Objective: More than 270,000 people across the world die every year from alcohol-related crashes. Introducing alcohol per se laws (APL) based on a blood alcohol concentration (BAC) threshold of .05% could save at least 16,000 lives annually. Nevertheless, little is known about the evolution of APL adoptions at this BAC threshold. This study organizes the available data to chart the evolution of APLs across 183 countries from 1936 to 2021.
Method: A review to identify relevant policies involved (a) probing multiple data sources, including legislation archives, international and national reports, and peer-review articles; and (b) an iterative record search and screening by two independent researchers, data collection, and expert consultations.
Results: Data for 183 countries were organized and integrated to form a new global data set. A global diffusion process framework describes the evolution of APLs based on the data set. In the first period of analysis (1936-1968), APLs emerged in Nordic countries as well as in England, Australia, and the United States. APLs then spread to other parts of continental Europe and to Canada. By 2021, more than 140 countries had adopted an APL with a BAC threshold of at least .05%.
Conclusions: The present study offers a methodology for tracing alcohol-related policies from a cross-national and historic perspective. Future studies could integrate other variables into this data set to chart the speed of adoption of APLs and to test how changes in APLs correlate with alcohol-related crashes over time between and within jurisdictions.