American Beverage Licensees attack Mothers Against Drunk Driving

In a recent campaign, the American Beverage Licensees (ABL), an organization that represents beer, wine and spirits retailers in the United States of America, has created a campaign called ‘MADD at GM’. On their ‘MADD at GM’ website, ABL makes several anti-MADD statements as well as criticizing General Motors (GM) for supporting MADD. This is an unwarranted attack on Mothers Against Drunk Driving (MADD)—an organization that is celebrating its 25-year anniversary of combating alcohol-related traffic crashes and providing victim support services. MADD was created in 1980 by two women, Cindi Lamb and Candy Lightner, both victims of drunk drivers. In 1979, Cindi Lamb and her five-and-a-half-month-old daughter were hit head-on by a drunk driver—her daughter was paralyzed from the crash. Less than a year later, Candy Lightner's 13-year-old daughter was killed by a drunk driver. Twenty-five years after they and their friends started MADD, it has grown to well over 600 chapters and over 3 million members, with affiliates in Canada, England, New Zealand, Sweden, Japan and Australia (MADD 2005a). MADD's original mission was ‘to mobilize victims and their allies to establish the public conviction that impaired driving is unacceptable and criminal in order to promote corresponding public policy, programs, and personal accountability’. In 1984, this mission statement was simplified to ‘stop drunk driving and to support victims of this violent crime.’ In 1999, recognizing the high percentage of alcohol-related traffic crashes experienced by youth, MADD's mission statement was expanded to include prevention of underage drinking (MADD 2005a). MADD has made great strides in achieving its mission. In 1982, 60% of traffic crash fatalities in the United States were alcohol-related but as of 2003, the percentage had decreased to 40%—a 33% decrease (NHTSA 2005). MADD has contributed to this decrease by advocating for increased penalties for repeat drink-driving offenders, consistent sentencing for offenders, an age-21 minimum legal drinking age (MLDA), and lower blood alcohol concentration (BAC) laws for youth and adult drivers (MADD, 2005a). In addition to helping reduce alcohol-related traffic crashes, MADD has grown to be the world's largest crime victims’ assistance organization. MADD served over 30 000 victims of alcohol-related traffic crashes in 2004. Over 1700 volunteers have completed MADD's 40-hour victim advocate education program (MADD, 2005a). On the MADD at GM website, ABL (2005) makes several misguided and unsubstantiated claims: ABL claims that ‘MADD has become more and more neo-prohibitionist’. Reality: According to Merriam-Webster's Online Dictionary (2005), prohibition is ‘the forbidding by law of the manufacture or sale of alcoholic liquors except for medicinal and sacramental purposes’. As indicated in MADD's mission statement, MADD is targeting alcohol-related traffic crashes and assisting victims of these crashes. MADD has not promoted or supported legislation or programs that prohibit the manufacture or sale of alcoholic beverages or that target responsible alcohol use among adults age 21 and older. MADD has worked to prevent repeat drunk-driving offenders as well as other individuals from getting behind the wheel when impaired. When alcohol-related traffic crashes do occur, MADD and its volunteers are there to support the victims of the crashes, helping them to survive and navigate the legal system. MADD does support legislation and programs that oppose any alcohol use by youth—in other words, MADD supports the current law prohibiting alcohol use among individuals under age 21. Traffic crashes are a leading cause of death among individuals aged 15–20 and, in 2003, 36% of these were estimated to involve alcohol use (MADD, 2005b). The preponderance of research evidence indicates that as the MLDA was increased to age 21, traffic crash deaths among individuals aged 18–20 years old decreased (Wagenaar & Toomey, 2002). Additionally, individuals who begin to drink alcohol at younger ages are more likely to develop alcohol-related problems later in life, and thus are more likely to contribute to alcohol-related traffic crashes (Hingson & Winter, 2003). ABL claims that MADD would have you arrested if you ‘had a glass of wine with dinner and then driven safely home’ or if ‘you had a cocktail with your friends after work before heading home’. ABL also claims that MADD wants ‘to criminalize the 40 million adults that responsibly enjoy a glass of wine with dinner or a beer at a ball game and drive safely home’. Reality: MADD is not trying to criminalize adults that have ‘a glass of wine…or beer’ in any setting. Staying true to its mission, during the past decade MADD supported lowering legal per se blood aclohol concentration (BAC) thresholds for adult drivers from 0.10 to 0.08. A 0.08 BAC level