Drinking and Driving among University Students in 22 Low, Middle Income and Emerging Economy Countries
Identifieur interne : 000108 ( Pmc/Corpus ); précédent : 000107; suivant : 000109Drinking and Driving among University Students in 22 Low, Middle Income and Emerging Economy Countries
Auteurs : Karl Peltzer ; Supa PengpidSource :
- Iranian Journal of Public Health [ 2251-6085 ] ; 2015.
Abstract
The aim of this study was investigate drinking, driving, and socio-behavioral factors among university students in low and middle income and emerging economy countries.
Using anonymous questionnaires, data were collected from 18476 university students, of which 15151 (82.0%) were drivers of a car or motorcycle (41.3% men and 58.7% women), with a mean age of 20.7 years (SD=2.9), from 22 countries across Africa, Asia and Americas.
Overall, 17.3% reported to have been driving a car or motorcycle after having had too much to drink in the past 12 months, ranging from below 5% in Bangladesh, Indonesia and Kyrgyzstan to above 35% in China, Singapore and Thailand. In multivariate logistic regression analysis, among both men and women, earlier year of study, living in an upper middle income or high income country (OR=3.58, CI=3.00–4.27 and OR=2.95, CI=2.52–3.46), low intrinsic religiosity (OR=0.67, CI=0.54–0.83 and OR=0.34, CI=0.28–0.42), injury from motorcycle accidents (OR=4.29, CI=2.69–6.82 and OR=3.24, CI=2.26–4.63), and weak belief in the importance of not drinking (OR=1.78, CI=1.50–2.11 and OR=1.61, CI=1.37–1.88) and driving were associated with drinking and driving. Further, among men, older age (OR=1.04, CI=1.01–1.07), binge drinking (OR=1.53, CI=1.27–1.86) and illicit drug use (OR=1.22, CI=1.01–1.47), and among women, younger age (OR=0.95, CI=0.97–0.98), and a lower country BAC limit (OR=0.01, CI=0.001–0.18) was associated with drinking and driving.
This study confirms low to high levels of drinking and driving in different cultures across Africa, Asia and the Americas. Various factors identified can be used to guide interventions to reduce drinking and driving among university students.
Url:
PubMed: 26576345
PubMed Central: 4644577
Links to Exploration step
PMC:4644577Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Drinking and Driving among University Students in 22 Low, Middle Income and Emerging Economy Countries</title><author><name sortKey="Peltzer, Karl" sort="Peltzer, Karl" uniqKey="Peltzer K" first="Karl" last="Peltzer">Karl Peltzer</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Pengpid, Supa" sort="Pengpid, Supa" uniqKey="Pengpid S" first="Supa" last="Pengpid">Supa Pengpid</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26576345</idno><idno type="pmc">4644577</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644577</idno><idno type="RBID">PMC:4644577</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000108</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000108</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Drinking and Driving among University Students in 22 Low, Middle Income and Emerging Economy Countries</title><author><name sortKey="Peltzer, Karl" sort="Peltzer, Karl" uniqKey="Peltzer K" first="Karl" last="Peltzer">Karl Peltzer</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Pengpid, Supa" sort="Pengpid, Supa" uniqKey="Pengpid S" first="Supa" last="Pengpid">Supa Pengpid</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></analytic><series><title level="j">Iranian Journal of Public Health</title><idno type="ISSN">2251-6085</idno><idno type="eISSN">2251-6093</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>The aim of this study was investigate drinking, driving, and socio-behavioral factors among university students in low and middle income and emerging economy countries.</p></sec><sec><title>Methods:</title><p>Using anonymous questionnaires, data were collected from 18476 university students, of which 15151 (82.0%) were drivers of a car or motorcycle (41.3% men and 58.7% women), with a mean age of 20.7 years (SD=2.9), from 22 countries across Africa, Asia and Americas.</p></sec><sec><title>Results:</title><p>Overall, 17.3% reported to have been driving a car or motorcycle after having had too much to drink in the past 12 months, ranging from below 5% in Bangladesh, Indonesia and Kyrgyzstan to above 35% in China, Singapore and Thailand. In multivariate logistic regression analysis, among both men and women, earlier year of study, living in an upper middle income or high income country (OR=3.58, CI=3.00–4.27 and OR=2.95, CI=2.52–3.46), low intrinsic religiosity (OR=0.67, CI=0.54–0.83 and OR=0.34, CI=0.28–0.42), injury from motorcycle accidents (OR=4.29, CI=2.69–6.82 and OR=3.24, CI=2.26–4.63), and weak belief in the importance of not drinking (OR=1.78, CI=1.50–2.11 and OR=1.61, CI=1.37–1.88) and driving were associated with drinking and driving. Further, among men, older age (OR=1.04, CI=1.01–1.07), binge drinking (OR=1.53, CI=1.27–1.86) and illicit drug use (OR=1.22, CI=1.01–1.47), and among women, younger age (OR=0.95, CI=0.97–0.98), and a lower country BAC limit (OR=0.01, CI=0.001–0.18) was associated with drinking and driving.</p></sec><sec><title>Conclusion:</title><p>This study confirms low to high levels of drinking and driving in different cultures across Africa, Asia and the Americas. Various factors identified can be used to guide interventions to reduce drinking and driving among university students.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ham, Ls" uniqKey="Ham L">LS Ham</name></author><author><name sortKey="Hope, Da" uniqKey="Hope D">DA Hope</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gore, Fm" uniqKey="Gore F">FM Gore</name></author><author><name sortKey="Bloem, Pj" uniqKey="Bloem P">PJ Bloem</name></author><author><name sortKey="Patton, Gc" uniqKey="Patton G">GC Patton</name></author><author><name sortKey="Ferguson, J" uniqKey="Ferguson J">J Ferguson</name></author><author><name sortKey="Joseph, V" uniqKey="Joseph V">V Joseph</name></author><author><name sortKey="Coffey, C" uniqKey="Coffey C">C Coffey</name></author><author><name sortKey="Sawyer, Sm" uniqKey="Sawyer S">SM Sawyer</name></author><author><name sortKey="Mathers, Cd" uniqKey="Mathers C">CD Mathers</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wechsler, H" uniqKey="Wechsler H">H Wechsler</name></author><author><name sortKey="Lee, Je" uniqKey="Lee J">JE Lee</name></author><author><name sortKey="Nelson, Tf" uniqKey="Nelson T">TF Nelson</name></author><author><name sortKey="Lee, H" uniqKey="Lee H">H Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Durkin, K" uniqKey="Durkin K">K Durkin</name></author><author><name sortKey="Wolfe, Se" uniqKey="Wolfe S">SE Wolfe</name></author><author><name sortKey="May, Rw" uniqKey="May R">RW May</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Labrie, Jw" uniqKey="Labrie J">JW LaBrie</name></author><author><name sortKey="Kenney, Sr" uniqKey="Kenney S">SR Kenney</name></author><author><name sortKey="Mirza, T" uniqKey="Mirza T">T Mirza</name></author><author><name sortKey="Lac, A" uniqKey="Lac A">A Lac</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hingson, R" uniqKey="Hingson R">R Hingson</name></author><author><name sortKey="Heeren, T" uniqKey="Heeren T">T Heeren</name></author><author><name sortKey="Zakocs, R" uniqKey="Zakocs R">R Zakocs</name></author><author><name sortKey="Winter, M" uniqKey="Winter M">M Winter</name></author><author><name sortKey="Wechsler, H" uniqKey="Wechsler H">H Wechsler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Clapp, Jd" uniqKey="Clapp J">JD Clapp</name></author><author><name sortKey="Shillington, Am" uniqKey="Shillington A">AM Shillington</name></author><author><name sortKey="Lange, Je" uniqKey="Lange J">JE Lange</name></author><author><name sortKey="Voas, Rb" uniqKey="Voas R">RB Voas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kohn, C" uniqKey="Kohn C">C Kohn</name></author><author><name sortKey="Saleheen, H" uniqKey="Saleheen H">H Saleheen</name></author><author><name sortKey="Borrup, K" uniqKey="Borrup K">K Borrup</name></author><author><name sortKey="Rogers, S" uniqKey="Rogers S">S Rogers</name></author><author><name sortKey="Lapidus, G" uniqKey="Lapidus G">G Lapidus</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kypri, K" uniqKey="Kypri K">K Kypri</name></author><author><name sortKey="Stephenson, S" uniqKey="Stephenson S">S Stephenson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Steptoe, A" uniqKey="Steptoe A">A Steptoe</name></author><author><name sortKey="Wardle, J" uniqKey="Wardle J">J Wardle</name></author><author><name sortKey="Bages, N" uniqKey="Bages N">N Bages</name></author><author><name sortKey="Sallis, Jf" uniqKey="Sallis J">JF Sallis</name></author><author><name sortKey="Sanabria Ferrand, Pa" uniqKey="Sanabria Ferrand P">PA Sanabria-Ferrand</name></author><author><name sortKey="Sanchez, M" uniqKey="Sanchez M">M Sanchez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Delcher, C" uniqKey="Delcher C">C Delcher</name></author><author><name sortKey="Johnson, R" uniqKey="Johnson R">R Johnson</name></author><author><name sortKey="Maldonado Molina, Mm" uniqKey="Maldonado Molina M">MM Maldonado-Molina</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cavazos Rehg, Pa" uniqKey="Cavazos Rehg P">PA Cavazos-Rehg</name></author><author><name sortKey="Krauss, Mj" uniqKey="Krauss M">MJ Krauss</name></author><author><name sortKey="Spitznagel, El" uniqKey="Spitznagel E">EL Spitznagel</name></author><author><name sortKey="Chaloupka, Fj" uniqKey="Chaloupka F">FJ Chaloupka</name></author><author><name sortKey="Schootman, M" uniqKey="Schootman M">M Schootman</name></author><author><name sortKey="Grucza, Ra" uniqKey="Grucza R">RA Grucza</name></author><author><name sortKey="Bierut, Lj" uniqKey="Bierut L">LJ Bierut</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Jh" uniqKey="Kim J">JH Kim</name></author><author><name sortKey="Lee, S" uniqKey="Lee S">S Lee</name></author><author><name sortKey="Chan, Kw" uniqKey="Chan K">KW Chan</name></author><author><name sortKey="Lau, J" uniqKey="Lau J">J Lau</name></author><author><name sortKey="Tsang, A" uniqKey="Tsang A">A Tsang</name></author><author><name sortKey="Griffiths, Sm" uniqKey="Griffiths S">SM Griffiths</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Segui Gomez, M" uniqKey="Segui Gomez M">M Segui-Gomez</name></author><author><name sortKey="Palma, S" uniqKey="Palma S">S Palma</name></author><author><name sortKey="Guillen Grima, F" uniqKey="Guillen Grima F">F Guillen-Grima</name></author><author><name sortKey="De Irala, J" uniqKey="De Irala J">J de Irala</name></author><author><name sortKey="Martinez Gonzalez, Ma" uniqKey="Martinez Gonzalez M">MA Martinez-Gonzalez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Goncalves, Pd" uniqKey="Goncalves P">PD Gonçalves</name></author><author><name sortKey="Cunha, Pj" uniqKey="Cunha P">PJ Cunha</name></author><author><name sortKey="Malbergier, A" uniqKey="Malbergier A">A Malbergier</name></author><author><name sortKey="Do Amaral, Ra" uniqKey="Do Amaral R">RA do Amaral</name></author><author><name sortKey="De Oliveira, Lg" uniqKey="De Oliveira L">LG de Oliveira</name></author><author><name sortKey="Yang, Jj" uniqKey="Yang