摘要：We used a panel design and the Nationwide Inpatient Sample from 19 states between 2003 and 2010 to examine the impact of texting bans on crash-related hospitalizations. We conducted conditional negative binomial regressions with state, year, and month fixed effects to examine changes in crash-related hospitalizations in states after the enactment of a texting ban relative to those in states without such bans. Results indicate that texting bans were associated with a 7% reduction in crash-related hospitalizations among all age groups. Texting bans were significantly associated with reductions in hospitalizations among those aged 22 to 64 years and those aged 65 years or older. Marginal reductions were seen among adolescents. States that have not passed strict texting bans should consider doing so. Roadway safety, although much improved over the years, 1,2 remains a major public health concern. 3 In 2009, more than 2.3 million adult drivers and passengers in the United States sought medical attention following involvement in a motor vehicle crash (MVC). 4 Of these individuals, 416 000 (18%) reported being injured in crashes involving a distracted driver. 5 Separate from the psychological 6–9 and physical consequences 10–12 of motor vehicle injuries are significant economic costs. 13,14 Naumann et al. found that the costs of motor vehicle fatality and injury exceeded $99 billion in 2005. 15 Because of limited resources and escalating health care costs, much attention has been devoted to exploring the factors that contribute to roadway safety hazards and to making the public aware of these threats. Previous research has found that motor vehicular crashes between 2 or more vehicles are often the result of at least 1 driver having been distracted from the primary task of driving. 16,17 According to the National Highway Traffic Safety Administration, there are 3 main types of distraction: (1) taking one’s hands off the wheel (i.e., manual distraction), (2) taking one’s eyes off the road (i.e., visual distraction), and (3) taking one’s mind off driving (i.e., cognitive distraction). 5 It is believed that the use of a cell phone while driving involves all 3 types of distraction. 5 The negative relationship between cell phone use and driving performance is well documented. A recent systematic review of the distracted driving literature found that of 165 analyses examining the relationship between cell phone use and driving performance, 163 (98%) found a significantly negative association. 18 Thus, it is not surprising that state policymakers have enacted bans on cell phone use while driving. In 2001, New York implemented the first state ban on talking on a handheld cell phone while driving. Several states, including California and Connecticut, followed suit. However, these early laws allowed handheld dialing and did not explicitly ban text messaging. 19 Some states subsequently enacted legislation explicitly banning drivers from texting (reading, manually composing, or sending text messages, instant messages, or e-mails via a portable electronic device) 20 while driving. However, because of the relative novelty of texting bans, little is known about their impact on roadway safety. Two recent studies examined the impact of texting bans on motor vehicle fatalities 21,22 and insurance collision claims. 23 Abouk and Adams published the first nationwide study of the impact of texting bans on the occurrence of single-vehicle, single-occupant accidents between 2007 and 2010. 21 They found that texting bans that applied to all drivers were associated with decreases in single-vehicle, single-occupant car accidents. Ferdinand et al. conducted a national study that examined all crash-related fatalities between 2000 and 2010 and found that states with texting bans saw significant reductions in this outcome relative to states with no such bans. 22 The Highway Loss Data Institute examined the relationship between collision claim frequencies and texting bans in 4 states (California, Louisiana, Minnesota, and Washington). 23 The researchers found that texting bans were associated with increased frequencies of collision claims. They posited that this increase may have stemmed from drivers lowering their phones from view to avoid citations and fines and, in so doing, taking their eyes off the road more than they did before the implementation of the bans. To our knowledge, no one has examined the impact of texting bans on hospitalizations resulting from MVCs. We examined the overall effectiveness of texting bans in preventing MVC-related hospitalizations. In addition, we examined the effect of texting bans on MVC-related hospitalizations by different age cohorts because texting while driving is thought to occur most frequently among younger individuals. Our study will help inform policymakers, health care administrators and providers, and other stakeholders interested in decreasing the occurrence of MVC-related hospitalizations.
