Cell phone use while driving laws and motor vehicle driver fatalities: differences in population subgroups and location

Purpose: Research suggests that cell phone use while driving laws are associated with lower driver fatalities. This study seeks to determine whether this relationship is modified by driver age (16–24, 25–39, 40–59, ≥60), sex (male, female), race/ethnicity (white non-Hispanic, white Hispanic, black non-Hispanic, other), or rurality (rural, urban). Methods: Fatality Analysis Reporting System data were merged with state legislation (2000–2014). The exposure was the type of legislation in effect. The outcome was non–alcohol-related driver fatalities by state-quarter-year. Incident rate ratios were estimated using generalized Poisson mixed regression for overdispersed count data with robust standard errors. Results: Amongst 190,544 drivers, compared to periods without bans, universal hand-held calling bans were associated with 10% (adjusted incident rate ratio = 0.90, 95% confidence interval 0.84, 0.96) lower non–alcohol-related driver fatalities overall and up to 13% lower fatalities across all age groups and sexes but not for race/ethnicity or rurality. When comparing state-quarter-years with bans to those without, universal texting bans were not associated with lower fatalities overall or for any demographic group. Conclusions: The relationships between cell phone laws and non–alcohol-related driver fatalities are modified by driver demographics, particularly for universal hand-held bans. Universal hand-held calling bans may benefit more types of drivers compared to texting bans.