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Motor Vehicle Injury – Safety Belts: Enhanced Enforcement Programs


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 15 studies (search period through June 2000).

The review was conducted on behalf of the CPSTF by scientists from CDC’s Division of Unintentional Injury Prevention with input from a team of specialists in systematic review methods and experts in research, practice and policy related to motor vehicle injury prevention.


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Summary of Results

More details about study results are available in the published evidence review pdf icon [PDF - 2.85 MB].

The systematic review included 15 studies.

  • Observed safety belt use increased by a median of 16 percentage points (15 studies)
  • Increases in safety belt use were similar for supplemental and targeted patrols.
  • Deaths and injuries combined decreased by 7% and 15% (2 studies)

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.


These findings should be generally applicable to all U.S. motorists covered by safety belt laws.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base.

  • How does the length and frequency of enhanced enforcement programs influence their effectiveness?
  • Does the effectiveness of enhanced enforcement programs vary based on the scale of the interventions (e.g., single community vs. multi-community programs)?
  • How does publicity, public education, and news coverage affect enhanced enforcement programs?
  • What penalties for violations of laws (e.g., fines, license demerits) are most effective among high-risk drivers (e.g., teenagers, drinking drivers)?
  • What are the most effective methods of publicizing enhanced enforcement to reach high-risk drivers?
  • Do enhanced enforcement programs for safety belt use decrease risky driving?
  • Do enhanced enforcement programs deter alcohol-impaired driving?
  • What are the cost-benefit, cost utility, and cost-effectiveness of enhanced enforcement programs?
  • Do enhanced enforcement programs divert police from other crimes?

Study Characteristics

  • Included studies focused on enhanced enforcement programs that specifically targeted safety belt use. Studies of programs targeting multiple unsafe driving practices were excluded from the review.
  • Included studies evaluated city, county, state, provincial, and national programs in the United States and Canada.
  • Evaluated programs varied in the amount of publicity they used. Studies were conducted in states with primary safety belt laws and states with secondary laws.


Zaza S, Sleet DA, Elder RW, Shults RA, Dellinger A, Thompson RS. Response to letter to the editor. American Journal of Preventive Medicine. 2002;22:330-1.

Sleet DA. Evidence based injury prevention: guidance for community action. In: Australian Third National Conference on Injury Prevention and Control. Australian Third National Conference on Injury Prevention and Control. Brisbane, Queensland, Australia; 1999.