The consumption of alcohol, even in relatively small amounts, increases the risk of being involved in a crash for motorists and pedestrians. Not only does alcohol impair processes critical to safe road use, such as vision and reaction time, it is also associated with impaired judgement and so is often linked to other high-risk road use behaviours such as speeding or not using seat-belts.

In many countries, research indicates that considerable proportions of drivers, motorcyclists and pedestrians have alcohol in their blood in sufficient concentrations to impair their road use skills. While the profile of drink-drivers differs somewhat between regions, there are a number of factors that increase the risk of crashes involving drinking and driving. For example, young male drivers are at a high risk of such crashes, and crashes involving alcohol are more frequent at night.

Unfortunately, in many countries, the scale of the problem is not well understood, there is little public awareness of the problem and legislation and enforcement are often inadequate. The World report on road traffic injury prevention identifies the effectiveness of programmes aimed at drinking and driving as a proven effective measure to reduce death and injury on the road.

The purpose of this manual is to inform readers of practical ways to develop coordinated and integrated programmes to reduce drinking and driving (including riding motorcycles) within a country. The manual is aimed at addressing drinking and driving among drivers. Commercial drivers are an especially important group to address in terms of drinking and driving because of the large number of passengers they can carry and/or the number of kilometres they are likely to travel. While impaired pedestrians are acknowledged as a problem, this issue is not addressed here.

The manual is aimed at policy-makers and practitioners, and draws on experience from countries that have succeeded in reducing drinking and driving. It provides the background evidence to start a drinking and driving programme, and takes the user through the steps needed to undertake a problem assessment in a country. It then explains how to plan and implement a programme, including setting up a working group, developing a plan, examples of laws and enforcement needed, how to develop public education and publicity campaigns, and finally how to evaluate the programme.

In developing this manual the authors have drawn on case studies from around the world to illustrate “good practice”. Examples from low and middle-income countries are given wherever possible, but it is a reflection on the lack of attention given to the issue in many countries that most examples are from highly motorized countries.