J">JJ Yang</name></author><author><name sortKey="De Andrade, Ag" uniqKey="De Andrade A">AG de Andrade</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Connor, J" uniqKey="Connor J">J Connor</name></author><author><name sortKey="Norton, R" uniqKey="Norton R">R Norton</name></author><author><name sortKey="Ameratunga, S" uniqKey="Ameratunga S">S Ameratunga</name></author><author><name sortKey="Jackson, R" uniqKey="Jackson R">R Jackson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lin, Mr" uniqKey="Lin M">MR Lin</name></author><author><name sortKey="Kraus, Jf" uniqKey="Kraus J">JF Kraus</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sloan, Fa" uniqKey="Sloan F">FA Sloan</name></author><author><name sortKey="Eldred, Lm" uniqKey="Eldred L">LM Eldred</name></author><author><name sortKey="Xu, Y" uniqKey="Xu Y">Y Xu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Desapriya, Eb" uniqKey="Desapriya E">EB Desapriya</name></author><author><name sortKey="Iwase, N" uniqKey="Iwase N">N Iwase</name></author><author><name sortKey="Brussoni, M" uniqKey="Brussoni M">M Brussoni</name></author><author><name sortKey="Shimizu, S" uniqKey="Shimizu S">S Shimizu</name></author><author><name sortKey="Belayneh, Tn" uniqKey="Belayneh T">TN Belayneh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Babor, Tf" uniqKey="Babor T">TF Babor</name></author><author><name sortKey="Higgins Biddle, Jc" uniqKey="Higgins Biddle J">JC Higgins-Biddle</name></author><author><name sortKey="Saunders, Jb" uniqKey="Saunders J">JB Saunders</name></author><author><name sortKey="Monteiro, Mg" uniqKey="Monteiro M">MG Monteiro</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wardle, J" uniqKey="Wardle J">J Wardle</name></author><author><name sortKey="Steptoe, A" uniqKey="Steptoe A">A Steptoe</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Lachman, Me" uniqKey="Lachman M">ME Lachman</name></author><author><name sortKey="Weaver, Sl" uniqKey="Weaver S">SL Weaver</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Hg" uniqKey="Koenig H">HG Koenig</name></author><author><name sortKey="Parkerson, Gr" uniqKey="Parkerson G">GR Parkerson</name></author><author><name sortKey="Meador, Kg" uniqKey="Meador K">KG Meador</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Li, Y" uniqKey="Li Y">Y Li</name></author><author><name sortKey="Xie, D" uniqKey="Xie D">D Xie</name></author><author><name sortKey="Nie, G" uniqKey="Nie G">G Nie</name></author><author><name sortKey="Zhang, G" uniqKey="Zhang G">G Zhang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nanakorn, S" uniqKey="Nanakorn S">S Nanakorn</name></author><author><name sortKey="Osaka, R" uniqKey="Osaka R">R Osaka</name></author><author><name sortKey="Chusilp, K" uniqKey="Chusilp K">K Chusilp</name></author><author><name sortKey="Tsuda, A" uniqKey="Tsuda A">A Tsuda</name></author><author><name sortKey="Maskasame, S" uniqKey="Maskasame S">S Maskasame</name></author><author><name sortKey="Ratanasiri, A" uniqKey="Ratanasiri A">A Ratanasiri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lim, Wy" uniqKey="Lim W">WY Lim</name></author><author><name sortKey="Subramaniam, M" uniqKey="Subramaniam M">M Subramaniam</name></author><author><name sortKey="Abdin, E" uniqKey="Abdin E">E Abdin</name></author><author><name sortKey="He, Vy" uniqKey="He V">VY He</name></author><author><name sortKey="Vaingankar, J" uniqKey="Vaingankar J">J Vaingankar</name></author><author><name sortKey="Chong, Sa" uniqKey="Chong S">SA Chong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wilsnack, Rw" uniqKey="Wilsnack R">RW Wilsnack</name></author><author><name sortKey="Wilsnack, Sc" uniqKey="Wilsnack S">SC Wilsnack</name></author><author><name sortKey="Kristjanson, Af" uniqKey="Kristjanson A">AF Kristjanson</name></author><author><name sortKey="Vogeltanz Holm, Nd" uniqKey="Vogeltanz Holm N">ND Vogeltanz-Holm</name></author><author><name sortKey="Gmel, G" uniqKey="Gmel G">G Gmel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rahav, G" uniqKey="Rahav G">G Rahav</name></author><author><name sortKey="Wilsnack, R" uniqKey="Wilsnack R">R Wilsnack</name></author><author><name sortKey="Bloomfield, K" uniqKey="Bloomfield K">K Bloomfield</name></author><author><name sortKey="Gmel, G" uniqKey="Gmel G">G Gmel</name></author><author><name sortKey="Kuntsche, S" uniqKey="Kuntsche S">S Kuntsche</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hanson, Dj" uniqKey="Hanson D">DJ. Hanson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kasantikul, V" uniqKey="Kasantikul V">V Kasantikul</name></author><author><name sortKey="Ouellet, Jv" uniqKey="Ouellet J">JV Ouellet</name></author><author><name sortKey="Smith, T" uniqKey="Smith T">T Smith</name></author><author><name sortKey="Sirathranont, J" uniqKey="Sirathranont J">J Sirathranont</name></author><author><name sortKey="Panichabhongse, V" uniqKey="Panichabhongse V">V. Panichabhongse</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ogazi, C" uniqKey="Ogazi C">C Ogazi</name></author><author><name sortKey="Edison, E" uniqKey="Edison E">E Edison</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Iran J Public Health</journal-id><journal-id journal-id-type="iso-abbrev">Iran. J. Public Health</journal-id><journal-id journal-id-type="publisher-id">IJPH</journal-id><journal-id journal-id-type="pmc">IJPH</journal-id><journal-title-group><journal-title>Iranian Journal of Public Health</journal-title></journal-title-group><issn pub-type="ppub">2251-6085</issn><issn pub-type="epub">2251-6093</issn><publisher><publisher-name>Tehran University of Medical Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26576345</article-id><article-id pub-id-type="pmc">4644577</article-id><article-id pub-id-type="publisher-id">ijph-44-1330</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Drinking and Driving among University Students in 22 Low, Middle Income and Emerging Economy Countries</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>PELTZER</surname><given-names>Karl</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF2"><sup>2</sup></xref><xref ref-type="aff" rid="AFF3"><sup>3</sup></xref><xref ref-type="corresp" rid="C1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>PENGPID</surname><given-names>Supa</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF2"><sup>2</sup></xref></contrib><aff id="AFF1"><label>1.</label> ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand</aff><aff id="AFF2"><label>2.</label>Dept. of Research & Innovation, University of Limpopo, Polokwane, South Africa</aff><aff id="AFF3"><label>3.</label>HIV/AIDS/STIs/and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa</aff></contrib-group><author-notes><corresp id="C1"><label>*</label><bold>Corresponding Author:</bold> Email: <email>karl.pel@mahidol.ac.th</email></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2015</year></pub-date><volume>44</volume><issue>10</issue><fpage>1330</fpage><lpage>1338</lpage><history><date date-type="received"><day>23</day><month>2</month><year>2015</year></date><date date-type="accepted"><day>11</day><month>5</month><year>2015</year></date></history><permissions><copyright-statement>Copyright© Iranian Public Health Association & Tehran University of Medical Sciences</copyright-statement><copyright-year>2015</copyright-year><license><license-p>This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.</license-p></license></permissions><abstract><sec><title>Background:</title><p>The aim of this study was investigate drinking, driving, and socio-behavioral factors among university students in low and middle income and emerging economy countries.</p></sec><sec><title>Methods:</title><p>Using anonymous questionnaires, data were collected from 18476 university students, of which 15151 (82.0%) were drivers of a car or motorcycle (41.3% men and 58.7% women), with a mean age of 20.7 years (SD=2.9), from 22 countries across Africa, Asia and Americas.</p></sec><sec><title>Results:</title><p>Overall, 17.3% reported to have been driving a car or motorcycle after having had too much to drink in the past 12 months, ranging from below 5% in Bangladesh, Indonesia and Kyrgyzstan to above 35% in China, Singapore and Thailand. In multivariate logistic regression analysis, among both men and women, earlier year of study, living in an upper middle income or high income country (OR=3.58, CI=3.00–4.27 and OR=2.95, CI=2.52–3.46), low intrinsic religiosity (OR=0.67, CI=0.54–0.83 and OR=0.34, CI=0.28–0.42), injury from motorcycle accidents (OR=4.29, CI=2.69–6.82 and OR=3.24, CI=2.26–4.63), and weak belief in the importance of not drinking (OR=1.78, CI=1.50–2.11 and OR=1.61, CI=1.37–1.88) and driving were associated with drinking and driving. Further, among men, older age (OR=1.04, CI=1.01–1.07), binge drinking (OR=1.53, CI=1.27–1.86) and illicit drug use (OR=1.22, CI=1.01–1.47), and among women, younger age (OR=0.95, CI=0.97–0.98), and a lower country BAC limit (OR=0.01, CI=0.001–0.18) was associated with drinking and driving.</p></sec><sec><title>Conclusion:</title><p>This study confirms low to high levels of drinking and driving in different cultures across Africa, Asia and the Americas. Various factors identified can be used to guide interventions to reduce drinking and driving among university students.</p></sec></abstract><kwd-group><kwd>Drink driving</kwd><kwd>Health behaviour</kwd><kwd>Health beliefs</kwd><kwd>University students</kwd><kwd>Multi-country</kwd></kwd-group></article-meta></front><body><sec sec-type="intro"><title>Introduction</title><p>A high public health burden among young people between 20 and 24 years in low- and middle-income countries is road traffic injuries, alcohol use and alcohol-related accidents (<xref rid="B1" ref-type="bibr">1</xref>–<xref rid="B3" ref-type="bibr">3</xref>). University students seem to be particularly vulnerable to driving under the influence of alcohol (<xref rid="B4" ref-type="bibr">4</xref>, <xref rid="B5" ref-type="bibr">5</xref>). Various studies among university students, mainly from high income countries found high levels of drinking and driving: in USA: 25.8% driving after having too much to drink (<xref rid="B5" ref-type="bibr">5</xref>); 19.1% driven after 3 or more drinks in the past 3 months (<xref rid="B6" ref-type="bibr">6</xref>); 41% after any drinking in the past 30 days (<xref rid="B7" ref-type="bibr">7</xref>); driving under the influence of alcohol in the past year 28.1% (<xref rid="B8" ref-type="bibr">8</xref>); 10.8% drover after more than 4 drinks in the past month (<xref rid="B4" ref-type="bibr">4</xref>); 23% drove after alcohol use (<xref rid="B9" ref-type="bibr">9</xref>); New Zealand driven (past 4 weeks) after having “perhaps too much to drink to be able to drive safely” 3.4% of women and 8.4% of men (<xref rid="B10" ref-type="bibr">10</xref>); university students from 19 high income and 4 middle income countries, past year driving after drinking too much, men 20% and women 7% (<xref rid="B11" ref-type="bibr">11</xref>).