Blood alcohol content limit laws and alcohol-related outcomes

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) awarded $282,353 to the Public Health Institute on September 16, 2025, under the Alcohol Research Programs (CFDA 93.273) to conduct a secondary analysis project examining the relationship between blood alcohol content (BAC) limit laws and alcohol-related outcomes beyond drunk driving. The project, which runs through August 31, 2027, will utilize causal inference methods and existing datasets spanning 1970-2024, including alcohol policy data, the National Alcohol Survey, Behavioral Risk Factor Surveillance System data, per capita sales figures, and vital statistics mortality files to analyze how BAC limit laws are associated with alcohol consumption and mortality outcomes in the general population and subpopulations.

This research directly supports NIAAA's mission to develop improved prevention strategies and treatment methods for alcohol-related problems by generating evidence on the broader public health impacts of stricter BAC limit legislation. As Utah is currently the only state with a 0.05 BAC limit (implemented in 2019), and multiple states including Washington, Hawaii, and Connecticut are considering similar legislation in 2024, the project's findings will provide policymakers with empirical data on alcohol-related outcomes beyond traffic safety to inform legislative decision-making efforts at the state level.

Abstract

Numerous studies show that blood alcohol content (BAC) limits for driving are effective at reducing alcohol-related car crashes in the general population and among young adults. However, few studies have examined how BAC limit laws are related to alcohol consumption and alcohol-related outcomes beyond drunk-driving. Examining how BAC laws are associated with alcohol-related outcomes is crucial because stricter BAC limit laws have unintended benefits beyond reducing drunk driving. As of june 2024, utah is the only US state with a BAC limit of 0.05 (utah passed legislation in 2017 with enforcement beginning in 2019). Forty-nine states remain with a 0.08 limit, though delaware, hawaii, and washington had similar legislation proposed but not passed in 2018. In response to a rise in traffic fatalities, washington and hawaii are again considering lowering the BAC limit for driving to 0.05 in 2024, as is connecticut. Given that this legislation did not pass in washington or hawaii before, data regarding how lower BAC limits are related to outcomes besides drunk driving could help influence policy-making efforts. The proposed secondary analysis project, "blood alcohol content limit laws and alcohol-related outcomes," will provide this information by utilizing causal methods and existing datasets: 1) 1970-2024 alcohol policy data that includes BAC limits laws and other general population policies regarding alcohol availability and tax data that can be used to adjust for potential confounding; and 2) alcohol-related outcome data from the national alcohol survey, behavioral risk factor surveillance system, per capita sales, and vital statistics mortality files (excluding deaths due to traffic fatalities). Specifically, aim 1. Is to examine how BAC limits for driving are related to alcohol consumption and alcohol-related mortality outcomes in the general population. Aim 2. Involves examining how BAC limits for driving are related to alcohol consumption and alcohol-related mortality outcomes among young adults. Finally, aim 3. Is to examine how alcohol consumption and alcohol- related mortality have changed in utah since its implementation of the 0.05 BAC limit in 2019. These aims are particularly timely given 2024 legislation proposing to lower the legal BAC limit for driving to 0.05 in washington, hawaii, and connecticut.