Alcohol interlocks and prevention of drunk-driving recidivism

Revue européenne de psychologie appliquée 64 (2014) 141–149
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Original article
Alcohol interlocks and prevention of drunk-driving recidivism
Éthylotests anti-démarrage et prévention de la récidive de conduite sous alcool
J.-P. Assailly , J. Cestac ∗
French institute of science and technology for transport, development and networks (IFSTTAR), laboratory of driver psychology (LPC), 25, allée des
Marronniers, 78000 Versailles, France
a r t i c l e
i n f o
Article history:
Received 29 March 2012
Received in revised form 4 November 2013
Accepted 26 March 2014
Keywords:
Drunk-driving
Alcohol interlock
Recidivism
Transtheoretical Model of Change
a b s t r a c t
Introduction. – Alcohol interlock programs (AIP) are aimed at preventing drunk-driving recidivism. They
first appeared in Europe in the nineties.
Objectives. – The purpose of this study was investigate whether AIPs are effective in reducing recidivism
and determine what factors of such programs contribute to their positive impact.
Method. – We performed a follow-up of AIP participants (n = 175) and control participants (n = 234) for
five years. Data such as blood alcohol concentration (BAC) at time of arrest, previous and subsequent
violations (alcohol-related or other types) were collected from the official driver’s license files. For selfevaluation and evaluation of the program (since November 2009 only), we used questionnaires based
on two theoretical models: the Transtheoretical Model of Change (Prochaska & DiClemente, 1984) and
the Diamond of Change Model from the DRUID project, build to explain which are the elements of driver
rehabilitation training courses that favor behavioral modification (Bukasa et al., 2009).
Results. – The data obtained allowed us to describe these populations of alcohol-drinking offenders, for
both the interlock program group and the control group. Two salient features were male proneness to
alcohol-related violations and a very high BAC (between 1.5 and 2 g/l) among the majority of drivers who
drink under the influence of alcohol. In terms of recidivism reduction, the interlock program was not
clearly linked to a beneficial effect. An analysis of behavioral change among the AIP participants showed
that consciousness raising took effect more quickly than did environmental reevaluation or reinforcement
management.
Conclusions. – The application of Prochaska et al.’s model to the follow-up of AIP programs would be more
fruitful in the future if psychologists are involved in the program. As we have seen, medical/psychological
monitoring may not have been strong enough in the program studied here.
© 2014 Elsevier Masson SAS. All rights reserved.
r é s u m é
Mots clés :
Alcool au volant
Éthylotest anti-démarrage
Récidive
Modèle transthéorique du changement de
comportement
Introduction. – Les programmes d’éthylotests anti-démarrage (EAD) visent à prévenir le récidivisme de
la conduite en état d’ivresse. Ils sont apparus en Europe dans les années 1990.
Objectifs. – Le but de cette recherche était d’étudier si l’EAD est efficace pour diminuer le récidivisme et
d’analyser quels sont les facteurs qui contribuent à un impact positif du programme.
Méthode. – Nous avons effectué un suivi sur cinq ans des participants au programme d’EAD (n = 175)
et d’un groupe témoin (n = 234). Les données ont été recueillies dans les dossiers des conducteurs en
préfecture (telles que l’alcoolémie lors de l’arrestation, les infractions antérieures et postérieures pour
alcoolémie, ou pour d’autres types d’infractions au code de la route). En ce qui concerne l’autoévaluation et
l’évaluation du stage accompagnant l’installation du dispositif (à partir de novembre 2009 uniquement),
nous avons utilisé des questionnaires s’appuyant sur deux modèles théoriques : le modèle transthéorique
du changement de Prochaska et DiClemente (1984), le modèle du diamant du changement, issu du projet DRUID et construit pour expliquer quels sont les éléments d’un programme de réhabilitation qui
favorisent la modification comportementale (Bukasa et al., 2009).
Résultats. – Les données obtenues permettent une description de ces populations « d’infractionnistesalcool » qui sont encore mal connues, que ce soit pour les participants au programme d’EAD ou pour
∗ Corresponding author.
E-mail address: [email protected] (J. Cestac).
http://dx.doi.org/10.1016/j.erap.2014.03.002
1162-9088/© 2014 Elsevier Masson SAS. All rights reserved.
142
J.-P. Assailly, J. Cestac / Revue européenne de psychologie appliquée 64 (2014) 141–149
les sujets du groupe témoin. Deux aspects sont notoires : le surrisque des conducteurs masculins et les
alcoolémies très élevées qui sont relevées lors de l’arrestation (entre 1,5 et 2 g/L). Le programme d’EAD
n’a pas provoqué de réduction significative de la récidive après l’enlèvement du dispositif. L’analyse des
processus de changement à propos de l’autoévaluation des problèmes d’alcool montre que « la prise de
conscience » est activée plus précocement que la « réévaluation environnementale » ou la « gestion des
renforcements » par ce programme.
Conclusions. – L’application du modèle de Prochaska et al. au suivi des programmes d’EAD sera plus efficace
lorsque des psychologues seront impliqués dans l’accompagnement de ces programmes. Nous avons vu en
effet que l’accompagnement médico-psychologique était probablement insuffisant dans ce programme.