</p><p>Factors associated with drinking and driving have been identified, among others, as follows: 1) sociodemographic: male gender (<xref rid="B4" ref-type="bibr">4</xref>,<xref rid="B9" ref-type="bibr">9</xref>, <xref rid="B12" ref-type="bibr">12</xref>), older age (<xref rid="B4" ref-type="bibr">4</xref>); younger age (<xref rid="B13" ref-type="bibr">13</xref>); senior year of study (<xref rid="B4" ref-type="bibr">4</xref>), low religious commitment/importance (<xref rid="B5" ref-type="bibr">5</xref>,<xref rid="B9" ref-type="bibr">9</xref>), not living with parents or guardians (<xref rid="B4" ref-type="bibr">4</xref>,<xref rid="B9" ref-type="bibr">9</xref>); Gross Domestic Product (GPD) country for women (<xref rid="B11" ref-type="bibr">11</xref>); 2) substance use: binge drinking, heavy drinker (6,8,14–16), smoking (<xref rid="B15" ref-type="bibr">15</xref>), and cannabis use (<xref rid="B8" ref-type="bibr">8</xref>); 3) other traffic related behaviour: not always using seat-belts (<xref rid="B15" ref-type="bibr">15</xref>) and traffic injuries (4,7,17,18) health beliefs: weak belief in the importance of not drinking and driving (<xref rid="B6" ref-type="bibr">6</xref>,<xref rid="B11" ref-type="bibr">11</xref>); 5) personality characteristics: lack of self-control (<xref rid="B19" ref-type="bibr">19</xref>); and 6) drinking and driving legislation: lower country legal BAC limits (<xref rid="B11" ref-type="bibr">11</xref>,<xref rid="B20" ref-type="bibr">20</xref>).</p><p>There is a lack of studies investigating drinking, driving, and social-behavioural factors among university students in low and middle income and emerging economy countries over the same time, using a standard questionnaire allowing for direct comparison, which prompted this study.</p></sec><sec sec-type="methods"><title>Methods</title><sec><title>Sample and procedure</title><p>This cross-sectional study was carried out with a network of collaborators in participating countries (see Acknowledgments). The anonymous, self-administered questionnaire used for data collection was developed in English, then translated and back translated into languages (Arabic, Bahasa, French, Lao, Russian, Spanish, Thai, and Turkish) of the participating countries. Questionnaires were tested in each country and language and found valid. The study was initiated through personal academic contacts of the principal investigators. These collaborators arranged for data to be collected from intended 400 male and 400 female undergraduate university students aged 16–30 years by trained research assistants in 2013 in one or two universities in their respective countries. The universities involved were located in the capital cities or other major cities in the participating countries. Research assistants working in the participating universities asked classes of undergraduate students to complete the questionnaire at the end of a teaching class. In each study country, undergraduate students were surveyed in classrooms selected through a stratified random sample procedure. A university department formed a cluster and was used as a primary sampling unit. One department was randomly selected from each faculty. For each selected department, undergraduate courses offered by the department were randomly ordered. The students who completed the survey varied in the number of years for which they had attended the university. A variety of majors were involved, including education, humanities and arts, social sciences, business and law, science, engineering, manufacturing and construction, agriculture, health and welfare and services. Informed consent was obtained from participating students, and the study was conducted in 2013. Response rates were in most countries over 90%. Ethics approvals were obtained from institutional review boards from all participating institutions.</p></sec><sec><title>Measures</title><p>Drinking and driving. Participants were asked, “Over the last year, how many times did you drive a car or ride a motorcycle when you felt that you had perhaps had too much to drink? Response options were “never”, or a numerical indication of the number of times (<xref rid="B11" ref-type="bibr">11</xref>).</p><sec><title>Substance use
</title><p><italic>Binge drinking</italic> was assessed with one item, “How often do you have (for men) five or more and (for women) four or more drinks on one occasion?” Response options ranged from 1=never to 5=daily or almost daily (<xref rid="B21" ref-type="bibr">21</xref>).</p><p><italic>Tobacco use</italic> was assessed with the question: Do you currently use one or more of the following tobacco products (cigarettes, snuff, chewing tobacco, cigars, etc.)? Response options were “yes” or “no” (<xref rid="B22" ref-type="bibr">22</xref>).</p><p><italic>Illicit drug use</italic> was assessed with the question, “How often have you taken drugs in the past 12 months; other than prescribed by the health care provider.”</p></sec><sec><title>Other traffic related behaviour
</title><p><italic>Seat belt use</italic> was assessed with the question, “When driving or riding in the front seat of a car do you wear a seat belt?” Response options were, All the time, Some of the time, Never, I don’t ride in cars (<xref rid="B23" ref-type="bibr">23</xref>).</p><p><italic>Traffic injury.</italic> Participants were asked, “During the past 12 months, how many times you were seriously injured?” Serious injury was defined as “When it makes you miss at least one full day of usual activities, such as university, sports, or a job, or requires treatment by a doctor or nurse.”Further, “During the past 12 months, what was the major cause of the most serious injury that happened to you?” Among the different response options, two related to traffic injury, i.e., “I was in a motor vehicle accident or hit by a motor vehicle.” And “I was on a motorcycle.” (<xref rid="B24" ref-type="bibr">24</xref>).</p><p><italic>Health beliefs</italic> in the importance of “never to drive after drinking alcohol”. The response option ranged from 1=of very low importance to 10=of very high importance (<xref rid="B11" ref-type="bibr">11</xref>).</p><p><italic>Personality characteristics</italic> in the form of a sense of control were operationalized with the dimension of three items of personal mastery. An example is, “I can do just about anything I really set my mind to” (<xref rid="B25" ref-type="bibr">25</xref>). Cronbach’s alpha for personal mastery in this sample was .75.</p><p><italic>Socio-demographic</italic> questions included age, gender, and residential status. We assessed <italic>religiousness</italic> with the 3 item intrinsic (or subjective) religiosity sub-scale of Duke University Religion Index (DUREL; (<xref rid="B26" ref-type="bibr">26</xref>). Cronbach’s alpha for the intrinsic religiosity sub-scale was .96 for this sample.</p></sec></sec><sec sec-type="methods"><title>Data analysis</title><p>The data were analyzed using STATA 11.00 (StatCorp LP, College Station, TX). Descriptive statistics were used for reporting the proportion of drinking and driving and Pearson Chisquare for gender differences in proportion of drinking and driving. The product - moment correlation was used to compare the country Blood Alcohol Concentration (BAC) limits with drinking and driving prevalence. Logistic regression was used to assess the association between social-behavioral variables and drinking and driving. Variance inflation factor (VIF) and tolerance values for each model indicate multi collinearity was not a concern in any of the multivariate analyses. Since the study used a clustered design, country was included as a clustering variable in the regression models.</p></sec></sec><sec sec-type="results"><title>Results</title><sec sec-type="intro"><title>Sample characteristics</title><p>The sample included 18476 university students, of which 15151 (82.0%) were drivers of a car or motorcycle (41.3% men and 58.7% women), with a mean age of 20.7 years (SD=2.9), from 22 countries across Africa, Asia and Americas. Overall, 17.3% reported to have been driving a car or motorcycle after having had too much to drink in the past 12 months; 19.2% among men and 16.1% among women. The overall prevalence of drinking and driving among university students differed by country, ranging from below 5% in Bangladesh, Indonesia and Kyrgyzstan to above 35% in China, Singapore and Thailand. Overall, men were more frequently drinking and driving than women were (<italic>P</italic><0.001). Although the preponderance of drinking and driving among men was true for students from 13 study countries, there were no significant gender differences in drinking and driving in 8 countries, and in Indonesia, more women than men were drinking and driving. The proportion of drinking and driving was not correlated across study countries with national BAC limits (r=0.02, <italic>P</italic>=0.059) (<xref ref-type="table" rid="T1">Table 1</xref>).</p><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Drinking and driving prevalence in the past 12 months among drivers or riders by country and gender (n=14651)</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th colspan="2" align="center" valign="top" rowspan="1"><bold>Men</bold></th><th colspan="2" align="center" valign="top" rowspan="1"><bold>Women</bold></th><th colspan="3" align="center" valign="top" rowspan="1"><bold>All</bold></th></tr><tr><th align="left" valign="top" rowspan="3" colspan="1"><bold>Sample</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Car or motorcycle driver</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Drinking and driving (all drivers)</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Car or motorcycle driver</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Drinking and driving (all drivers)</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Statistic for sex differences</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Drinking and driving (all drivers)</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Country Blood Alcohol concentration (BAC) limiits (<xref rid="B27" ref-type="bibr">27</xref>,<xref rid="B28" ref-type="bibr">28</xref>)</bold></th></tr><tr><th align="center" valign="top" rowspan="1" colspan="1"><bold>n</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>%</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>%</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>%</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold><italic>P</italic>-Value</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>% (95% CI)</bold></th><th align="left" valign="top" rowspan="1" colspan="1"></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>All</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>6147</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>19.2</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>8504</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>16.1</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1"><bold>17.3 (16.7–17.9)</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Caribbean and South America</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Barbados<xref ref-type="table-fn" rid="TFN4"><sup>4</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">261</td><td align="center" valign="top" rowspan="1" colspan="1">18.0</td><td align="center" valign="top" rowspan="1" colspan="1">175</td><td align="center" valign="top" rowspan="1" colspan="1">4.6</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">12.6 (9.5–15.7)</td><td align="center" valign="top" rowspan="1" colspan="1">0.