males. Forty college students, 29 junior college students, 79
members of the military. 92 employed persons, 36 unemployed persons, and 40
persons in vocational training were recruited through advertisements in schools, worksites, and military bases and through local chapters of AAA. Forty focus groups were
arranged, varying in size from 3 to 18 members each.
and
The Focus Group Discussion
The methodology used incorporated standard focus group format (group discussion) around a set of questions developed by the research team that focused on traffic
safety issues. A discussion guide was developed by the authors to assist in standardizing the scope of questions and to indicate where probing questions might be appropriate. Approximately 10-15 questions on drinking and driving were asked as part of
a larger battery of 40-50 questions. The wording and sequencing of the questions
were reviewed by an experienced focus group moderator and the question/discussion
format was pilot tested by the authors in two sites.
Twenty-two groups were moderated by the first author and 18 were moderated by
the second author within a three-month period. Focus groups were conducted in the
facilities of the 40 host sites. The moderators explained that the purpose of the study
was to learn about opinions of young drivers concerning traffic safety issues. The
moderator obtained consent from participants to tape record the sessions to facilitate
analysis.
Discussions began on general topics of driving and proceeded to specific issues,
including drinking and driving. The procedure included asking a general question of
the group, obtaining several responses, then probing further with more specific ques-
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391
tions until all relevant views had been expressed. Then the moderator moved to the
question. Each discussion lasted approximately two hours and included topics
related to safety belts, speeding, and alcohol and driving. After the discussion, the
moderators listened to the recorded tapes and made additional notes. Recorded transcripts were used in conjunction with notes to complete the moderators’ impressions
and to record relevant responses. After the responses were categorized, material on
drinking and driving was extracted, compiled, and summarized.
next
EXAMINING RESPONSES
procedures of Zemke and Kramlinger’ were adapted in examining the responses. The process consisted of generating a list of key ideas, words, phrases, and
verbatim quotes and capturing sentiments; using the ideas to formulate categories of
concerns and placing the ideas and quotes in the most appropriate categories; examining the contents of each category for subtopics and selecting the most useful quotes
and illustrations for the various ideas. Responses from participants did not reflect the
strength of opinion or consensus and are not generalizable to other groups. 13
The
FINDINGS
The findings from focus group discussions are presented in four sections: ( 1 ) lack
of knowledge and decision-making skills; (2) beliefs about normative behavior; (3)
previous drinking/driving experiences; and, (4) other factors that may support a decision to drink and drive. Key points are illustrated by stating the questions asked by
the moderator (M) followed by direct quotes from respondents. Only illustrative
responses are presented.
Lack of Knowledge and Decision-Making Skills
The discussions revealed a lack of knowledge about the effects of alcohol on driving
and a lack of skill in making decisions whether to drink and drive. Many misconceptions about the relationship of alcohol consumption to blood alcohol level, intoxication, and crash risk were revealed.
M:
How do you tell when you’ve had a little too much to drink?
That’s one thing I don’t understand-this legally intoxicated stuff.
~
I don’t know what the legal limit is.
~
Well, I don’t know, I’ve never been tested ... at least three or four times
I’ve driven when I was too drunk to drive.
~
If you’re getting into the car and you’re putting the key in
if you really
can’t find that keyhole ... then you shouldn’t be getting into the car.
M: How do you tell if you’ve had too much to drink and to drive?
~
If I can’t even walk.
.
If you feel sleepy.
.
You feel dizzy.
~
...
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392
M:
So you feel pretty comfortable if you’ve had a little to drink, but you’re not
really drunk. How do you tell when you’ve had a little too much?
~
When you start seeing double.
~
When you can’t drive a straight line.
~
When you’re constantly having to squint your eyes and everything starts to
get blurry, or you feel light-headed, or start talking funny.
some participants frankly reported extreme-sometimes bizarre-feelings of
being &dquo;far gone,&dquo; other relied on their subjective judgment and were confident that
they could tell when they were intoxicated. For example:
While
M:
So how do you tell your limit?
~
It depends. Sometimes if I’m working real hard in the summer and I have
one beer, I can feel it. Then on other nights, I can drink a case and can’t
feel it.
~
You just know.
~
I’ve been drinking for a long time; I just know.
Ole misconception among participants related to the effects of consuming different
types of alcohol beverages. For example:
M:
How much could you drink in one hour and still be under the legal limit
.
a six (pack)
with beer it’s no problem to drink, but I’ve had three shots
of whiskey and I’ve been absolutely stupid.
...
Another misconception related to alcohol’s presumed effect on improved driving ability. For example:
M:
If you’ve just had a little bit to drink, do you think you can drive pretty well?
~
I’m sure someone (who) is relaxed and has no worries ... can drive a lot
better than someone who’s under stress.... When you have a beer or two,
a lot of the stress goes away.
~
Some people tell me I drive better when I’ve had something to drink....
once you get into the car, maybe you sober up. Some people say that.
Beliefs About Normative Behavior
In the context of a discussion about preventing crashes among youth, a belief about
drinking and driving as normative practice surfaced:
M: What should be done to cut down the number of serious accidents?
~
Teaching (young drivers) to drink responsibly ... that’s the most important
~
thing.
Everybody’s going to drink and get behind the wheel some time.
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393
Previous Drinking/Driving Experience
Young people’s experience driving while intoxicated without incident may result in
a false sense of assurance, as these comments indicate:
Don’t you think after you’ve been drinking that your driving is affected?
.
