The issue of driver distractions is attracting considerable attention from road safety advocates and legislators alike. Although driver distractions have always been present, the increasing availability and use of portable and pre-installed electronic devices in cars (and motorbikes) has raised serious concerns about the role of distraction and inattention in road traffic crashes. Cell phone use while driving or riding is only one of many driver distractions and it should be noted that in many studies, several other forms of distraction outrank cell phone use in importance. In spite of this, cell phones have, rightly or wrongly, received the most attention especially from legislators in part because cell phone use is so prevalent and visible. Bermuda has followed suit.What is known about the driver distraction and cell phones?There is no doubt whatsoever that cell phone use while driving is a distraction that can lead to inattention. However, there seems to be a general misunderstanding as to the nature and relative importance of this distraction. There are many other factors both inside and outside the vehicle that can distract the driver from the task at hand. A number of studies have ranked the following distractors ahead of cell phone use: eating or drinking, events happening outside the vehicle, adjusting climate control or radio settings, consulting on-board GPS navigation screens, and conversations with passengers (Most would now agree that a conversation with someone on a cell phone is more dangerous than a conversation with someone in the vehicle because the passenger is aware of the current driving circumstance and will tend to cease conversation if he perceives danger whereas the person at the other end of the cell phone is oblivious to the driver’s environment.)It has been well demonstrated that it is the cognitive aspects of cell phone use and not the mechanical ones that contribute most to the distraction. Sure, texting at the wheel requires both your dominant hand and your eyes and that’s obviously not too smart. However, the issue at hand is talking on a cell phone and the main consideration here is what percentage of your attention is dedicated to the conversation rather than to driving. “Hi honey, I’m on my way home,” takes up much less of your attention (I know not all husbands will agree!) than having an argument with your business partner. Furthermore, the longer the cell phone conversation, the more distracted the driver becomes.Most importantly, it is also well proven that there is virtually no difference in cognitive distraction between a conversation using a hand-held phone and one using a hands-free unit. Remember, what takes your attention away from driving is the amount of brain power dedicated to the conversation and not the act of holding something in your hand. Yes, dialling a cell phone is a factor but nowhere as important than the intensity and length of the conversation.The distractive effects of cell phone use while driving have been well documented and publicised. Some studies have demonstrated that using a cell phone while driving is equivalent to driving with a 0.08 percent blood alcohol, the legal alcohol limit in Bermuda.Other studies have noted numerous other undesirable effects including increased reaction times and stopping distances.What is the cost/benefit of cell phone legislation, ie what is the cost of implementation and enforcement for every life saved?Cell phones have become ubiquitous and are now viewed as a necessity rather than a luxury. In this context, individuals place a great importance on being able to communicate anytime, anywhere with anyone they choose. There is a real or perceived benefit to using cell phones even while driving. The Harvard Center for Risk Analysis addressed this question in a series of studies. The studies conducted focus groups to examine the perceived benefits of cellular telephone use while driving. The studies found the following:Individual/Family Benefitsl Peace of mindl Reducing the number and duration of tripsl Expanding productive timel Contacting emergency servicesl Strengthening social networkingCommunity Benefitsl Decreased accident response timesl Improved knowledge about emergencies for emergency response teams (e.g. how to get to the scene, what equipment to bring)l Improved life-saving outcomesl More effective apprehension of criminals (such as drunk drivers)Furthermore, economic studies (Ropeik, D., Cellular Phones and Driving: Weighing the Risks and Benefits. Harvard Center for Risk Analysis, 2000) by the same group suggest that the monetary value of using a cellular telephone while driving exceeds the cost, even when those costs include both human injury and material damage expressed in dollar units. Importantly, compared to several other ways of improving traffic safety such as lap/shoulder belts or daytime running lights, restrictions on the use of cellular telephones while driving appear to be inefficient, ie they cost several thousand-fold more than other safety measures to produce similar safety benefits.How effective has cell phone legislation been in other jurisdictions?Jurisdictions that have introduced cell phone bans have had little success in decreasing the prevalence of cell phone use by drivers. New York State was the first prohibit the use hand-held cell phones while driving. The