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Grenada<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">130</td><td align="center" valign="top" rowspan="1" colspan="1">16.9</td><td align="center" valign="top" rowspan="1" colspan="1">262</td><td align="center" valign="top" rowspan="1" colspan="1">3.4</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">7.9 (5.2–10.6)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Jamaica<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">148</td><td align="center" valign="top" rowspan="1" colspan="1">4.7</td><td align="center" valign="top" rowspan="1" colspan="1">501</td><td align="center" valign="top" rowspan="1" colspan="1">5.8</td><td align="center" valign="top" rowspan="1" colspan="1">0.612</td><td align="center" valign="top" rowspan="1" colspan="1">5.5 (3.8–7.3)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Colombia<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">351</td><td align="center" valign="top" rowspan="1" colspan="1">27.4</td><td align="center" valign="top" rowspan="1" colspan="1">440</td><td align="center" valign="top" rowspan="1" colspan="1">6.4</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">15.7 (13.1–18.2)</td><td align="center" valign="top" rowspan="1" colspan="1">0.039</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Venezuela<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">221</td><td align="center" valign="top" rowspan="1" colspan="1">19.5</td><td align="center" valign="top" rowspan="1" colspan="1">328</td><td align="center" valign="top" rowspan="1" colspan="1">8.5</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">12.9 (10.1–15.7)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Sub-Saharan Africa</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Cameroon<xref ref-type="table-fn" rid="TFN2"><sup>2</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">268</td><td align="center" valign="top" rowspan="1" colspan="1">6.7</td><td align="center" valign="top" rowspan="1" colspan="1">358</td><td align="center" valign="top" rowspan="1" colspan="1">5.0</td><td align="center" valign="top" rowspan="1" colspan="1">0.369</td><td align="center" valign="top" rowspan="1" colspan="1">5.8 (3.9–7.6)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Ivory Coast<xref ref-type="table-fn" rid="TFN2"><sup>2</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">313</td><td align="center" valign="top" rowspan="1" colspan="1">11.8</td><td align="center" valign="top" rowspan="1" colspan="1">247</td><td align="center" valign="top" rowspan="1" colspan="1">5.7</td><td align="center" valign="top" rowspan="1" colspan="1">0.012</td><td align="center" valign="top" rowspan="1" colspan="1">9.1 (6.7–11.5)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Madagascar<xref ref-type="table-fn" rid="TFN1"><sup>1</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">355</td><td align="center" valign="top" rowspan="1" colspan="1">10.7</td><td align="center" valign="top" rowspan="1" colspan="1">342</td><td align="center" valign="top" rowspan="1" colspan="1">2.9</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">6.9 (5.0–8.8)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Namibia<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">192</td><td align="center" valign="top" rowspan="1" colspan="1">19.6</td><td align="center" valign="top" rowspan="1" colspan="1">253</td><td align="center" valign="top" rowspan="1" colspan="1">5.9</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">9.5 (6.5–12.4)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Nigeria<xref ref-type="table-fn" rid="TFN2"><sup>2</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">324</td><td align="center" valign="top" rowspan="1" colspan="1">34.7</td><td align="center" valign="top" rowspan="1" colspan="1">271</td><td align="center" valign="top" rowspan="1" colspan="1">21.1</td><td align="center" valign="top" rowspan="1" colspan="1">0.046</td><td align="center" valign="top" rowspan="1" colspan="1">29.7 (23.3–36.2)</td><td align="center" valign="top" rowspan="1" colspan="1">0.05</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>North Africa, Neareast and Central Asia</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Tunesia<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">171</td><td align="center" valign="top" rowspan="1" colspan="1">26.3</td><td align="center" valign="top" rowspan="1" colspan="1">234</td><td align="center" valign="top" rowspan="1" colspan="1">9.0</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">16.4 (12.8–20.0)</td><td align="center" valign="top" rowspan="1" colspan="1">0.05</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Turkey<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">354</td><td align="center" valign="top" rowspan="1" colspan="1">13.6</td><td align="center" valign="top" rowspan="1" colspan="1">344</td><td align="center" valign="top" rowspan="1" colspan="1">5.5</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">9.6 (7.4–11.8)</td><td align="center" valign="top" rowspan="1" colspan="1">0.05</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Russia<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">223</td><td align="center" valign="top" rowspan="1" colspan="1">6.7</td><td align="center" valign="top" rowspan="1" colspan="1">266</td><td align="center" valign="top" rowspan="1" colspan="1">10.2</td><td align="center" valign="top" rowspan="1" colspan="1">0.178</td><td align="center" valign="top" rowspan="1" colspan="1">8.6 (6.1–11.1)</td><td align="center" valign="top" rowspan="1" colspan="1">0.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Kyrgyzstan<xref ref-type="table-fn" rid="TFN1"><sup>1</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">358</td><td align="center" valign="top" rowspan="1" colspan="1">5.3</td><td align="center" valign="top" rowspan="1" colspan="1">478</td><td align="center" valign="top" rowspan="1" colspan="1">0.6</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">2.6 (1.5–3.7)</td><td align="center" valign="top" rowspan="1" colspan="1">0.05</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>South Asia and China</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Bangladesh<xref ref-type="table-fn" rid="TFN1"><sup>1</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">385</td><td align="center" valign="top" rowspan="1" colspan="1">4.9</td><td align="center" valign="top" rowspan="1" colspan="1">294</td><td align="center" valign="top" rowspan="1" colspan="1">3.4</td><td align="center" valign="top" rowspan="1" colspan="1">0.431</td><td align="center" valign="top" rowspan="1" colspan="1">4.2 (2.7–5.7)</td><td align="center" valign="top" rowspan="1" colspan="1">0.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">India<xref ref-type="table-fn" rid="TFN2"><sup>2</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">469</td><td align="center" valign="top" rowspan="1" colspan="1">6.0</td><td align="center" valign="top" rowspan="1" colspan="1">218</td><td align="center" valign="top" rowspan="1" colspan="1">5.5</td><td align="center" valign="top" rowspan="1" colspan="1">0.808</td><td align="center" valign="top" rowspan="1" colspan="1">5.8 (4.1–7.6)</td><td align="center" valign="top" rowspan="1" colspan="1">0.03</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">China<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">267</td><td align="center" valign="top" rowspan="1" colspan="1">74.9</td><td align="center" valign="top" rowspan="1" colspan="1">811</td><td align="center" valign="top" rowspan="1" colspan="1">58.1</td><td align="center" valign="top" rowspan="1" colspan="1"><0.001</td><td align="center" valign="top" rowspan="1" colspan="1">62.2 (59.3–65.1)</td><td align="center" valign="top" rowspan="1" colspan="1">0.02</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Southeast Asia</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Indonesia<xref ref-type="table-fn" rid="TFN2"><sup>2</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">231</td><td align="center" valign="top" rowspan="1" colspan="1">0.0</td><td align="center" valign="top" rowspan="1" colspan="1">519</td><td align="center" valign="top" rowspan="1" colspan="1">3.5</td><td align="center" valign="top" rowspan="1" colspan="1">0.004</td><td align="center" valign="top" rowspan="1" colspan="1">2.4 (1.3–3.5)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Laos<xref ref-type="table-fn" rid="TFN2"><sup>2</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">268</td><td align="center" valign="top" rowspan="1" colspan="1">33.2</td><td align="center" valign="top" rowspan="1" colspan="1">533</td><td align="center" valign="top" rowspan="1" colspan="1">26.8</td><td align="center" valign="top" rowspan="1" colspan="1">0.060</td><td align="center" valign="top" rowspan="1" colspan="1">28.9 (25.8–32.1)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Philippines<xref ref-type="table-fn" rid="TFN2"><sup>2</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">200</td><td align="center" valign="top" rowspan="1" colspan="1">9.0</td><td align="center" valign="top" rowspan="1" colspan="1">580</td><td align="center" valign="top" rowspan="1" colspan="1">5.2</td><td align="center" valign="top" rowspan="1" colspan="1">0.052</td><td align="center" valign="top" rowspan="1" colspan="1">6.2 (4.5–7.8)</td><td align="center" valign="top" rowspan="1" colspan="1">0.05</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Singapore<xref ref-type="table-fn" rid="TFN4"><sup>4</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">428</td><td align="center" valign="top" rowspan="1" colspan="1">41.6</td><td align="center" valign="top" rowspan="1" colspan="1">425</td><td align="center" valign="top" rowspan="1" colspan="1">46.1</td><td align="center" valign="top" rowspan="1" colspan="1">0.183</td><td align="center" valign="top" rowspan="1" colspan="1">43.7 (40.4–47.0)</td><td align="center" valign="top" rowspan="1" colspan="1">0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Thailand<xref ref-type="table-fn" rid="TFN3"><sup>3</sup></xref></td><td align="center" valign="top" rowspan="1" colspan="1">230</td><td align="center" valign="top" rowspan="1" colspan="1">40.4</td><td align="center" valign="top" rowspan="1" colspan="1">625</td><td align="center" valign="top" rowspan="1" colspan="1">34.1</td><td align="center" valign="top" rowspan="1" colspan="1">0.086</td><td align="center" valign="top" rowspan="1" colspan="1">35.8 (32.6–39.0)</td><td align="center" valign="top" rowspan="1" colspan="1">0.05</td></tr></tbody></table><table-wrap-foot><fn id="TFN1"><label>1</label><p>Low income country;</p></fn><fn id="TFN2"><label>2</label><p>Lower middle income country;</p></fn><fn id="TFN3"><label>3</label><p>Upper middle income country;</p></fn><fn id="TFN4"><label>4</label><p>High income country (Source: World Bank, 2013)(<xref rid="B29" ref-type="bibr">29</xref>).</p></fn></table-wrap-foot></table-wrap></sec><sec><title>Associations with drinking and driving</title><p>In multivariate logistic regression analysis, among both men and women, earlier year of study, living in an upper middle income or high income country, low intrinsic religiosity, injury from motorcycle accidents, and weak belief in the importance of not drinking and driving were associated with drinking and driving.