Injuries, especially from motor vehicle collisions, are the leading cause of death for individuals under age 44. The presence of alcohol is the factor most frequently associated with fatalities in vehicles, drownings, falls, and fire (U.S. Department of Health and Human Services, 1987). In the first report to Congress on traffic safety and alcohol (U.S. Department of Transportation, 1968), it was concluded that more than 50 percent of fatal traffic collisions and 33 percent of serious injury traffic collisions were alcohol-related.

Although the association between alcohol consumption and traffic accidents had been recognized by the beginning of the twentieth century, the magnitude of the problem did not capture public attention until the 1970s. Public tolerance of DRIVING UNDER THE INFLUENCE of alcohol decreased sharply—a shift in attitude that, combined with increased legal countermeasures, resulted in a significant decline in alcohol-related fatalities from a high...