III Awareness Building
IV Policy Implications
V Going Forward
-- Submitted by Benjamin Rempel, MPH, Health Promotion Field Support Specialist in Alcohol Policy, Health Promotion, Chronic Disease & Injury Prevention, Public Health Ontario and Jayne Morrish, MA, Research Coordinator, Ontario Injury Prevention Resource Centre, Parachute
With the approaching winter season comes an increased risk of motor vehicle crashes. Many of these concerns lie with adolescents, as research suggests those 15–24 years old are overrepresented in vehicle crashes causing disability, injury, or death. 
A recent literature search commissioned by Parachute – a national charitable organization dedicated to preventing injuries and saving lives – identified that impaired driving was one of three prominent driving practices that place adolescents at a greater risk for injury, with distracted driving and emotional driving rounding out the top three. 
Alcohol is carcinogenic to humans, contributing to a number of cancers. Other chronic conditions resulting from heavy alcohol consumption include cirrhosis of the liver, diabetes, adverse cardiovascular outcomes, and fetal alcohol spectrum disorders. [2, 3]
Negative acute events are also associated with alcohol use. These events may include crime, family abuse, motor vehicle crashes, and both non-intentional and intentional injuries.  These harms are especially concerning among adolescents (15–24 year olds), as this age group has been found to account for approximately 24% of road-related fatalities and serious injuries in Canada . Moreover, this same age group is at the highest risk of death per kilometre travelled . Roughly 40% per cent of teen drivers fatally injured on the road have consumed alcohol before the incident. 
While consuming alcohol just before driving appears to be a declining trend; much carnage on roadways is still associated with this practice. Nearly 33% of drinking drivers involved in a fatal crash were adolescents,  while 4–15% of this same age group reported being a passenger of a drinking driver. 
Distracted driving can be defined as anything that takes a driver’s attention away from the task at hand. It is a major issue among teenagers due to the prevalence of hand-held electronic devices among this age group, their attachment to their social groups and the tendency of the younger generation to multi-task. [7, 8] Being distracted may increase individuals’ likelihood of engaging in maladaptive driving behaviours including becoming distressed or experiencing an increase in anxiety levels, which may relate to an increased crash risk. [9, 10, 11]
Emotional driving includes various behaviours, such as being aggressive behind the wheel, speeding and allowing one’s mood to dictate the way in which one drives. Statistics from the United States demonstrate that 56% of crashes between 2003 and 2007 may have involved some form of aggressive driving behaviour;  speeding may have been involved in 31% of total crashes and reckless/careless/erratic driving may have been involved in 74% of crashes. This issue is particularly problematic for youth, as American researchers have demonstrated that 16- to 17-year-olds may be more likely to drive aggressively than adults 65 or older.  Moreover, Canadian data have shown that roughly 40% of speeding drivers in fatal crashes tend to be aged 16–24, with 40% of these drivers reporting they had been drinking. 
III Awareness Building
To help address these concerning statistics, several programs are being implemented with a focus on reducing road injuries among adolescents.
One program is Project Gearshift, a national campaign from Parachute that invites youth and their communities to raise awareness around teen driver safety through a variety of resources: activity ideas, curriculum resources, and community leader meeting toolkits.  All resources are designed to inform and activate community change by starting dialogue around teen driver safety issues. Parachute has been working to promote the project among its’ extensive network of community partners, schools and relevant organizations. The Project Gearshift task force on teen driver safety has also been integral in the promotion of the project.
Promotion of Project Gearshift will be front and centre as Parachute launches National Teen Driver Safety Week, October 20–26th, 2013. Community participation opportunities include:
- Pledge your commitment to driver safety (link: http://projectgearshift.ca/gearshift-in-action/photo-video-pledge)
- Host a meeting in your community to create change around teen driver safety— the Project Gearshift toolkit lays out all the details (link: http://projectgearshift.ca/tools-for-change/community-change-tools)
- Raise awareness with some of these new ideas found online (link: http://projectgearshift.ca/tools-for-change/peer-leadership-initiatives)
- Combine teen driver safety messaging with teacher’s learning objectives with the Project Gearshift curriculum resources (link: http://projectgearshift.ca/tools-for-change/curriculum-resources)
- Host any Project Gearshift activities or events and claim promotional items. Report what you are doing for Teen Driver Safety online (Link: http://projectgearshift.ca/gearshift-in-action/application-form )
- Proclaim a teen driver safety week in your community. For more information, contact email@example.com.
A second awareness program is the State Farm sponsored Celebrate My Drive. This initiative focuses on celebrating getting one's driver’s licence while staying safe on the road.  Schools may register for a competition before October 17th. From October 18th – October 26th, participating schools will try to mobilize their students, faculty and surrounding communities to log on to http://www.celebratemydrive.com and make a commitment to safe driving. The school with the greatest number of commitments in its division is eligible to win prizes. Individuals can make a commitment once a day, every day, for the school of their choice. Awareness is raised through the promotion of voting and the individual user experience of logging on to vote.
"More needs to be done to teach teens about risky driving behaviours like driving while impaired or having too many passengers in their car," encourages Chris Mullen, Director of Technology Research at State Farm. 
IV Policy Implications
In August of 2010, laws related to Blood Alcohol Concentration (BAC) for novice and young drivers were put in place. This legislation, entitled Bill-126, introduced the following rules:
- All drivers 21 years of age and under are required to have a BAC of zero while driving; and
- All novice drivers (Class G1, G2, M1 and M2) will face escalating sanctions for repeatedly violating their licence conditions or for convictions that carry four or more demerit points. 