</p><p>Further, among men, older age, binge drinking and illicit drug use, and among women, younger age, and a lower country BAC limit was associated with drinking and driving (<xref ref-type="table" rid="T2">Table 2</xref>).</p><table-wrap id="T2" position="float"><label>Table 2</label><caption><p>Logistic regression analyses predicting drinking and driving by gender</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th colspan="3" align="center" valign="top" rowspan="1"><bold>Men</bold></th><th colspan="3" align="center" valign="top" rowspan="1"><bold>Women</bold></th></tr><tr><th align="left" valign="top" rowspan="1" colspan="1"><bold>Variables (N,% or M, SD)</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Drink and drive % or M</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Crude OR (95% CI)</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Adjusted OR (95% CI)</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Drink and drive % or M</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Crude OR (95% CI)</bold></th><th align="center" valign="top" rowspan="1" colspan="1"><bold>Adjusted OR (95% CI)</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Socio-demographic variables</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><italic>Age in years</italic></td><td align="center" valign="top" rowspan="1" colspan="1">21.1</td><td align="center" valign="top" rowspan="1" colspan="1">1.03 (1.01–1.06)**</td><td align="center" valign="top" rowspan="1" colspan="1">1.04 (1.01–1.07)*</td><td align="center" valign="top" rowspan="1" colspan="1">20.3</td><td align="center" valign="top" rowspan="1" colspan="1">0.96 (0.94–0.98)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.95 (0.97–0.98)**</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><italic>Year of study</italic></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> 1</td><td align="center" valign="top" rowspan="1" colspan="1">20.8</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">21.5</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> 2</td><td align="center" valign="top" rowspan="1" colspan="1">15.6</td><td align="center" valign="top" rowspan="1" colspan="1">0.70 (0.59–0.84)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.64 (0.51–0.81)***</td><td align="center" valign="top" rowspan="1" colspan="1">13.3</td><td align="center" valign="top" rowspan="1" colspan="1">0.56 (0.47–0.66)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.61 (0.51–0.73)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> 3</td><td align="center" valign="top" rowspan="1" colspan="1">24.0</td><td align="center" valign="top" rowspan="1" colspan="1">1.20 (1.01–1.43)*</td><td align="center" valign="top" rowspan="1" colspan="1">1.23 (0.99–1.52)</td><td align="center" valign="top" rowspan="1" colspan="1">15.6</td><td align="center" valign="top" rowspan="1" colspan="1">0.67 (0.58–0.78)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.69 (0.59–0.82)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> 4</td><td align="center" valign="top" rowspan="1" colspan="1">16.4</td><td align="center" valign="top" rowspan="1" colspan="1">0.75 (0.62–0.90)**</td><td align="center" valign="top" rowspan="1" colspan="1">0.85 (0.68–1.06)</td><td align="center" valign="top" rowspan="1" colspan="1">11.4</td><td align="center" valign="top" rowspan="1" colspan="1">0.47 (0.40–0.56)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.61 (0.50–0.74)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Residence</td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> With parents/relatives</td><td align="center" valign="top" rowspan="1" colspan="1">17.5</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">14.2</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> On campus/Off campus (on their own)</td><td align="center" valign="top" rowspan="1" colspan="1">20.9</td><td align="center" valign="top" rowspan="1" colspan="1">1.25 (1.10–1.42)***</td><td align="center" valign="top" rowspan="1" colspan="1">1.04 (0.88–1.22)</td><td align="center" valign="top" rowspan="1" colspan="1">18.1</td><td align="center" valign="top" rowspan="1" colspan="1">1.33 (1.18–1.50)***</td><td align="center" valign="top" rowspan="1" colspan="1">1.03 (0.91–1.18)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Intrinsic religiosity</td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Low (3–10)</td><td align="center" valign="top" rowspan="1" colspan="1">25.3</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">27.2</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Medium (11–13)</td><td align="center" valign="top" rowspan="1" colspan="1">15.3</td><td align="center" valign="top" rowspan="1" colspan="1">0.53 (0.46–0.62)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.70 (0.58–0.84)***</td><td align="center" valign="top" rowspan="1" colspan="1">10.2</td><td align="center" valign="top" rowspan="1" colspan="1">0.30 (0.26–035)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.43 (0.37–0.51)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> High (14–15)</td><td align="center" valign="top" rowspan="1" colspan="1">14.6</td><td align="center" valign="top" rowspan="1" colspan="1">0.50 (0.42–0.60)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.67 (0.54–0.83)***</td><td align="center" valign="top" rowspan="1" colspan="1">8.0</td><td align="center" valign="top" rowspan="1" colspan="1">0.23 (0.20–0.28)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.34 (0.28–0.42)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Country income</td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Low income/Lower middle income</td><td align="center" valign="top" rowspan="1" colspan="1">10.4</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">7.5</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Upper middle income/High income</td><td align="center" valign="top" rowspan="1" colspan="1">28.4</td><td align="center" valign="top" rowspan="1" colspan="1">3.41 (2.95–3.94)***</td><td align="center" valign="top" rowspan="1" colspan="1">3.58 (3.00–4.27)***</td><td align="center" valign="top" rowspan="1" colspan="1">23.5</td><td align="center" valign="top" rowspan="1" colspan="1">3.80 (3.30–4.38)***</td><td align="center" valign="top" rowspan="1" colspan="1">2.95 (2.52–3.46)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Substance use</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Binge drinking (past month)</td><td align="center" valign="top" rowspan="1" colspan="1">30.1</td><td align="center" valign="top" rowspan="1" colspan="1">2.14 (1.84–2.49)***</td><td align="center" valign="top" rowspan="1" colspan="1">1.53 (1.27–1.86)***</td><td align="center" valign="top" rowspan="1" colspan="1">12.0</td><td align="center" valign="top" rowspan="1" colspan="1">1.17 (0.97–1.42)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Tobacco use (current)</td><td align="center" valign="top" rowspan="1" colspan="1">18.5</td><td align="center" valign="top" rowspan="1" colspan="1">0.97 (0.83–1.15)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td><td align="center" valign="top" rowspan="1" colspan="1">14.5</td><td align="center" valign="top" rowspan="1" colspan="1">0.74 (0.67–0.98)*</td><td align="center" valign="top" rowspan="1" colspan="1">0.76 (0.57–1.03)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Illicit drug use (past year)</td><td align="center" valign="top" rowspan="1" colspan="1">19.9</td><td align="center" valign="top" rowspan="1" colspan="1">1.16 (1.00–1.36)*</td><td align="center" valign="top" rowspan="1" colspan="1">1.22 (1.01–1.47)*</td><td align="center" valign="top" rowspan="1" colspan="1">18.1</td><td align="center" valign="top" rowspan="1" colspan="1">1.03 (0.88–1.20)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Other traffic related bahaviour</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Not always using seatbelt (base=always)</td><td align="center" valign="top" rowspan="1" colspan="1">19.3</td><td align="center" valign="top" rowspan="1" colspan="1">0.99 (0.86–1.14)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td><td align="center" valign="top" rowspan="1" colspan="1">16.5</td><td align="center" valign="top" rowspan="1" colspan="1">1.03 (0.90–1.17)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Injury in motorcycle accident (past year) (base=none)</td><td align="center" valign="top" rowspan="1" colspan="1">41.3</td><td align="center" valign="top" rowspan="1" colspan="1">3.10 (2.14–4.48)***</td><td align="center" valign="top" rowspan="1" colspan="1">4.29 (2.69–6.82)***</td><td align="center" valign="top" rowspan="1" colspan="1">38.5</td><td align="center" valign="top" rowspan="1" colspan="1">3.34 (2.42–4.62)***</td><td align="center" valign="top" rowspan="1" colspan="1">3.24 (2.26–4.63)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Injury in car accident (past year) (base=none)</td><td align="center" valign="top" rowspan="1" colspan="1">21.4</td><td align="center" valign="top" rowspan="1" colspan="1">1.16 (0.74–1.82)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td><td align="center" valign="top" rowspan="1" colspan="1">9.7</td><td align="center" valign="top" rowspan="1" colspan="1">0.55 (0.28–1.10)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Health beliefs</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Weak belief in the importance of not drinking and driving (weak=1–8; base=strong=9–10)</td><td align="center" valign="top" rowspan="1" colspan="1">27.7</td><td align="center" valign="top" rowspan="1" colspan="1">2.05 (1.79–2.35)***</td><td align="center" valign="top" rowspan="1" colspan="1">1.78 (1.50–2.11)***</td><td align="center" valign="top" rowspan="1" colspan="1">23.3</td><td align="center" valign="top" rowspan="1" colspan="1">1.78 (1.55–2.05)***</td><td align="center" valign="top" rowspan="1" colspan="1">1.61 (1.37–1.88)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Personality characteristics</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Personal mastery</td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Low</td><td align="center" valign="top" rowspan="1" colspan="1">23.1</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">20.8</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td><td align="center" valign="top" rowspan="1" colspan="1">1.