implementation of the law was preceded by an extensive public awareness campaign. Prior to the law, 2.7 percent of drivers admitted to using a cell phone while driving. One year after the ban, cell phone use had dropped to 1.3 percent. However, one year later and in spite of heavy ticketing for the offence, the number of cell phone users had returned the pre-ban level of 2.7 percent.Furthermore, an important study released in 2010 by the Highway Loss Data Institute, an affiliate of the Insurance Institute for Highway Safety, found no reductions in crashes after hand-held phone bans took effect. Comparing insurance claims for crash damage in four US jurisdictions before and after such bans, the researchers found steady claim rates compared with nearby jurisdictions without such bans. An excerpt of the January 29, 2010 news release of this study follows:“The laws aren’t reducing crashes, even though we know that such laws have reduced hand-held phone use, and several studies have established that phoning while driving increases crash risk,” says Adrian Lund, president of both the Insurance Institute for Highway Safety and HLDI.“So the new findings don’t match what we already know about the risk of phoning and texting while driving,” Lund points out.“If crash risk increases with phone use and fewer drivers use phones where it’s illegal to do so, we would expect to see a decrease in crashes. But we aren’t seeing it. Nor do we see collision claim increases before the phone bans took effect. This is surprising, too, given what we know about the growing use of cell phones and the risk of phoning while driving. We’re currently gathering data to figure out this mismatch.”Lund points to factors that might be eroding the effects of hand-held phone bans on crashes. One is that drivers in jurisdictions with such bans may be switching to hands-free phones because no US state currently bans all drivers from using such phones. In this case crashes wouldn’t go down because the risk is about the same, regardless of whether the phones are hand-held or hands-free.Twenty-one states and the District of Columbia do prohibit beginning drivers from using any type of phone, including hands-free, but such laws are difficult to enforce. This was the finding inNorth Carolina, where teenage drivers didn’t curtail phone use in response to a ban, in part because they didn’t think the law was being enforced.“Whatever the reason, the key finding is that crashes aren’t going down where hand-held phone use has been banned,” Lund points out. “This finding doesn’t auger well for any safety payoff from all the new laws that ban phone use and texting while driving.”Might our time, money and efforts be better spent addressing other road safety issues?Based on our analysis of recent road statistics as well as on our study Road Traffic Injuries in Bermuda 2003-2004, the following observations about road traffic injuries and deaths can be made:l 16 to 19-year-olds are at significantly increased injury risk compared to any other age group. Our study suggests that inexperience, lack of adequate motorcycle training and speeding are the main causes. No Bermuda statistics are available to gauge the role cell phone use plays in this group.l The average age of road fatalities in Bermuda (1997-2009) is 35.5. The main contributing factors for the fatalities are alcohol/drugs and speed. Based on the high percentage of fatal head injuries in this group, another contributing factor is felt to be inadequate quality or improper fastening of helmets. No Bermuda statistics are available to gauge the role cell phone use plays in this group.I think we can all agree that the current state of affairs on our roads is unacceptable. Here is how our road fatality rate compares to other OECD countries:FIRST CHARTIf you think this is an unfair comparison, here is how we compare to other Pan American countries:SECOND CHARTThe bottom line, in my opinion, is that introduction of cell phone legislation is unlikely to have a significant effect on our road injury and death statistics. Banning hand-held units alone simply hides the problem of inattention. Furthermore, it does not address the most important causes of injuries and deaths on our roads. Bermudians are sustaining injuries and dying on our roads because they speed, they drink and drive and because they wear inadequate or inadequately fastened helmets. Our young riders are at highest risk of injury because they are inexperienced and because we do not teach them how to ride. Project Ride is not sufficient; we need to introduce professional, internationally approved rider education into the high school curriculum as many other jurisdictions do. The youth licence may also be helpful if it is enforced. However, a full graduated licensing program would be more effective.At present, we are failing to enforce the very basic rules of the road. Bermudians speed, drink and drive and wear improper or unfastened helmets. Does anyone seriously think that we can enforce a cell phone ban if we can’t even address these other basic issues effectively? I, for one, do not. Our time and money would be better spent implementing measures to address the real causes of road deaths and injuries.Dr Joseph Froncioni is the founder and president of BermudaSMARTRISK and the former chairman of the Bermuda Road Safety Council