Alcohol affects people differently ... I’ll drink and drive ... but I know
sometimes I get too drunk to drive, so I just don’t drive. The rest of the
time I drive. I never have any problem.
M: How do you tell when you’ve had too much?
.
I do not think I’ve ever had so much to drink that I (couldn’t) drive. I’m
always driving and I’ve never had an accident.
M: But as you said, sometimes you wake up the next day and you say, &dquo;boy, how
did I get home?&dquo;
So aren’t you worried about that?
.
Even if I’m way over the alcohol limit, I just pay extra close (attention)
I do a lot of driving ... driving is second nature to me
and even
drunk driving, I do that a lot. (One) should just know how to do it.
M:
...
...
...
Other Reasons That May Support A Decision To Drink and Drive
Responses revealed three additional reasons that may support a decision to drink
and drive: (1) willingness to accept the risks of driving while intoxicated; (2) denial;
and, (3) social benefits from drinking and driving. Examples are:
M:
M:
Sometimes you say you know drinking and driving is wrong, but you still do it.
.
Yes. There’s a lot of things you shouldn’t do, but you still have to experience them ... when you get hurt, you realize they were wrong.
Do you think you’ll have to get caught drinking and driving before you’ll
change?
~
Well, you always think it’ll never happen to you.
There’s a lot of bright people (who) have never (been caught).
But with drinking and driving, that one time can really ...
o
Yes, that’s true. But you don’t think about that when you’re young.
Have you ever driven when you thought you could drive okay and had second
thoughts about it later?
.
To tell the truth, I don’t remember. I was at this party and next thing you
know, I’m home ... I was in bed the next day and gosh, I didn’t remember
which way I went, and that is just horrible.
Well, how come you did it?
o
I don’t know.
Weren’t you worried about having an accident?
o
No. I wasn’t.
Why do others drive unsafely?
.
Because of the new experience. They have freedom; they can do what they
~
M:
M:
M:
M:
M:
want.
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394
What is it that makes some people your age more responsible?
.
Because they don’t have fun.
M: Do you still race a little now and then?
M:
Yes.
think everybody does, every once in a whilc.
M: Why do thcy do that?
o
To show off.
M: Any other way to show of~f?
.
z
.
Driving drunk.
SUMMARY
Responses in this study suggest that there are many factors related to a young person’s decision to drink and drive. Individual driving experience, knowledge, attitudes,
decision-making skills, risk-taking behavior, as well as denial, perceived social benefits,
and norms may influence drinking and driving behavior. Conclusions and implications
for research and programs are presented below. These conclusions should be considered tentative and warrant further testing using different research methods.
Knowledge
appeared to be widespread ignorance of the relationship between alcohol
consumption, levels of blood alcohol, and intoxication. Some participants stated their
inability to estimate blood alcohol level: others reported that when they are drinking,
their judgment is impaired and they do not consider the risks of driving. These findings
may indicate the need for interventions to improve knowledge about alcohol’s effects
on driving.
There
Decision Making
Young people in this study lacked decision-making skills about drinking and driving. Responses indicated participants’ inability to determine the alcohol content of
various drinks; identify the effects of alcohol on judgment, sensory perception, and
motor coordination; estimate blood alcohol concentration when considering beverage
type, speed of drinking, gender, and body weight; determine rates of alcohol absorption and degrees of intoxication; and describe characteristics of impairment related to
increased driving risk. Specific skill training in using information to make sound decisions about drinking and driving is an identified need.
Perceived Norms
Some young people view drinking and driving as a normative practice, and such
beliefs may increase the predisposition to drink and drive. The strength, prevalence,
and influence of such beliefs needs further research. Health education interventions
may help youth reduce overestimates of drinking and driving.
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395
Experience
Because of their own drinking and driving experience, some young people believe it
is safe to drive under the influence of alcohol. Some youth use their arrest- and crashfree experience to support their decision to drink and drive. Research is needed to
improve understanding about how to help youth recognize and respect the risks of
drinking and driving.
Denial and Rationalization
Young drivers may deny the risks of drinking and driving and use rationalizations,
such as &dquo;I’m not that drunk,&dquo; &dquo;I’ll be extra careful,&dquo; and &dquo;I’m a good driver.&dquo; Additional research is needed to address these factors and plan interventions that discourage young people from using denial and rationalization. Increasing perceived susceptibility to injury or arrest from impaired driving may also be a useful approach.
Social Benefits
Drinking and driving offers some young people social rewards such as fun, freedom,
peer acceptance, and status. Other perceived benefits include independence, attention
(including that of the opposite sex), thrill, and relief from boredom. Safe driving is
thought by some to have few rewards. Interventions that enable youth to gain social
benefits in healthful ways should be explored.
CONCLUSIONS
One way to better understand the drinking and driving motives and behaviors of
young people is from the perspective of the young person. This requires:
~
Assessing levels of knowledge about use of alcohol and its effects on driving
~
~
~
performance.
Understanding the beliefs, values, and goals of young people.
Recognizing the social attractiveness of driving while intoxicated by some young
people.
Identifying and addressing the emotional and social causes of drinking and
driving.
~
Identifying and influencing aspects of the social environment, including alcohol
programs and policies in schools, media, worksites, athletic events, and other
~
settings.
Encouraging and rewarding behaviors consistent with reductions in drinking and
driving, including community programs and insurance incentives.
References
1.
Wagenaar AC: Alcohol, Young Drivers and Traffic Accidents. Lexington, MA,
Lexington Books, DC Heath & Co., 1983.
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