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Medium (11–13)</td><td align="center" valign="top" rowspan="1" colspan="1">18.3</td><td align="center" valign="top" rowspan="1" colspan="1">0.75 (0.64–0.87)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.75 (0.63–0.91)**</td><td align="center" valign="top" rowspan="1" colspan="1">17.2</td><td align="center" valign="top" rowspan="1" colspan="1">0.79 (0.70–0.90)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.86 (0.74–1.00)*</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> High (14–15)</td><td align="center" valign="top" rowspan="1" colspan="1">15.9</td><td align="center" valign="top" rowspan="1" colspan="1">0.63 (0.53–0.74)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.60 (0.49–0.74)***</td><td align="center" valign="top" rowspan="1" colspan="1">9.3</td><td align="center" valign="top" rowspan="1" colspan="1">0.39 (0.33–0.46)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.49 (0.41–0.59)***</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Drinking and driving legislation</bold></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Study country BAC limits</td><td align="center" valign="top" rowspan="1" colspan="1">0.052</td><td align="center" valign="top" rowspan="1" colspan="1">7.06 (0.71–70.16)</td><td align="center" valign="top" rowspan="1" colspan="1">---</td><td align="center" valign="top" rowspan="1" colspan="1">0.048</td><td align="center" valign="top" rowspan="1" colspan="1">0.00 (0.00–0.001)***</td><td align="center" valign="top" rowspan="1" colspan="1">0.01 (0.001–0.179)***</td></tr></tbody></table></table-wrap></sec></sec><sec sec-type="discussion"><title>Discussion</title><p>The study found, among a large sample of university students from 22 low, middle income and emerging economy countries across Asia, Africa and the Americas, a high proportion (17.3%) reporting to have been driving a car or motorcycle after having had too much to drink in the past 12 months, which is comparable to a previous study among university students from 19 high income and 4 middle income countries (<xref rid="B11" ref-type="bibr">11</xref>), but seems much lower than in the College student samples in the USA (<xref rid="B4" ref-type="bibr">4</xref>–<xref rid="B9" ref-type="bibr">9</xref>,<xref rid="B11" ref-type="bibr">11</xref>). However, the study found a large country variation in the overall prevalence drinking and driving among university students, ranging from below 5% in Bangladesh, Indonesia and Kyrgyzstan to above 35% in China, Singapore and Thailand. Some studies have identified a serious problem of drinking and driving road crashes in China (<xref rid="B14" ref-type="bibr">14</xref>, <xref rid="B30" ref-type="bibr">30</xref>). Using the same measurement instrument, one previous older study (1999) in Thailand (<xref rid="B31" ref-type="bibr">31</xref>) found a much higher prevalence of drink driving among university students in Northeast Thailand (83.7% among male and 92.2% of female students), and one newer study (2003) found a much lower prevalence of drinking and driving in university students (10% and 3%, in males and females, respectively) in Thailand (<xref rid="B11" ref-type="bibr">11</xref>). Although no studies were found reporting drinking and driving in Singapore, it was found that Singapore has a relatively high prevalence of 12-month heavy drinking of 12.6% (<xref rid="B32" ref-type="bibr">32</xref>). In some predominantly Muslim countries, including Bangladesh, Indonesia and Kyrgyzstan university students had a low prevalence of drinking and driving, but in other Muslim countries such as Turkey and Tunisia medium rates of drinking and driving were found.</p><p>In concordance with a number of other studies (e.g., <xref rid="B4" ref-type="bibr">4</xref>,<xref rid="B9" ref-type="bibr">9</xref>,<xref rid="B12" ref-type="bibr">12</xref>), the study found across the countries that men engaged more frequently in drinking and driving than women. However, the preponderance of drinking and driving among men was only true for students from 13 study countries, while there were no significant gender differences in 8 countries, and in Indonesia the preponderance of drinking and driving was among women. Although the preponderance of drinking and driving among men was true for students from 13 study countries, there were no significant gender differences in drinking and driving in 8 countries, and in Indonesia, more women than men were drinking and driving. No gender differences in drinking and driving were found in students from some low prevalence drinking Hindu or Muslim cultures, medium prevalence in countries such as Russia and in high prevalence drinking and driving students from Laos, Singapore and Thailand. Gender differences in drinking and driving may be influenced by biological and cultural factors such as self-restraint of drinking by women (<xref rid="B33" ref-type="bibr">33</xref>) and women’s position in society (<xref rid="B34" ref-type="bibr">34</xref>). It is possible that in the study countries, Laos, Singapore and Thailand, with a high prevalence of drinking and driving among both men and women, a higher women’s position in the society reduces the difference between men and women drinking and driving rates. In relation to the age or year of study, we found that older students and earlier year of study were more likely to report drinking and driving. This can be explained in that drinking and driving sharply increases from age 16 to 18, peaks at 18 years (20.8%), with the largest number of students at in their first year (27.4%), and then gradually reduces from 19 to 30 years. The peak of 18 years may be attributed to the reason that in the majority of the study countries the minimum legal drinking age is set at 18 years (<xref rid="B35" ref-type="bibr">35</xref>). Further, our findings are in agreement with a study among US university students, where older age was associated with drinking and driving (<xref rid="B4" ref-type="bibr">4</xref>), but in contrast to another study in American university students where the younger age was associated with lower levels of driving and drinking (<xref rid="B13" ref-type="bibr">13</xref>). Unlike in some other studies (<xref rid="B4" ref-type="bibr">4</xref>, <xref rid="B9" ref-type="bibr">9</xref>), this study did not find that living with parents or guardians was associated with less frequent drinking and driving. University students in the upper middle income and high-income countries were much more likely to engage in drinking and driving (25.3%) than students from low income and lower middle-income countries (8.8%). A similar trend was found among women in a study among university students from 19 high income and 4 upper middle-income countries comparing GPD of these countries (<xref rid="B11" ref-type="bibr">11</xref>). It is possible that if income levels rise, alcohol use as well as drinking and driving levels increase. Further, in agreement with previous studies (<xref rid="B5" ref-type="bibr">5</xref>,<xref rid="B9" ref-type="bibr">9</xref>), this study found that low intrinsic religiosity was highly associated with drinking and drinking. It is possible that students with higher intrinsic religiosity are more likely to abstain or limit drinking and contravene traffic regulations of BAC limits.</p><p>This study found that among men binge drinking and illicit drug use was associated with drinking and driving. This finding is confirmed from previous studies (<xref rid="B6" ref-type="bibr">6</xref>,<xref rid="B8" ref-type="bibr">8</xref>,<xref rid="B14" ref-type="bibr">14</xref>–<xref rid="B16" ref-type="bibr">16</xref>). Interventions, particularly among men, may need to consider in cooperating the co-occurrence of other drug use. This study found a high correlation between drinking and driving and injury from a motorcycle accident. Previous studies (<xref rid="B7" ref-type="bibr">7</xref>,<xref rid="B17" ref-type="bibr">17</xref>,<xref rid="B18" ref-type="bibr">18</xref>,<xref rid="B36" ref-type="bibr">36</xref>) have clearly shown the relationship between drinking and driving and traffic injuries. Unlike a previous study (<xref rid="B15" ref-type="bibr">15</xref>), this study did not find an association between not always using seat belts and drinking and driving.</p><p>Further, university students with a weaker belief in the importance of not drinking and driving were more likely drinking and driving, as found in other studies (<xref rid="B6" ref-type="bibr">6</xref>,<xref rid="B11" ref-type="bibr">11</xref>). This finding that attitudes played a role in drinking and driving may call for the development of an intervention to address the modification of these health beliefs (<xref rid="B11" ref-type="bibr">11</xref>). Low personal mastery as a form of lack of self-control was previously also found to be associated with drinking and driving (<xref rid="B19" ref-type="bibr">19</xref>). Students with lower personal mastery may less likely engage in drink planning in terms of long-term planning, resulting in drinking and driving (<xref rid="B19" ref-type="bibr">19</xref>). Contrary to previous studies (<xref rid="B11" ref-type="bibr">11</xref>,<xref rid="B20" ref-type="bibr">20</xref>), this study did not find that lower country legal BAC limits were associated with less drinking and driving. Possible reasons for this may be lack of enforcement of the BAC limit law and/or low penalties for violations (<xref rid="B13" ref-type="bibr">13</xref>,<xref rid="B37" ref-type="bibr">37</xref>).</p><sec><title></title><sec sec-type="methods"><title>Study limitations</title><p>This study had several limitations. The study was cross-sectional, so causal conclusions cannot be drawn. The investigation was carried out with students from one or two universities in each country, and inclusion of other centers could have resulted in different results. University students are not representative of young adults in general, and the drinking and driving levels, socio demographic and health variables may be different in other sectors of the population. A further limitation of the study was that all information collected in the study was based on self-reporting. It is possible that certain behaviors were under or over reported. Underreporting of self-reported drinking and driving may be attributed to social stigma with possible legal implications (<xref rid="B13" ref-type="bibr">13</xref>). However, in this study the questionnaire was self-administered rather than interview-administered which may have helped to mitigate under-reporting of drinking and driving (<xref rid="B13" ref-type="bibr">13</xref>).</p></sec></sec></sec><sec sec-type="conclusion"><title>Conclusion</title><p>This study confirms low to high levels of drinking and driving in different cultures across Africa, Asia and the Americas. Various factors identified, such as socioeconomic status (having low intrinsic religiosity and coming from a higher income country), weak beliefs in the importance of not drinking and driving, injury from motorcycle accidents and co-occurrence of substance use (binge drinking and illicit drug use) among men can be used to guide interventions to reduce drinking and driving among university students.</p></sec><sec><title>Ethical considerations</title><p>Ethical issues (Including plagiarism, informed consent, misconduct, data fabrication and/or falsification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors.</p></sec></body><back><ack><title>Acknowledgements</title><p>The study was partially funded by the South African Department of Higher Education. The authors declare that there is no conflict of interests.</p></ack><ref-list><title>References</title><ref id="B1"><label>1.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ham</surname><given-names>LS</given-names></name><name><surname>Hope</surname><given-names>DA</given-names></name></person-group>(<year>2003</year>).
