You’re behind the wheel and you receive a text message from a loved one. They want to know if you’re running late. But if you pick up your phone to reply, you may never reach your destination.
Impaired driving is not a new phenomenon. As medical ethicist Dr. Barron Lerner observes in his history of drunk driving, One for the Road, “there has probably been drunk driving for as long as there has been driving.” Alongside drug or alcohol consumption, drivers may also impair themselves by engaging in a whole host of other activities while behind the wheel, from eating to reading a map.
Texting while driving, however, is a recent and increasingly common form of distraction, particularly in the U.S. According to a study published in Pediatrics, in 2011, 45% of high school students aged 16 years or older reported texting while driving in the past 30 days. From 2005 to 2009, the proportion of fatal crashes with reported driver distraction increased from 10 percent to 16 percent.
Texting is especially hazardous because it takes a driver’s eyes off the road entirely. One study from the Virginia Tech Transportation Institute used cameras to assess where drivers were looking. They found that texting while driving increased the risk of a crash or near-crash by 23 times. This is simply one estimate, and studies measuring the risk of this relatively new driver behavior remain limited. But it is clear that texting while driving is highly dangerous.
Safety researchers have taken note of emerging data on the dangers of texting, but what about the public? In his new film, acclaimed documentary director Werner Herzog gives a face to this growing public health problem through personal human narrative.
“She had her life planned. She was always planning everything. Now she can’t plan anything.”
“This was the last text message I sent before I caused an accident that killed three people.”
“I can’t say ‘go play.’ Any mother understands. I can’t say ‘go play.’”
“I don’t remember what I was texting. I don’t remember what the message said. That’s how important it was.”
These are some of the heartbreaking lines from Herzog’s film, a short documentary with over two million views, which can be viewed on YouTube. At 35 minutes in length—suitable for viewing in high school assemblies or driver’s education courses—the documentary tells the stories of four devastating car crashes caused by drivers who were texting.
Public service announcements (PSAs) about the hazards of driving may evoke memories of dramatic videos about drinking while driving. Dr. Lerner noted that it’s understandable that “the anti-texting movement is taking a page from the book of the drunk driving people. To me, the basic issue is the same. When you’re driving, the ability to react as well as possible is threatened.”
But instead of taking the familiar graphic approach to PSAs, Herzog’s film does not focus on images of blood and chaos. Instead, as Herzog told NPR, he wanted to depict “the interior side of the catastrophes.” The result is disturbing, powerful, and “emotionally” graphic. The camera hovers as a man kneels by the site of a crash he caused, and zooms in as families struggle through both silences and breakdowns to convey their losses. A mother says “There are times when the pain is so bad that I can’t breathe.” Even as a viewer, the sorrow takes your breath away.
The extended time frame and carefully composed shots enable Herzog to depict the profound long-term consequences of car crashes. Viewers become acquainted with each family’s particular circumstances and losses, allowing for a much fuller appreciation of their individual stories than is possible in a typical short PSA.
The New York Times editorial board suggested that From One Second to the Next “may be the first example of a new genre: the art house public service announcement.” Herzog’s accomplishment suggests that public health awareness campaigns can benefit from a more artistic approach to convey prevention messages.
But are moving narratives enough to change driver behavior?
The CDC selected reducing motor vehicle deaths and injuries as one of the top public health achievements of the 20th century. This extraordinary success, resulting from a diverse array of prevention strategies—including improved roadways, technologies such as air bags and seat belts, and public education—demonstrates that car crashes are highly preventable. In fact, driving has never been safer, even for teenagers who are most at risk.
Yet texting while driving threatens these improvements and, as Dr. Lerner put it, “pushes the pendulum back in the wrong direction.”
Herzog’s film is a highly effective approach to making us pay attention. But education alone is probably not enough to prevent car crashes due to texting. Those beguiling chimes indicating an incoming message are hard to resist, even for people who have learned about the dangers of distracted driving. One Michigan survey found that while 80 percent of respondents considered talking on their phone while driving to be dangerous, 56 percent did it anyway. In isolation, strategies to increase awareness of risks may not always reduce risky behavior.
According to the “3 E’s” theory of injury prevention, the multiple approaches of education, enforcement and engineering are all essential strategies. Columbia University injury epidemiologist Charles DiMaggio observed, “The Herzog movie strikes me very much as an educational approach which will be effective if combined with other approaches.”
In addition to educational campaigns to inform the public, injury prevention professionals should advocate for enacting and enforcing laws prohibiting texting while driving, and for developing engineering approaches to make vehicles and roads safer. Currently, 39 states have passed laws banning texting while driving for all drivers. Enforcement of these laws can prove challenging because it is not always obvious when motorists are texting. In Virginia, for instance, texting is forbidden, but drivers are still allowed to use their hands to make phone calls or to search for directions using a phone’s GPS system. Laws banning any handheld phone use while driving, as 11 states have enacted, appear to be more effective than only banning texting while driving. Increasing penalties for infractions, as some states have done, may also improve the effectiveness of these laws.
To tackle the third E of injury prevention, how might we engineer away the risk? Existing technologies can make phones inaccessible to users while driving, by using data from a phone’s accelerometer to prevent use. There is even a driving app call live2text which can block messages and send an automated response indicating that you are driving and will reply later.
As an alternative to relying on drivers’ willingness to voluntarily restrict their cell phone use, car and cell phone companies could prevent the use of cell phones once cars reach a certain speed. An article in the Journal of the American Medical Association advocated this technological fix, stating that “handheld portable devices must be rendered inoperable whenever the automobile is in motion or when the transmission shaft lever is in forward or reverse gear. Automobile and cell phone equipment manufacturers have the engineering capabilities to implement these safeguards and they should be required to do so.” A range of other possible incentives, such as insurance companies offering a discount on premiums for people who use these technologies, might further encourage their adoption.
The CDC considers preventing motor vehicle injuries to be a “winnable battle” that could greatly benefit public health. But as Charles DiMaggio says, “We know how to prevent injuries. The question is: is there the societal and political will to do it?” Will drivers put down their phones? Will companies introduce technologies to restrict the use of their products while driving? We have yet to see.
But those looking for the will to enact these life-saving strategies might find inspiration from the people featured in Herzog’s documentary. In the end, one of the protagonists who caused deaths due to his texting summed up his remorse simply: “That accident was preventable. There’s no other way to look at it. Put my phone away and I save those two men’s lives. It’s that simple.”
Photo courtesy of It Can Wait campaign. Edited by Joshua Brooks