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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Man to Man Man to Man

Distracted Driving -- Fast Lane to Disaster

October 23, 2014

By Harvey B. Simon M.D.

Harvard Medical School

By now, virtually everyone with a driver's license has heard that distracted driving causes motor vehicles accidents. It's a very important message, but it's only half right.

Distracted driving is indeed the culprit, but the calamities that result are not accidents. Far from being random, unpredictable events, the consequences of distracted driving are all too predictable. And because these car crashes are predictable, they're preventable.

If you understand the hazards of driving under the influence of cell phones and other mobile devices, you can arrive safely at your destination with enough time to make your calls and send your texts.

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The Big Three

There are three major types of distractions:

  • Visual (taking your eyes off the road)
  • Manual (taking your hands off the wheel)
  • Mental (taking your mind off the complex task of driving)

All are important. And when a person experiences all three at the same time, the risk multiplies exponentially (think texting).

Distracted driving is not a new problem. For decades, drivers have been distracted by eating or drinking, grooming, checking a map, fiddling with the radio, intense conversations with passengers and mental preoccupation with personal or professional issues. But the digital age has multiplied the hazards; cell phones, texting and navigational devices have driven distraction to new and more dangerous levels.

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Crushing Statistics

Each day, more than 16 Americans are killed and more than 1,300 are injured in car crashes that involve a distracted driver. In 2008 alone, nearly 6,000 deaths and over 500,000 injuries occurred. And the problem is getting worse every year. Overall, vehicular deaths are declining, but the share of road deaths caused by distracted driving has risen to 16%.

Drunk Driving

Cell phones are a new threat to safe driving; alcohol is an old hazard.

Alcohol-impaired driving takes 11,000 lives a year. It accounts for about one-third of the road fatalities in the United States. And men are responsible for over 80% of all episodes of alcohol-impaired driving.

Although the message is familiar, it merits repeating: Don't drink and drive.

Just who is driving while distracted?

  • About three-quarters are white males; although no age group is immune, young men are disproportionally likely to be distracted drivers.
  • Nearly two-thirds are alone in the car at the time of the crash.

About 60% of crashes do not involve another moving vehicle. And nearly 40% occur on city roads.

The rise in death and injury due to distracted driving correlates well with the explosive increase in mobile devices. One estimate links every additional one million cell phone subscriptions to a 19% rise in distracted driving fatalities. At present, over 275 million Americans own cell phones, and 81% admit to talking while driving.

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Texting to Death

Texting has become a way of life in the digital age. In 2002, Americans sent one million text messages a month. By 2008, the number had increased to 110 million a month. And it continues to soar.

Texting is the most dangerous form of distracted driving; drivers who text are 23 times more likely to crash than nondistracted drivers. Since texting involves visual, manual and mental distractions, it's easy to see why it's so dangerous.

Texting for Health

Although cell phones are responsible for many road fatalities, they can be life saving in medical emergencies. And doctors are just starting to learn how to text for health.

A 2011 study reported that a cell phone texting program (txt2stop) can help smokers break the tobacco habit. Let's hope the texts don't arrive while recipients are driving.

According to a survey by the AAA Foundation for Traffic Safety, 14% of drivers admitted to texting while driving during the previous 30 days. At least 39 states and the District of Columbia have enacted laws restricting the use of mobile communication devices while driving, but enforcement is proving very difficult. In the last analysis, personal responsibility is the only way to contain the problem. To put the message in context, "if u txt & drive u cn di."

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Look, Officer, No Hands

Talking on a cell phone is not as hazardous as texting while driving — but that doesn't mean it's safe. One study showed that drivers who talk on cell phones are four times more likely to crash than non-distracted drivers. That makes driving while talking on a cell phone as risky as driving while drunk.

Using a standard, hand-held cell phone involves visual distraction while dialing, manual distraction while holding the phone and mental distraction throughout. In theory, hands-free calling should be safer, but data from auto insurance companies, experiments on driving simulators and tests on tracks show that it's not.

Talking with a passenger can be distracting, but talking on a phone is much worse. Passengers and drivers see the same road conditions and pause or modify their conversation accordingly. Passengers can even alert drivers to impending hazards. But people talking to drivers by phone will continue their distracting conversation without regard for driving conditions. With phone calls, the rhythm of talk and the rhythm of the road are out of synch; too often a crash is the result of mental overload.

At best, driving is a demanding and potentially hazardous activity; it's no time for multitasking. As with texting, personal responsibility is the ultimate solution to the hazards posed by distracted driving. In our busy, networked, wired society the temptation to talk on the phone while driving is strong. Remember, though, that we got along without cell phones for decades. And while we're thinking about the good old days, remember that getting out of your car to do a little walking will go a long way toward preserving your health. distracted_driving/

Wilson F., Stimson J. "Trends in fatalities from distracted driving in the United States, 1999 to 2008." American Journal of Public Health. 2010; 100(11):2213-2219.

Ibrahim JK et al. "State laws restricting driver use of mobile communications devices." American Journal of Preventive Medicine. 2011; 40:659-665.

Ship AN. "The most primary of care — Talking about driving and distraction. The New England Journal of Medicine. 2010; 362:2145-2147.

Morbidity and Mortality Weekly Report. "Vital signs: Alcohol-impaired driving among adults — United States, 2010." 2011; 60(39):1351-1356.

Free C et al. "Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial." The Lancet. 2011; 378:49-55.

Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of the Harvard Men's Health Watch newsletter and author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan, Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.

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