Breath testing checkpoints

There is strong evidence that breath testing checkpoints reduce alcohol-impaired driving, alcohol-related crashes, and associated fatal and non-fatal injuries, especially when checkpoints are highly publicized (CG-Motor vehicle injury, Jones 2022c, Lenk 2016). Positive effects have been shown for both random breath testing (RBT) (IAS-Anderson 2006, CG-Motor vehicle injury) and selective breath testing (SBT) (CG-Motor vehicle injury, Lenk 2016).

States where breath testing checkpoints are legal have lower rates of alcohol-impaired driving, 17% fewer fatal crashes, and 25% fewer driving under the influence (DUI) arrests compared to states where breath testing checkpoints are illegal (Jones 2022c). U.S.-based and international studies indicate checkpoints and their enforcement actions may have short-term deterrent effects, with the reduction in alcohol-related crashes and DUI arrests lasting about a week (Jones 2022c, Erke 2009, Morrison 2021a, Morrison 2019). States that conduct checks frequently (i.e., at least monthly) have lower rates of alcohol-impaired driving and alcohol-related crashes than states that conduct checks less frequently (Morrison 2019, Lenk 2016). Studies of checkpoints in Australia suggest that testing all drivers may increase the checkpoint’s effectiveness (Erke 2009), and that the checkpoint size, duration, and density do not appear to impact its effectiveness (Morrison 2021, Morrison 2021a).

Breath testing checkpoints also have the potential to reduce alcohol consumption among underage youth (RAND-Imm 2007). A California-based study finds small and short-term effects on reductions in reported simple and aggravated assaults near checkpoints (Seifarth 2023). A community initiative in California appears to effectively reduce DUI arrests and public intoxication citations by using a combination of strategies including increasing sobriety checkpoints, adopting a social host liability law, using minor decoy and shoulder tap programs (Fell 2018).

Breath testing checkpoints appear to be implemented more in urban areas; this may be due to differences in resources, enforcement activity priorities, and population densities (i.e., increased density of alcohol establishments in more populated areas) (Calvert 2020). A survey of law enforcement agencies shows the frequency of breath testing checkpoints has remained stable or slightly declined from 2010 to 2019, even though they report prioritizing alcohol enforcement higher than before. Breath testing checkpoints may be perceived as too costly or resource-intensive to run despite their potential to reduce health and safety consequences of excessive alcohol use (Lenk 2023). Cost-benefit analyses of breath testing checkpoints show a range of benefit to cost ratios from 2:1 to 57:1, highlighting a net benefit to society through the reduction in alcohol-related harms to the general public (CG-Motor vehicle injury). Alternatively, an analysis of states where checkpoints are illegal found it costs states at least $1.9 billion annually in lost life (Jones 2022c).

Breath testing checkpoints have the potential to decrease disparities in driving under the influence (DUI), particularly for Black drivers (Jones 2022c, Kagawa 2021). Experts suggest that checkpoints, on top of their deterrent effects, may limit racial bias in enforcement actions because their procedures are standardized and more regulated than alternative enforcement actions that rely on officer discretion (Jones 2022c). Available evidence suggests that states where sobriety checkpoints are illegal have increases in racial disparities in DUI and marijuana possession arrests, with larger impacts on arrests among Black residents compared to states where sobriety checkpoints are legal (Jones 2022c). Furthermore, once arrested for suspicion of DUI, individuals from racialized backgrounds are more likely to be convicted than those who are white (Kagawa 2021). Experts recommend using data-informed solutions that are responsive to local context in determining when and where to conduct checkpoints, and taking steps to make sure they are not misused to target certain groups by race, ethnicity or income level (Jones 2022c, Kagawa 2021).

Evidence consistently demonstrates some groups, particularly Blacks and Latinos, can experience disproportionate personal and social consequences, including alcohol use disorder symptoms and various social problems, at similar levels of alcohol use, compared with other racial and ethnic groups (Mulia 2017). Evidence suggests that the combined effects of drinking cultures, historically rooted patterns of racial discrimination and persistent socioeconomic disadvantage in racialized groups contribute to these disparities (Vaeth 2017).