<article-title>College students and problematic drinking: A review of the literature</article-title>.
<source>Clin Psychol Rev</source>,
<volume>23</volume>:
<fpage>719</fpage>–<lpage>759</lpage>.
<pub-id pub-id-type="pmid">12971907</pub-id></mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gore</surname><given-names>FM</given-names></name><name><surname>Bloem</surname><given-names>PJ</given-names></name><name><surname>Patton</surname><given-names>GC</given-names></name><name><surname>Ferguson</surname><given-names>J</given-names></name><name><surname>Joseph</surname><given-names>V</given-names></name><name><surname>Coffey</surname><given-names>C</given-names></name><name><surname>Sawyer</surname><given-names>SM</given-names></name><name><surname>Mathers</surname><given-names>CD</given-names></name></person-group>(<year>2011</year>).
<article-title>Global burden of disease in young people aged 10–24 years: a systematic analysis</article-title>.
<source>Lancet</source>,
<volume>377</volume>(
<issue>9783</issue>):
<fpage>2093</fpage>–<lpage>102</lpage>.
<pub-id pub-id-type="pmid">21652063</pub-id></mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><collab>World Health Organization (WHO)</collab></person-group>(<year>2009</year>).
<source>Global status report on road safety</source>.
<publisher-loc>Geneva, Switzerland</publisher-loc>:
<publisher-name>WHO</publisher-name>.
</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wechsler</surname><given-names>H</given-names></name><name><surname>Lee</surname><given-names>JE</given-names></name><name><surname>Nelson</surname><given-names>TF</given-names></name><name><surname>Lee</surname><given-names>H</given-names></name></person-group>(<year>2003</year>).
<article-title>Drinking and driving among college students: the influence of alcohol-control policies</article-title>.
<source>Am J Prev Med</source>,
<volume>25</volume>:
<fpage>212</fpage>–<lpage>8</lpage>.
<pub-id pub-id-type="pmid">14507527</pub-id></mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Durkin</surname><given-names>K</given-names></name><name><surname>Wolfe</surname><given-names>SE</given-names></name><name><surname>May</surname><given-names>RW</given-names></name></person-group>(<year>2007</year>).
<article-title>Social bond theory and drunk driving in a sample of college students</article-title>.
<source>College Student J</source>,
<volume>41</volume>:
<fpage>734</fpage>–<lpage>744</lpage>.
</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>LaBrie</surname><given-names>JW</given-names></name><name><surname>Kenney</surname><given-names>SR</given-names></name><name><surname>Mirza</surname><given-names>T</given-names></name><name><surname>Lac</surname><given-names>A</given-names></name></person-group>(<year>2011</year>).
<article-title>Identifying factors that increase the likelihood of driving after drinking among college students</article-title>.
<source>Accid Anal Prev</source>,
<volume>43</volume>:
<fpage>1371</fpage>–<lpage>7</lpage>.
<pub-id pub-id-type="pmid">21545868</pub-id></mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hingson</surname><given-names>R</given-names></name><name><surname>Heeren</surname><given-names>T</given-names></name><name><surname>Zakocs</surname><given-names>R</given-names></name><name><surname>Winter</surname><given-names>M</given-names></name><name><surname>Wechsler</surname><given-names>H</given-names></name></person-group>(<year>2003</year>).
<article-title>Age of first intoxication, heavy drinking, driving after drinking and risk of unintentional injury among U.S. college students</article-title>.
<source>J Stud Alcohol</source>,
<volume>64</volume>:
<fpage>23</fpage>–<lpage>31</lpage>.
<pub-id pub-id-type="pmid">12608480</pub-id></mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Clapp</surname><given-names>JD</given-names></name><name><surname>Shillington</surname><given-names>AM</given-names></name><name><surname>Lange</surname><given-names>JE</given-names></name><name><surname>Voas</surname><given-names>RB</given-names></name></person-group>(<year>2003</year>).
<article-title>Correlation between modes of drinking and modes of driving as reported by students at two American universities</article-title>.
<source>Accid Anal Prev</source>,
<volume>35</volume>:
<fpage>161</fpage>–<lpage>6</lpage>.
<pub-id pub-id-type="pmid">12504136</pub-id></mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kohn</surname><given-names>C</given-names></name><name><surname>Saleheen</surname><given-names>H</given-names></name><name><surname>Borrup</surname><given-names>K</given-names></name><name><surname>Rogers</surname><given-names>S</given-names></name><name><surname>Lapidus</surname><given-names>G</given-names></name></person-group>(<year>2014</year>).
<article-title>Correlates of drug use and driving among undergraduate college students</article-title>.
<source>Traffic Inj Prev</source>,
<volume>15</volume>:
<fpage>119</fpage>–<lpage>24</lpage>.
<pub-id pub-id-type="pmid">24345012</pub-id></mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kypri</surname><given-names>K</given-names></name><name><surname>Stephenson</surname><given-names>S</given-names></name></person-group>(<year>2005</year>).
<article-title>Drink-driving and perceptions of legally permissible alcohol use</article-title>.
<source>Traffic Inj Prev</source>,
<volume>6</volume>:
<fpage>219</fpage>–<lpage>24</lpage>.
<pub-id pub-id-type="pmid">16087461</pub-id></mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Steptoe</surname><given-names>A</given-names></name><name><surname>Wardle</surname><given-names>J</given-names></name><name><surname>Bages</surname><given-names>N</given-names></name><name><surname>Sallis</surname><given-names>JF</given-names></name><name><surname>Sanabria-Ferrand</surname><given-names>PA</given-names></name><name><surname>Sanchez</surname><given-names>M</given-names></name></person-group>(<year>2004</year>).
<article-title>Drinking and driving in university students: an international study of 23 countries</article-title>.
<source>Psychol Health</source>,
<volume>19</volume>:
<fpage>527</fpage>–<lpage>540</lpage>.
</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Delcher</surname><given-names>C</given-names></name><name><surname>Johnson</surname><given-names>R</given-names></name><name><surname>Maldonado-Molina</surname><given-names>MM</given-names></name></person-group>(<year>2013</year>).
<article-title>Driving after drinking among young adults of different race/ethnicities in the United States: unique risk factors in early adolescence?</article-title><source>J Adolesc Health</source>,
<volume>52</volume>(
<issue>5</issue>):
<fpage>584</fpage>–<lpage>91</lpage>.
<pub-id pub-id-type="pmid">23608720</pub-id></mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cavazos-Rehg</surname><given-names>PA</given-names></name><name><surname>Krauss</surname><given-names>MJ</given-names></name><name><surname>Spitznagel</surname><given-names>EL</given-names></name><name><surname>Chaloupka</surname><given-names>FJ</given-names></name><name><surname>Schootman</surname><given-names>M</given-names></name><name><surname>Grucza</surname><given-names>RA</given-names></name><name><surname>Bierut</surname><given-names>LJ</given-names></name></person-group>(<year>2012</year>).
<article-title>Associations between selected state laws and teenagers’ drinking and driving behaviors</article-title>.
<source>Alcohol Clin Exp Res</source>,
<volume>36</volume>:
<fpage>1647</fpage>–<lpage>52</lpage>.
<pub-id pub-id-type="pmid">22702907</pub-id></mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kim</surname><given-names>JH</given-names></name><name><surname>Lee</surname><given-names>S</given-names></name><name><surname>Chan</surname><given-names>KW</given-names></name><name><surname>Lau</surname><given-names>J</given-names></name><name><surname>Tsang</surname><given-names>A</given-names></name><name><surname>Griffiths</surname><given-names>SM</given-names></name></person-group>(<year>2010</year>).
<article-title>A population-based study on the prevalence and correlates of drinking and driving in Hong Kong</article-title>.
<source>Accid Anal Prev</source>,
<volume>42</volume>:
<fpage>994</fpage>–<lpage>1002</lpage>.
<pub-id pub-id-type="pmid">20441805</pub-id></mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Segui-Gomez</surname><given-names>M</given-names></name><name><surname>Palma</surname><given-names>S</given-names></name><name><surname>Guillen-Grima</surname><given-names>F</given-names></name><name><surname>de Irala</surname><given-names>J</given-names></name><name><surname>Martinez-Gonzalez</surname><given-names>MA</given-names></name></person-group>(<year>2007</year>).
<article-title>Self-reported drinking and driving amongst educated adults in Spain: The “Seguimiento Universidad de Navarra” (SUN) cohort findings</article-title>.
<source>BMC Public Health</source>,
<volume>7</volume>:
<fpage>55</fpage>.
<pub-id pub-id-type="pmid">17430581</pub-id></mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gonçalves</surname><given-names>PD</given-names></name><name><surname>Cunha</surname><given-names>PJ</given-names></name><name><surname>Malbergier</surname><given-names>A</given-names></name><name><surname>do Amaral</surname><given-names>RA</given-names></name><name><surname>de Oliveira</surname><given-names>LG</given-names></name><name><surname>Yang</surname><given-names>JJ</given-names></name><name><surname>de Andrade</surname><given-names>AG</given-names></name></person-group>(<year>2012</year>).
<article-title>The association between low alcohol use and traffic risk behaviors among Brazilian college students</article-title>.
<source>Alcohol</source>,
<volume>46</volume>(
<issue>7</issue>):
<fpage>673</fpage>–<lpage>9</lpage>.
<pub-id pub-id-type="pmid">22921955</pub-id></mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Connor</surname><given-names>J</given-names></name><name><surname>Norton</surname><given-names>R</given-names></name><name><surname>Ameratunga</surname><given-names>S</given-names></name><name><surname>Jackson</surname><given-names>R</given-names></name></person-group>(<year>2004</year>).
<article-title>The contribution of alcohol to serious car crash injuries</article-title>.
<source>Epidemiology</source>,
<volume>15</volume>:
<fpage>337</fpage>–<lpage>44</lpage>.
<pub-id pub-id-type="pmid">15097015</pub-id></mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lin</surname><given-names>MR</given-names></name><name><surname>Kraus</surname><given-names>JF</given-names></name></person-group>(<year>2009</year>).
