Texting and Health Promotion Policy

Recently I’ve been reading research reports on the effects of cell phone use, particularly texting, on driving safety. Because of the rapid diffusion of cell phone technology and the practice of sending text messages, the research has been proliferating, but has not kept up with the diffusion wave.


The immediate reason for my interest in cell phone safety is that Kentucky has passed specific legislation prohibiting texting or e-mailing while driving for all ages, and prohibiting all driving cell phone use by those under age 19. The new rules went into effect summer, 2010; actual penalties begin January 1, 2011.

The rationale for Kentucky’s legislation and parallel bills around the country is that cell phones interfere with safe driving. In my searching I’ve discovered an obscure web site – http://www.distraction.gov/– maintained by the U.S. Department of Transportation. The larger issue is distracted driving, of which cell phone use is only one example. Distraction in driving can occur in three ways. Manual distraction is when a driver’s hands are doing something besides driving, such as using a phone, applying make-up, or interacting with a global positioning system. Visual distraction occurs when a driver is not looking at the road and surrounding traffic. This is a problem for most drivers when we look at things on the side of the road or inside the vehicle. Finally, cognitive distraction is the circumstance where drivers are thinking about something other than driving. Most drivers are unable to keep all of their brain power focused on driving, even if they are alone in the car. From the outline of types of distraction it is obvious that all drivers are distracted at times.

The forms of distraction come together in a perfect storm with texting. When a driver is conversing with a passenger, the distraction may only be cognitive, but not manual or visual. While all distraction increases risk for collisions, texting seems to present more danger than most other distractions, since it constitutes all three forms of distraction. The other factor that makes texting so concerning is that it is more frequently done by younger people, who have other characteristics that make them less safe as drivers.

Part of the reason many states are outlawing texting is that not only is it dangerous and worth trying to decrease if not eliminate, but the laws are effecting predominantly youth, who have very little political power and influence. If laws were to be directed more broadly at distracted driving, there would be more intense and more organized political opposition.

A final point is about the actual risk of driving while cell phoning. A lot of the research is done with driving simulators. Research subjects go through a series of typical driving challenges, with and without cell phone use. In general, these studies consistently show that drivers using phones perform more poorly, indicating higher risk for collisions. This science supports what most people would think intuitively. However, I wonder if it is more complex?

All cars come with radios, and operating and listening to a radio while driving is distracting from the task at hand. However, drivers also have collisions from fatigue and “highway hypnosis.” Those problems may be moderated by having a radio. If we compare perfect driving performance with radio-assisted driving, the perfect driving will have a lower collision rate. But if we compare real world driving with radio-assisted driving, the radio-accompanied driving may actually be better. It will be interesting to see in the future whether hands-free cell phone use actually has a safety benefit in real world driving.

At the present time we rely on public education to persuade people not to use cell phone functions while driving.  In addition, there is a growing body of policies trying to restrict and regulate drivers with cell phones.  It is too early to know what works and what doesn't.  Educational messages are fairly simple (Don't
!) so that makes communication easier.  However, cell phones and texting in cars have become ingrained in our culture, so this makes the behavior change process more challenging.  I think it will take a lot more people to have personal narratives about cell phone induced collisions before there is a critical mass of public credibility given to the issue.  As far as policy restrictions, support seems to be growing, but it is not clear yet what policies actually matter.

People are skeptical about enforcing cell phone with driving policies, and obviously that is a challenge.  However, that was and still is a concern regarding seat belt laws.  Forty years into the seat belt campaign, we still don't have universal compliance with the laws.  However, it is clear that the combination of educational messages and legal mandates have been effective in bringing seat belt habits to the level of a social norm, making our highways much safer than before.  We must work for that same outcome with drivers and cell phone use.