Alcohol is deeply rooted in American life and history. Prior to the American Revolution, alcohol was perceived as an invigorating and restorative beverage that did not spoil easily and was safer than water (Olson 1985). Its taxation provided a major source of revenue for colonial governments (Olson 1985). After the American Revolution, the temperance and women’s rights movements shifted societal perspectives of alcohol and led efforts for its banishment. These efforts led to the adoption of the 18th Amendment in 1920, which banned the manufacture, sale, and transport of alcohol across the U.S., also known as Prohibition (Aaron 1981). Prohibition ended in 1933 in large part because of the need to generate tax revenue and stimulate job growth during the Great Depression and gave states authority to regulate alcohol; each have approached regulation differently (Olson 1985). Today, the federal government has limited authority to impose national-level rules and regulations, which continues to be a patchwork of alcohol regulations that vary by state. Some state legislatures have preempted local government from implementing certain regulations and laws (APIS-State Preemption).

Throughout history, alcohol misuse was seen as a personal failing. This evolved over the 19th century as the addictive properties of alcohol were understood (Olson 1985). Alcohol use disorder is now seen as a chronic disease that is influenced by genetics, neighborhood disadvantage, stress, access to alcohol, drinking cultures and contexts, and alcohol-industry influences (Zapolski 2014, Sudhinaraset 2016).

The use of breath testing checkpoints in the U.S. began in the 1980s, however the approach has faced continued debates and legal challenges against the use on the grounds that it violates fourth Amendment rights against unjustified search (Jones 2022c). In 1990, the U.S. Supreme Court handed down a ruling wherein the potential benefits of sobriety checkpoints in reducing fatal crashes were seen to outweigh their potential interference with liberty. The ruling allowed individual states to retain the right to operate checkpoints as long as the programs pre-selected checkpoint sites, were well-publicized, and adhered to specific procedure regarding which drivers were stopped (i.e. every driver, every fourth driver, etc.) (Jones 2022c).

• Do local law enforcement agencies have the necessary resources and staff to implement checkpoints safely and in a standardized manner? Who can you partner with to secure the necessary funding and staffing to implement checkpoints?
• Do local law enforcement agencies have standardized protocols to support decision-making on where to implement checkpoints? Do these protocols prevent targeting specific groups of people or minoritized neighborhoods? How can you help advocate for improvement in the regulation of checkpoints and their implementation?
• Are checkpoints conducted at times when alcohol-impaired drivers are most likely to be on the roads, such as weekend evenings or after large community events (i.e. concerts, sporting events), and during safe weather conditions?

As of 2022, 38 states and Washington, D.C. permit law enforcement officers to conduct publicized random breath testing checkpoints by law; frequency and other specifics vary. Twelve states prohibit or do not authorize checkpoints (NHTSA-Kirley 2023).

NHTSA-Kirley 2023 - Kirley BB, Robison KL, Goodwin AH, et al. Countermeasures that work: A highway safety countermeasure guide for State Highway Safety Offices. 11th edition. Washington, D. C.: National Highway Traffic Safety Administration (NHTSA); 2023.

* Journal subscription may be required for access.

Aaron 1981 - Aaron P, Musto D. Temperance and prohibition in America: A historical overview. In: Alcohol and public policy: Beyond the shadow of prohibition. Moore MH, Gerstein DR eds. Washington, D.C.: The National Academies Press; 1981.

APIS-State Preemption - Alcohol Policy Information System (APIS). About alcohol policy.

Calvert 2020 - Calvert C, Toomey T, Lenk K, et al. Variation in alcohol policy enforcement across urban and nonurban communities. Journal of Rural Health. 2020;36(2):240-246.

CG-Motor vehicle injury - The Guide to Community Preventive Services (The Community Guide). Motor vehicle injury prevention.

Erke 2009* - Erke A, Goldenbeld C, Vaa T. The effects of drink-driving checkpoints on crashes - A meta-analysis. Accident Analysis & Prevention. 2009;41(5):914-23.