<article-title>A review of risk factors and patterns of motorcycle injuries</article-title>.
<source>Accid Anal Prev</source>,
<volume>41</volume>:
<fpage>710</fpage>–<lpage>22</lpage>.
<pub-id pub-id-type="pmid">19540959</pub-id></mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sloan</surname><given-names>FA</given-names></name><name><surname>Eldred</surname><given-names>LM</given-names></name><name><surname>Xu</surname><given-names>Y</given-names></name></person-group>(<year>2014</year>).
<article-title>The behavioral economics of drunk driving</article-title>.
<source>J Health Econ</source>,
<volume>35</volume>:
<fpage>64</fpage>–<lpage>81</lpage>.
<pub-id pub-id-type="pmid">24603444</pub-id></mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Desapriya</surname><given-names>EB</given-names></name><name><surname>Iwase</surname><given-names>N</given-names></name><name><surname>Brussoni</surname><given-names>M</given-names></name><name><surname>Shimizu</surname><given-names>S</given-names></name><name><surname>Belayneh</surname><given-names>TN</given-names></name></person-group>(<year>2003</year>).
<article-title>International policies on alcohol impaired driving: are legal blood alcohol concentration (BAC) limits in motorized countries compatible with the scientific evidence?</article-title><source>Nihon Arukoru Yakubutsu Igakkai Zasshi</source>,
<volume>38</volume>:
<fpage>83</fpage>–<lpage>102</lpage>.
<pub-id pub-id-type="pmid">12784660</pub-id></mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><name><surname>Babor</surname><given-names>TF</given-names></name><name><surname>Higgins-Biddle</surname><given-names>JC</given-names></name><name><surname>Saunders</surname><given-names>JB</given-names></name><name><surname>Monteiro</surname><given-names>MG</given-names></name></person-group>(<year>2001</year>)
<source>AUDIT: The Alcohol Use Disorder Identification Test</source>.
<publisher-loc>Geneva, Switzerland</publisher-loc>:
<publisher-name>World Health Organization</publisher-name>.
</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><collab>World Health Organization (WHO)</collab></person-group>(<year>1998</year>).
<source>Guidelines for controlling and monitoring the tobacco epidemic</source>.
<publisher-loc>Geneva, Switzerland</publisher-loc>:
<publisher-name>WHO</publisher-name>.
</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wardle</surname><given-names>J</given-names></name><name><surname>Steptoe</surname><given-names>A</given-names></name></person-group>(<year>1991</year>).
<article-title>The European Health and Behaviour Survey: rationale, methods and initial results from the United Kingdom</article-title>.
<source>Soc Sci Med</source>,
<volume>33</volume>:
<fpage>925</fpage>–<lpage>36</lpage>.
<pub-id pub-id-type="pmid">1745917</pub-id></mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation publication-type="webpage"><person-group person-group-type="author"><collab>Centers for Disease Control and Prevention (CDC)</collab></person-group>(<year>2010</year>).
<article-title>Global School-based Student Health Survey (GSHS)</article-title>.
Available from
<ext-link ext-link-type="uri" xlink:href="http://www.cdc.gov/gshs/">http://www.cdc.gov/gshs/</ext-link>(accessed 23 July 2014)
</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lachman</surname><given-names>ME</given-names></name><name><surname>Weaver</surname><given-names>SL</given-names></name></person-group>(<year>1998</year>).
<article-title>The sense of control as a moderator of social classdifferences in health and well-being</article-title>.
<source>J Pers Soc Psychol</source>,
<volume>74</volume>:
<fpage>763</fpage>–<lpage>773</lpage>.
<pub-id pub-id-type="pmid">9523418</pub-id></mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Koenig</surname><given-names>HG</given-names></name><name><surname>Parkerson</surname><given-names>GR</given-names><suffix>Jr</suffix></name><name><surname>Meador</surname><given-names>KG</given-names></name></person-group>(<year>1997</year>).
<article-title>Religion index for psychiatric research</article-title>.
<source>Am J Psychiatry</source>,
<volume>154</volume>:
<fpage>885</fpage>–<lpage>886</lpage>.
<pub-id pub-id-type="pmid">9167530</pub-id></mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation publication-type="webpage"><person-group person-group-type="author"><collab>World Health Organization (WHO)</collab></person-group>(<year>2014</year>).
<article-title>Global status report on alcohol and health, 2014</article-title>.
Available from at
<ext-link ext-link-type="uri" xlink:href="http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_3.pdf">http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_3.pdf</ext-link>; accessed 10 July 2014
</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation publication-type="webpage"><person-group person-group-type="author"><collab>Blood Alcohol Concentration (BAC) Limits</collab></person-group>Available from Worldwide
<ext-link ext-link-type="uri" xlink:href="http://www.icap.org/table/BACLimitsWorldwide">http://www.icap.org/table/BACLimitsWorldwide</ext-link>; accessed 12 July 2014.
</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation publication-type="webpage"><person-group person-group-type="author"><collab>World Bank. New Country Classifications</collab></person-group>(<year>2013</year>).
<ext-link ext-link-type="uri" xlink:href="ttp://data.worldbank.org/news/new-country-classifications">ttp://data.worldbank.org/news/new-country-classifications</ext-link> (accessed 5 April 2014).
</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Li</surname><given-names>Y</given-names></name><name><surname>Xie</surname><given-names>D</given-names></name><name><surname>Nie</surname><given-names>G</given-names></name><name><surname>Zhang</surname><given-names>G</given-names></name></person-group>(<year>2012</year>).
<article-title>The drink driving situation in China</article-title>.
<source>Traffic Inj Prev</source>, 12;
<volume>13</volume>:
<fpage>101</fpage>–
<lpage>8</lpage>.
<pub-id pub-id-type="pmid">22458786</pub-id></mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Nanakorn</surname><given-names>S</given-names></name><name><surname>Osaka</surname><given-names>R</given-names></name><name><surname>Chusilp</surname><given-names>K</given-names></name><name><surname>Tsuda</surname><given-names>A</given-names></name><name><surname>Maskasame</surname><given-names>S</given-names></name><name><surname>Ratanasiri</surname><given-names>A</given-names></name></person-group>(<year>1999</year>).
<article-title>Gender differences in health-related practices among university students in northeast Thailand</article-title>.
<source>Asia Pac J Public Health</source>,
<volume>11</volume>:
<fpage>10</fpage>–<lpage>5</lpage>.
<pub-id pub-id-type="pmid">10829821</pub-id></mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lim</surname><given-names>WY</given-names></name><name><surname>Subramaniam</surname><given-names>M</given-names></name><name><surname>Abdin</surname><given-names>E</given-names></name><name><surname>He</surname><given-names>VY</given-names></name><name><surname>Vaingankar</surname><given-names>J</given-names></name><name><surname>Chong</surname><given-names>SA</given-names></name></person-group> (
<year>2013</year>)..
<article-title>Lifetime and twelve-month prevalence of heavy-drinking in Singapore: results from a representative cross-sectional study</article-title>.
<source>BMC Public Health</source>,
<volume>13</volume>:
<fpage>992</fpage>.
<pub-id pub-id-type="pmid">24499269</pub-id></mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wilsnack</surname><given-names>RW</given-names></name><name><surname>Wilsnack</surname><given-names>SC</given-names></name><name><surname>Kristjanson</surname><given-names>AF</given-names></name><name><surname>Vogeltanz-Holm</surname><given-names>ND</given-names></name><name><surname>Gmel</surname><given-names>G</given-names></name></person-group>(<year>2009</year>).
<article-title>Gender and alcohol consumption: patterns from the multinational GENACIS project</article-title>.
<source>Addiction</source>,
<volume>104</volume>:
<fpage>1487</fpage>–<lpage>500</lpage>.
<pub-id pub-id-type="pmid">19686518</pub-id></mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rahav</surname><given-names>G</given-names></name><name><surname>Wilsnack</surname><given-names>R</given-names></name><name><surname>Bloomfield</surname><given-names>K</given-names></name><name><surname>Gmel</surname><given-names>G</given-names></name><name><surname>Kuntsche</surname><given-names>S</given-names></name></person-group>(<year>2006</year>).
<article-title>The influence of societal level factors on men’s and women’s alcohol consumption and alcohol problems</article-title>.
<source>Alcohol Alcohol</source>,
<volume>41</volume>:
<fpage>i47</fpage>–<lpage>55</lpage>.
</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation publication-type="webpage"><person-group person-group-type="author"><name><surname>Hanson</surname><given-names>DJ.</given-names></name></person-group><article-title>Minimum Legal Drinking Ages around the World</article-title>. Available from
<ext-link ext-link-type="uri" xlink:href="http://www2.potsdam.edu/alcohol/LegalDrinkingAge.html#.U9HWOnTTeUw">http://www2.potsdam.edu/alcohol/LegalDrinkingAge.html#.U9HWOnTTeUw
</ext-link>(accessed 24 July 2014
</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kasantikul</surname><given-names>V</given-names></name><name><surname>Ouellet</surname><given-names>JV</given-names></name><name><surname>Smith</surname><given-names>T</given-names></name><name><surname>Sirathranont</surname><given-names>J</given-names></name><name><surname>Panichabhongse</surname><given-names>V.</given-names></name></person-group>(<year>2005</year>).
<article-title>The role of alcohol in Thailand motorcycle crashes</article-title>.
<source>Accid Anal Prev</source>,
<volume>37</volume>:
<fpage>357</fpage>–<lpage>66</lpage>.
<pub-id pub-id-type="pmid">15667823</pub-id></mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ogazi</surname><given-names>C</given-names></name><name><surname>Edison</surname><given-names>E</given-names></name></person-group>(<year>2012</year>).
<article-title>The drink driving situation in Nigeria</article-title>.
<source>Traffic Inj Prev</source>,
<volume>13</volume>:
<fpage>115</fpage>–<lpage>9</lpage>.
<pub-id pub-id-type="pmid">22458788</pub-id></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000108 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000108 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaSubSaharaV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:4644577
|texte= Drinking and Driving among University Students in 22 Low, Middle Income and Emerging Economy Countries
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:26576345" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a SidaSubSaharaV1
| This area was generated with Dilib version V0.6.32. |  |