© 2014 Elsevier Masson SAS. Tous droits réservés.
1. Introduction
Despite advances in the prevention of alcohol addiction and
abuse, and despite progress in preventing driving under the influence of alcohol (DUI), excessive drinking is still a major road safety
issue in France. Indeed, the per capita yearly consumption of alcohol
dropped from 17 liters of pure alcohol in 1960 to 10 liters in 2011
(World Health Organization, 2011), and the frequency of random
police checks and preventive operations like breathalyzer testing,
and encouraging the designation of non-drinking drivers in group
outings, have also increased during the same time gap. Yet in 2012,
32% of road fatalities in France were still alcohol-related (ONISR,
2013b).
The common penalty for drunk-driving in France at the present
time is suspension of one driver’s license (up to 6 months). However, this kind of sanction may not always be satisfactory. In the
Voas, Marques, Tippetts, & Beirness (2000) study, among the drivers
whose license had been suspended for drunk-driving, a significant
proportion kept on driving during the suspension period; this figure was as high as 75% in the work by Griffin and De La Zerda (2000).
One can assume in this case that these drivers take fewer risks while
driving because of greater fear of being caught and penalized. This
behavior is a problem nonetheless, in terms of both education and
prevention.
For this reason, alternative penalties are being tested around
the world. One proposal is to install an alcohol interlock in an
offender’s car. An alcohol interlock is a device connected to the
ignition that prevents the car from starting when a certain alcohol
level is detected in the driver’s breath. The device was invented in
the United States in the 1960s but was not marketed until 1986.
It is now considered one of the most promising measures for preventing drunk-driving, i.e., for deterring drivers who have already
been ticketed for this offense from repeating this behavior. Interlocks have been capturing the attention of road safety experts for
forty years now (Voas & Marques, 2003), but the actual use of this
device is uncommon in France. The study reported here is based
on data obtained from the only area of France that is testing an
interlock program.
A Cochrane review (Willis & Lybrand, 2005) and more recently
a literature review (Elder et al., 2011) were conducted on the
effectiveness of interlock programs. Both reviews concluded that
interlock programs are effective in reducing the re-arrest rate,
at least until the device is removed. An important point here is
that interlocks appear to be effective for first offenders as well as
repeated offenders, which is not the case for other penal measures
(Beck & Rauch, 1999; Fulkerson, 2003). Positive results have been
obtained on various populations of offenders, in various years, and
in various legal contexts.
Unfortunately however, unless medical and psychological support is associated with the interlock program, the recidivism rate
increases again when the device is removed, returning to a level
similar to that of control group (Robertson, Holmes, & Van Laar,
2009). A number of objections have been made about drivers’
possible attempts to circumvent the device, but they have been
countered by technological advances. It was assumed, for example, that offending drivers involved in these programs could simply
drive another vehicle than the equipped one, but this objection was
eliminated because interlocks can also record mileage, which helps
control this phenomenon. Another objection is that a driver could
get someone else to blow into the device and start the car. Again,
a technological solution was provided by having the device issue
a request for confirmation of the first breath test within a random
period of time after the car started.
Despite enabling legislation, interlocks are still not widely used:
in North America, less than 10% of drivers eligible for these programs are equipped with the device. However, certain conditions
have obviously had some effect on its frequency of use. For example, when offenders were given the choice between confinement at
home and participation in an alcohol interlock program (AIP), the
use of the system rose to 70% (Willis & Lybrand, 2005).
The results of some studies on the effectiveness of ignition interlocks (Robertson et al., 2009) indicate that it is possible to predict
post-program behavior from the data recorded by the interlock
during the program. Variations in blood alcohol levels recorded
by the device were found to be better predictors of recidivism
than DUI offenses before the program. So the risk of recidivism
can be estimated, which means that those identified as “high-risk
drivers” could be forced to continue driving with an interlock device
after the program ends. Vézina (2002) suggested that some drivers
should be equipped for life. Lastly, according to the SUPREME
report (European Commission DG TREN, 2007), AI devices have
been termed “a good practice” in the area of DUI prevention.
As stated above, alcohol interlock programs seem to be more
effective when combined with medical and psychological followup (Elder et al., 2011). However, only one study (Silverans & Alvarez,
2006) has evaluated this approach. Participants were followed-up
by probation officers, and those with alcohol dependence were
followed-up by a psychiatrist. The data recorded by the interlocks
were collected and analyzed. During the first rehabilitation training course, the instructor assessed the driver’s motivation based on
Prochaska’s model in order to determine what was the initial state
of this motivation before the program. Since the drivers were only
in the first or second stage of change (precontemplation and contemplation), an interlock program was unlikely to have a long-term
effect, so the trainer’s job was to help the subject reach the later
stages of the process of change. For this progress to be made, groupdynamic work among participants turned out to be very important,
especially for individuals with little social or family support.
Silverans and Alvarez (2006) thus showed that an interlock program could have a positive impact on the drunk-driving behavior
when associated with a follow-up process. Their analysis of practical problems revealed that many technical difficulties and problems
with the device occurred during the first six months of the program.
Only two participants reported having problems later on. Although
ID
895466
Title
Alcoholinterlocksandpreventionofdrunk-drivingrecidivism
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