driving (148).

“Evidential” breath-testing devices

(devices that are considered accurate enough for
the results to be used as evidence in law courts)
are
a means of substantially increasing breath-testing
activity. Though used in most high-income
countries,
they are not currently widespread elsewhere.
This greatly limits the ability of many countries to
respond effectively to the problem of drink-
driving.
The deterrent effect of breath-testing devices is
to a large extent dependent on the legislation
governing
their use (126). Police powers vary between
countries, and include the following:
— stopping obviously impaired drivers;
— stopping drivers at roadblocks or sobriety
checkpoints and testing only those suspected
of alcohol impairment;
— stopping drivers at random and testing all
who are stopped.
The following components have been identifi ed
as being central to successful police enforcement
operations to deter drinking drivers (128):
• A high proportion of people tested (at least one
in
ten drivers every year but, if possible, one in three
drivers, as is the case in Finland). This can only be
achieved through wide-scale application of
random
breath testing and evidential breath testing.
• Enforcement that is unpredictable in terms of
time and place, deployed in such a manner so
as to ensure wide coverage of the whole road
network and to make it diffi cult for drivers to
avoid the checkpoints.
• Highly visible police operations. For drinking
drivers who are caught, remedial treatment
can be offered as an alternative to traditional
penalties, to reduce the likelihood of repeated
offending.
Random breath testing and sobriety checkpoints
Random breath testing is carried out in several
countries, including Australia, Colombia, France,
the Nordic countries, the Netherlands, New
Zealand
and South Africa. The use of sustained and
intensive random breath testing is a highly
effective
means of reducing injuries resulting from alcohol
impairment. In Australia, for instance, since 1993
it has led to estimated reductions in alcohol-
related
deaths in New South Wales of 36% (with one in
three drivers tested), in Tasmania of 42% (three
in four tested) and in Victoria of 40% (one in two
tested) (126).
An international review of the effectiveness of
random breath testing and sobriety checkpoints
found that both reduced alcohol-related crashes
by about 20% (149). The reductions appeared to
be similar, irrespective of whether the
checkpoints
were used for short-term intensive campaigns or
continuously over a period of several years.
A Swiss study has shown that random breath
testing is one of the most cost-effective safety
measures that can be employed, with a cost–
benefi
t ratio estimated at 1:19 (150). In New South
Wales, Australia, the estimated cost–benefi t ratio
of random breath testing ranged from 1:1 to
1:56 (126, 151, 152). Similarly, economic analyses
on the sobriety checkpoint programmes in the
United States estimated benefi ts totalling
between
6 and 23 times their original cost (153, 154).
Mass media campaigns
It is generally accepted that enforcement of
alcohol
impairment laws is more effective when
accompanied
by publicity aimed at:
— making people more alert to the risk of
detection, arrest and its consequences;
— making drinking and driving less publicly