is not reached by ‘a glass of wine…or beer’ but rather is ‘reached by a 170-pound man after consuming four drinks in 1 h on an empty stomach, or by a 135-pound woman consuming three drinks’ (Hingson & Winter, 2003). MADD's support for the 0.08 BAC level is backed by research evidence indicating that a 0.08 BAC limit is associated with fewer traffic crashes and fatalities (Dee, 2001; Eisenberg, 2003; Bernat et al. 2004). Currently all 50 states have passed a 0.08 BAC law. MADD also supported lowering the legal BAC threshold for youth to 0.02 or less because of the increased risk of traffic crashes faced by youth at even low BAC levels, and research evidence that legislation lowering the youth BAC level was associated with fewer traffic crash deaths among youth (Hingson, Hereen & Winter, 1994; Wagenaar, O’Malley & Lafond, 2001; Voas, Tippetts & Fell, 2003). ABL claims that: ‘To speed up their march to zero tolerance, MADD and other neo-prohibitionists are investing millions of dollars in PR campaigns designed to frighten responsible adults out of enjoying a cold beer, a glass of wine or a cocktail outside the home. Roadblocks are the law enforcement centerpiece of this scare campaign.’ Reality: Social drinkers do not attain a BAC of 0.08. Again, MADD is not a neo-prohibitionist organization. MADD does support use of sobriety checkpoints, where law enforcement officers systematically stop drivers to assess their BAC levels (Shults et al. 2001). In the United States, law enforcement officers must have a reason to suspect that the driver has been drinking before administering the breath test at the checkpoint. These enforcement campaigns are made more effective through publicity. The goal of these checkpoints is to increase the perception among drivers that they will be caught if they are drinking while impaired. Approximately two-thirds of individuals who are arrested for impaired driving are first-time offenders (NHTSA 1995). The preponderance of research evidence indicates that these enforcement campaigns decrease traffic crashes (Elder et al. 2002). ABL states: ‘When you buy a GM car or truck, you are supporting MADD's efforts to harass and possibly arrest you, your friends, and your neighbors—anybody who has a beer, a cocktail, or a glass of wine before driving home.’ Reality: MADD's mission is to save lives and prevent injuries by preventing alcohol-related traffic crashes. When prevention efforts fail and a crash occurs, MADD assists the victims of the crash. MADD is not targeting individuals who have had one drink of alcohol before driving home. GM's support of MADD's mission is admirable. Certainly, as pointed out by ABL, in addition to alcohol use there are other factors that contribute to traffic crashes such as speeding and cell phones use (Bedard et al. 2002; Laberge-Nadeau et al. 2003; Strayer & Drews, 2004). We need to identify programs and legislation to target these other traffic crash risk factors. We also need a champion to address these other risk factors; we need a champion that will, like MADD, remain focused and true to its mission to ensure that these identified programs and policies are implemented. Given ABL's expressed concern for risk factors such as speeding and cell phone use, we expect ABL to support future initiatives in these areas. ABL claims that ‘taverns, restaurants, and manufacturers have spent tens of millions of dollars to prevent drunk driving and irresponsible drinking’. Reality: individuals who appear obviously intoxicated are able to purchase alcohol at retail establishments in 58–85% of their attempts (Freisthler et al. 2003; Toomey et al. 2005). One study estimates that the alcohol industry makes a significant amount of money from the nation's heaviest alcohol users; the top 2.5% of the heaviest alcohol consumers account for approximately one-fourth of all self-reported alcohol use in the country (Rogers & Greenfield, 1999). Similarly, the National Survey of Drug Use and Health in 2002 indicated that binge drinkers (five or more drinks in one sitting in last month) are only 23% of the population but they consume 76% of the alcohol in this country (US OJJDP, 2003). In addition, several studies have shown that bars and restaurants are the most frequently cited as place of last drink among impaired drivers (Gruenewald et al. 1999; O’Donnell, 1985; Wood et al. 1995). If ABL and other industry organizations are truly committed to decreasing drunk driving and irresponsible drinking, they should be applauding rather than attacking organizations that support use of scientifically based strategies to save lives. Although drunk-driving is still a major public health issue, MADD has consistently used sound approaches to make progress towards achieving its mission and should be recognized for its outstanding work. Dr Toomey is also on the Board of Directors for MADD.

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