Fell 2018* - Fell JC, Tanenbaum E, Chelluri D. Evaluation of a combination of community initiatives to reduce driving while intoxicated and other alcohol-related harms. Traffic Injury Prevention. 2018;19:S176-S179.

IAS-Anderson 2006 - Anderson P, Baumberg B. Alcohol in Europe: A public health perspective. London, UK: Institute of Alcohol Studies (IAS); 2006.

Jones 2022c* - Jones LE, Morin CB. Sobriety checkpoint laws, fatal car crashes and arrests. Drug Enforcement and Policy Center: The Ohio State University Moritz College of Law. 2022: Working Paper.

Kagawa 2021 - Kagawa RMC, McCort CD, Schleimer J, et al. Racial bias and DUI enforcement: Comparing conviction rates with frequency of behavior. Criminology and Public Policy. 2021;20(4):645-663.

Lenk 2016* - Lenk KM, Nelson TF, Toomey TL, et al. Sobriety checkpoint and open container laws in the United States: Associations with drinking-driving. Traffic Injury Prevention. 2016;17(8):782-787.

Lenk 2023* - Lenk KM, Scholz N, Erickson DJ, et al. Alcohol enforcement in the United States from 2010 to 2019. Journal of Studies on Alcohol and Drugs. 2023;84(3):416-423.

Morrison 2019* - Morrison CN, Ferris J, Wiebe DJ, Peek-Asa C, Branas CC. Sobriety checkpoints and alcohol-involved motor vehicle crashes at different temporal scales. American Journal of Preventive Medicine. 2019;56(6):795-802.

Morrison 2021* - Morrison CN, Kwizera M, Chen Q, et al. Alcohol-involved motor vehicle crashes and the size and duration of random breath testing checkpoints. Alcoholism: Clinical and Experimental Research. 2021;45(4):784-792.

Morrison 2021a* - Morrison CN, Kwizera M, Chen Q, et al. The geography of sobriety checkpoints and alcohol-impaired driving. Addiction. 2021;117(5):1450-1457.

Mulia 2017 - Mulia N, Karriker-Jaffe KJ, Witbrodt J, et al. Racial/ethnic differences in 30-year trajectories of heavy drinking in a nationally representative U.S. sample. Drug and Alcohol Dependence. 2017;170:133-141.

NHTSA-Kirley 2023 - Kirley BB, Robison KL, Goodwin AH, et al. Countermeasures that work: A highway safety countermeasure guide for State Highway Safety Offices. 11th edition. Washington, D. C.: National Highway Traffic Safety Administration (NHTSA); 2023.

Olson 1985* - Olson S, Gerstein DR. Alcohol in America: Taking action to prevent abuse. Washington, D.C.: The National Academies Press; 1985.

RAND-Imm 2007 - Imm P, Chinman M, Wandersman A, et al. Preventing underage drinking: Using Getting To Outcomes™ with the SAMHSA strategic prevention framework to achieve results. Santa Monica: RAND Corporation; 2007: Technical Report 403.

Seifarth 2023* - Seifarth J, Ferris J, Peek-Asa C, et al. Unintended reductions in assaults near sobriety checkpoints: A longitudinal spatial analysis. Spatial and Spatio-temporal Epidemiology. 2023;44:100567.

Sudhinaraset 2016 - Sudhinaraset M, Wigglesworth C, Takeuchi DT. Social and cultural contexts of alcohol use: Influences in a social–ecological framework. Alcohol Research: Current Reviews. 2016;38(1):35-45.

Vaeth 2017* - Vaeth PAC, Wang-Schweig M, Caetano R. Drinking, alcohol use disorder, and treatment access and utilization among U.S. racial/ethnic groups. Alcoholism: Clinical and Experimental Research. 2017;41(1):6-19.

Zapolski 2014 - Zapolski TCB, Pedersen SL, McCarthy DM, Smith GT. Less drinking, yet more problems: Understanding African American drinking and related problems. Psychological Bulletin. 2014;140(1).