Phone use and crashes while driving: a representative survey of drivers in two Australian states

Since the introduction of mobile phones into Australia in 1987, there has been concern about the effect on road safety of mobile phone use while driving.1 Today, the number of mobile phone connections exceeds the number of landlines, and more than 80% of Australians own or use a mobile phone.2 Throughout Australia, hand-held mobile phone use while driving is illegal, but drivers who wish to use a mobile phone may do so with a hands-free device.3

Nevertheless, an observational survey conducted in Melbourne in 2002 found that, at any given time, about 2% of drivers were using a hand-held phone while driving.4 Moreover, the purported safety benefit conferred by hands-free devices remains questionable. Experimental research has shown that both hand-held and hands-free phone use can impair driving performance, as measured by reaction time and situational awareness.5-7 In young drivers, using a mobile phone to send text messages has been shown to degrade driving performance in a simulator.8 Epidemiological research has found that mobile phone use while driving is associated with a fourfold increase in crash risk, irrespective of whether a hands-free device is used.9,10

To assess the effect of phone use while driving in order to inform public health initiatives, several other factors require investigation. These include an estimate of the prevalence of mobile phone use while driving, the current pattern and frequency of phone use while driving, the extent to which drivers continue to use hand-held phones while driving, the attitudes of drivers to the risk of crashing conferred by phone use, and the effect of mobile phone use on road safety as measured by the self-reported adverse outcomes resulting from phone use.

We addressed these matters by conducting a representative survey of drivers in New South Wales and Western Australia.

There were 1347 respondents across the two states. The overall response rate was 48.3% (1347/2787; NSW, 44.8%; WA, 52.5%). Box 1 shows the breakdown of screened households and individuals. There were 1114 mobile phone users (85.1% ± 1.1%). Of these, 726 reported using a mobile phone while driving (57.3% ± 1.5% of all drivers). This means that almost 2.8 million drivers aged between 18 and 65 years in NSW and WA will have used a phone while driving (pop est ± SE, 2 787 518 ± 74 287). These drivers are more likely to be male, young (18–30 years), drive in metropolitan areas, and drive more frequently (as measured by distance driven annually, average driving frequency and average time driven daily), compared with drivers who did not (Box 2). In the multiple regression model, adjusting for distance driven annually, males, young drivers and metropolitan drivers were each independently associated with reported phone use while driving. Importantly, in the model, young drivers were almost five times more likely than older drivers to report phone use while driving (50–65 years, referent group; odds ratio, 4.8; 95% CI, 3.4–6.9; P < 0.001).

The prevalence of mobile phone use while driving is high: almost 60% of drivers have used a mobile phone while driving at least occasionally, and a third will have done so in the preceding week. Young drivers, particularly young men, are most likely to use a phone while driving and to report a higher frequency of use — these are the groups who are over-represented in crash statistics.13 More than 30% of young drivers have written and sent text messages while driving. Notably, a number of international surveys have demonstrated that younger drivers,14-17 men,15,16 and metropolitan residents15,16 are more likely to use a phone while driving or have higher levels of phone use.

Those who use a phone while driving considered phone use, speeding and driving with a BAC of 0.05 g/dL to be significantly less risky than those who do not use a phone, even after adjusting for sex, age group and area of residence. Thus, drivers who use a phone while driving may have more permissive attitudes to a range of risk-taking behaviours on the road.

Hand-held phone use while driving remains prevalent (22.5% of all drivers) and almost 70% of drivers felt that enforcement of the ban on hand-held mobile phone use while driving is low. Some respondents volunteered that they were unsure about whether text messaging is included in the current ban, so increased driver awareness about this is required.

Our findings highlight the potential dangers of mobile phone use while driving in relation to near misses and crashes. About 1% of all drivers have crashed while using a mobile phone. By way of comparison, in a survey of predominantly male, heavy vehicle drivers in Denmark,14 five drivers (0.5%) had crashed as a result of phone use and 6% had experienced dangerous situations on account of their phone use in the previous year. Two-thirds had been in dangerous situations in the previous year because of phone use by other road users. In Finland, 50% of surveyed drivers had experienced dangerous situations arising from their phone use.17

Our study has limitations. First, random digit dialling was not undertaken, because it is a more costly and less efficient method. Instead, phone numbers were randomly selected from the residential Electronic White Pages. Consequently, respondents were sampled from households with a landline and a phone book listing. Importantly, there is evidence to suggest that using the Electronic White Pages as the sampling frame for population health surveys does not introduce significant bias.18 Second, the overall response rate approached 50%. As part of the introduction, potentially eligible respondents were told that this was a survey about driving safety. Mobile phone use was one component and was not mentioned specifically in the introduction. Although selection bias due to the response rate cannot be ruled out, its effect is expected to have been low, as a decision to participate would not have been based on opinions about mobile phone use per se. Finally, data were self-reported, and it is possible that drivers who use a phone while driving, especially those who use a hand-held mobile phone, may have been reticent to admit to such behaviour or its untoward effects. However, there is evidence that social desirability does not significantly influence self-reported driving behaviour.19 Any resultant bias would tend to underestimate the extent of the problem, not overestimate it.

To date, information on phone use while driving in Australia has been limited to industry surveys (Telstra. National summary: Drive Safe Phone Safe survey. April 2003). Our study has demonstrated that phone use while driving is prevalent, and adverse consequences, including crashes, occur. Increased enforcement and media campaigns to raise drivers’ awareness about the ban on text messaging and the risks of phone use (hand-held or hands-free) while driving are needed. As young drivers are particularly likely to use phones while driving, targeted education of novice drivers is warranted. Importantly, a ban on all phone use among novice drivers is to be introduced in Victoria.13 However, our data suggest that any proposal to impose further restrictions on phone use while driving for more experienced drivers would require increased public support. As the prevalence of mobile phone use and other in-vehicle distractions is only likely to increase, investment to investigate, monitor and minimise the harm is required to maintain road safety and reduce consequent injury.