Violations of the BAC rules are met with an immediate 24-hour roadside driver licence suspension and, if convicted, carry a fine of $60–$500 and a 30-day licence suspension.  This new piece of legislation demonstrates government commitment to ensuring that young and novice drivers drive responsibly while obeying conditions of their licence. Recent research recommends that all provinces adopt a comprehensive, enforced 3-year graduated licensing program for all new drivers along with a 0.00% Blood Alcohol Concentration level for all drivers with five or fewer years of driving experience. 
Further attention has been brought to the topic of impaired driving through the release of a report comparing provincial alcohol policies across Canada.  This report celebrates recent activities to curb road deaths and injuries including graduated licensing programs, licensing suspensions and revocations, and vehicle and remedial programs. However, authors of the report argue “the overall picture indicates much unrealised potential for achieving public health and safety benefits.”  They also clarify that although many or most provinces have adopted licensing programs, few of these programs are supported through enforcement measures.
V Going Forward
As shown through recent research, adolescents demonstrate increased risk-taking behaviours, particularly when driving.  Moreover, young and novice drivers face unique challenges when behind the wheel, particularly around alcohol use. Further legislative support is needed to ensure these drivers are supported in making safe driving decisions. The program initiatives outlined above should increase awareness about these issues and apply pressure for strengthened legislation to decrease harms related to adolescent or novice driving.
However, still more can be done to translate research into effective policies and programs.
“There is always room for improvement when it comes to practicing safe driving …” 
 Morrish, J. & Carey, S. (2013). Teen Driver Safety: A Review of Key Factors Influencing Teen Driver Behaviours. Blair, K (Ed.). Parachute: Toronto, ON.
 Cancer Care Ontario, Ontario Agency for Health Protection and Promotion (Public Health Ontario). (2012). Taking action to prevent chronic disease: recommendations for a healthier Ontario. Toronto: Queen’s Printer for Ontario. Available at: https://www.cancercare.on.ca/pcs/prevention/healthieron/?WT.mc_id=/takin...
 National Alcohol Strategy Working Group, Health Canada. (2007). Reducing alcohol-related harm in Canada: toward a culture of moderation—recommendations for a National Alcohol Strategy. Retrieved July 2013 from: http://www.nationalframework-cadrenational.ca/uploads/files/FINAL_NAS_EN....
 Government of Canada. (2011). Road Safety in Canada. Ottawa.
 Transport Canada. (2008). A quick look at alcohol-related crashes in Canada. Ottawa.
 Harre, N., Field, J. & Kirkwood, B. (1996). Gender differences and areas of common concern in the driving behaviours and attitudes of adolescents. Journal of Safety Research, 27(3), 163-173.
 Bibby, R. W., Russell, S., & Rolheiser, R. (2009). The emerging millennials: How Canada's newest generation is responding to change & choice. Project Canada Books.
 Goodwin, A., Foss, R., Harrell, S., O’Brien, N.P., & the UNC Highway Safety Research Centre. (2012). Distracted Driving Among Newly Licensed Teen Drivers. AAA Foundation for Traffic Safety: Washington, DC.
 Winston, F.K., Kallan, M.J., Senserrick, T.M., and Elliott, M.R. (2008). Risk Factors for Death Among Older Children and Teenage Motor Vehicle Passengers. Archives of Pediatric Medicine, 162, 253-260.
 Insurance Institute for Highway Safety (IIHS). Fatality Facts 2006: Teenagers. Data from the U.S. Department of Transportation Fatal Analysis Reporting System. Retrieved from: http://www.iihs.org/research/fatality_facts_2006/teenagers.html.
 Mirman, J.H., Albert, D., Jacobsohn, L.S., & Winston, F.K. (2012). Factors Associated with Adolescents' Propensity to Drive with Multiple Passengers and to Engage in Risky Driving Behaviors. Journal of Adolescent Health, 50, 634-640.
 Paleti, R., Eluru, N., & Bhat, C. R. (2010). Examining the influence of aggressive driving behavior on driver injury severity in traffic crashes. Accident Analysis & Prevention, 42(6), 1839-1854.
 Government of Canada. (2011). Road Safety in Canada. Ottawa.
 Marketwired. (June 18, 2013). Road Hazards Lurk as Summer Driving Season Heats Up. Retrieved July 2013: http://www.marketwire.com/press-release/state-farm-canada-road-hazards-l....
 Project Gearshift, A Project of Parachute. Retrieved July 2013: http://www.projectgearshift.ca.
 Celebrate My Drive, Powered by State Farm. Retrieved July 2013: http://www.celebratemydrive.com.
 Giesbrecht, N. & Wettlaufer, A., April, N., Asbridge, M., Cukier, S., Mann, R., McAllister, J., Murie, A., Pauley, C., Plamondon, L., Stockwell, T., Thomas, G., Thompson, K., & Vallance, K. (2013). Strategies to Reduce Alcohol-Related Harms and Costs in Canada: A Comparison of Provincial Policies. Toronto: Centre for Addiction and Mental Health.
 Bill 126 – Zero Blood Alcohol Concentration (BAC) for Young Drivers and Escalating Sanctions for Novice Drivers. Ontario Ministry of Transportation. Retrieved August 2013 from: http://www.mto.gov.on.ca/english/about/bill126.shtml.
 Impaired Driving. Ontario Ministry of Transportation. Retrieved August 2013 from: http://www.mto.gov.on.ca/english/safety/impaired/.
Public Health Ontario site includes programs and services, resources, and listing of events: http://www.publichealthontario.ca.
Centre for Addiction and Mental Health (CAMH) website includes research, news and publications, studies and reports: http://www.camh.ca.