The behavioral economics of driving after drinking among college drinkers

Background: Driving after drinking (DAD) among college students is a significant public health concern, yet little is known about specific theoretical risk factors for DAD, beyond drinking level, among college student drinkers. This study had the following aims: (i) to examine the associations between elevated alcohol demand and DAD, (ii) to determine whether demand decreases in response to a hypothetical driving scenario, (iii) to determine whether drivers who report DAD in the past 3 months would show less of a reduction in demand in response to the hypothetical driving scenario, and (iv) to determine whether delayed reward discounting (DRD) is associated with DAD. Method: Participants were 419 college students who reported at least 1 day of past-month alcohol use. Participants completed 2 alcohol purchase tasks (APTs) that assessed hypothetical alcohol consumption across 17 drink prices with and without a driving scenario, a delay-discounting task, and a series of questions regarding DAD. Results: In logistic regression models that controlled for drinking level, demographics, and sensation seeking, participants reporting higher demand intensity (95% confidence interval [95% CI] [1.04, 2.34]), breakpoint (95% CI [1.23, 2.28]), Omax (95% CI [1.03, 1.53]), and lower elasticity (95% CI [0.15, 1.02]) were more likely to report DAD. Additionally, in analyses of covariance, DAD+ participants exhibited significantly less of a reduction in demand between the standard and the driving APT (intensity, p \u3c 0.01, breakpoint, p = 0.05, and Omax, p \u3c 0.01). A binary logistic regression model with identical covariates revealed that DRD is not associated with DAD. Conclusions: DAD is associated with elevated/inelastic demand and less sensitivity to a hypothetical driving scenario. Drinkers with elevated demand should be prioritized for DAD intervention efforts