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The correlation between sanction adjustments and drunk-driving violations and related outcomes in Taiwan: A nationwide interrupted time series analysis.

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Title: The correlation between sanction adjustments and drunk-driving violations and related outcomes in Taiwan: A nationwide interrupted time series analysis.
Authors: Kuo LW; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan., Liao CA; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.; Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei City, Taiwan., Cheng CT; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan., Liao CH; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan., Hsu CP; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan., Fu CY; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan., Kang SC; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan., Olin B; Alexander Blewett III School of Law, University of Montana, MT, USA., Yang CS; New Taipei City Police Department, Taipei City, Taiwan., Huang JF; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.; Division of Trauma and Emergency Surgery, Department of General Surgery, Jen-Ai Hospital, Dali Branch, Taichung, Taiwan.
Source: Addiction (Abingdon, England) [Addiction] 2026 May; Vol. 121 (5), pp. 1166-1178. Date of Electronic Publication: 2025 Dec 17.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9304118 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0443 (Electronic) Linking ISSN: 09652140 NLM ISO Abbreviation: Addiction Subsets: MEDLINE
Imprint Name(s): Publication: Oxford : Wiley-Blackwell
Original Publication: Abingdon, Oxfordshire, UK : Carfax Pub. Co., c1993-
MeSH Terms: Accidents, Traffic*/statistics & numerical data , Driving Under the Influence*/legislation & jurisprudence , Driving Under the Influence*/statistics & numerical data , Automobile Driving*/legislation & jurisprudence , Automobile Driving*/statistics & numerical data, Taiwan/epidemiology ; Hospitalization/statistics & numerical data ; Humans ; Interrupted Time Series Analysis ; Retrospective Studies ; Male ; Adult ; Female ; Middle Aged ; Law Enforcement
Abstract: Background and Aims: Drunk-driving accounts for a significant portion of traffic crashes in Taiwan. From 2008 to 2013, both the Taiwan Legislative Yuan and the federal administrative agencies collaborated to increase drunk-driving penalties. This study aimed to determine whether these sanction changes are associated with changes in the incidence of drunk-driving and subsequent hospital admissions.
Design: Exploratory retrospective cohort study.
Setting: Taiwan.
Participants: All traffic crashes involving drunk-driving violations and every involved individual from 2003 to 2019 in Taiwan.
Measurements: Interrupted time series analysis (ITSA) method was used to examine the effects of the three policy interventions in January 2008, December 2011 and June 2013. The numbers of drunk-driving crashes, drunk-driving casualties, drunk-driving-related admissions, drunk-driving-related major traumas, drunk-driving-related deaths and drunk-driving-related medical expenses in different time segments were compared to evaluate the effect of each policy intervention. All three policy initiatives increased drunk-driving penalties, and there were no intervening policy changes that reduced said penalties.
Findings: From January 2003 to January 2008, the numbers of all drunk-driving-related outcomes gradually increased. After the first penalty adjustment, the reported number of drunk-driving crashes had a sudden decrease (1632 in January 2008 to 1374 crashes in February 2008, β2 = -0.146, P < 0.001), but the overall trend continued upward (β3 = -0.001, P = 0.111). However, after the second policy intervention, drunk-driving crashes began trending downward rapidly (β5 = -0.021, P < 0.001). Finally, after the third adjustment, the trend of drunk-driving crashes continued to decrease, but the slope became significantly milder (β7 = 0.009, P < 0.001). Most of the target outcomes followed a similar trend as the drunk-driving crashes, except for the number of deaths caused by drunk-driving, which demonstrated a statistically significant decline after the first adjustment (β3 = -0.006, P = 0.007).
Conclusions: Increasing the fine and maximum incarceration periods for drunk-driving in Taiwan appears to be associated with a reduction of the number of drunk-driving crashes and other related outcomes; however, the decrease in drunk-driving crashes diminished over time, especially after the third sanction change in 2013.
(© 2025 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
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Grant Information: CMRPG3K1131 Chang Gung Memorial Hospital, Linkou; MOST 110-2314-B-182A-037 Ministry of Science and Technology
Contributed Indexing: Keywords: casualty; drunk‐driving; major trauma; medical expense; mortality; outcome; policy intervention
Entry Date(s): Date Created: 20251217 Date Completed: 20260417 Latest Revision: 20260419
Update Code: 20260419
PubMed Central ID: PMC13088936
DOI: 10.1111/add.70285
PMID: 41405361
Database: MEDLINE
Description
ISSN:1360-0443
DOI:10.1111/add.70285