Primary seat belt enforcement laws

Primary seat belt enforcement laws allow law enforcement officials to stop drivers solely for failing to use a seat belt (CG-Motor vehicle injury). Primary seat belt laws differ from secondary seat belt laws, which allow police officers to issue a seat belt citation only after stopping the driver for another reason (NHTSA-Goodwin 2013).

Expected Beneficial Outcomes (Rated)

  • Increased seat belt use

  • Reduced fatal and non-fatal injuries

Evidence of Effectiveness

There is strong evidence that primary seat belt enforcement laws increase the use of seat belts (CG-Motor vehicle injury). Primary enforcement laws increase seat belt use and reduce fatal and non-fatal injuries more effectively than secondary enforcement laws (CG-Motor vehicle injury).

States that change from secondary to primary seat belt enforcement laws have increased rates of seat belt use after primary enforcement laws go into effect (Dihn-Zarr 2001). Changing from secondary to primary enforcement has been shown to increase seat belt use during the day and night (NHTSA-Chaudhary 2010). Primary enforcement laws appear to have the largest effects among high-risk drivers, such as alcohol-impaired drivers, and among populations with lower rates of seat belt use, such as blacks and Hispanics (Dihn-Zarr 2001).

Despite concern, there is no evidence that minorities are stopped at higher rates than whites for seat belt violations in states with primary enforcement laws. Several states have added anti-harassment language to their primary seat belt laws to reduce the risk of such differential enforcement (Dihn-Zarr 2001).

Primary law enforcement can include paid media efforts (NHTSA-Nichols 2010, NHTSA-Hedlund 2008). Primary seat belt laws that are enforced with well-publicized seat belt use checkpoints appear to yield more benefits through quality adjusted life years (QALYs) saved and injuries prevented than they cost to implement ().

Impact on Disparities

Likely to decrease disparities

Implementation Examples

As of May 2015, 34 states and Washington, DC have primary seat belt laws for front seat occupants; in 17 of these states and Washington, DC, primary enforcement laws also cover rear seats (GHSA-Seat belt laws).

Citations - Evidence

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CG-Motor vehicle injury - The Guide to Community Preventive Services (The Community Guide). Motor vehicle injury prevention.

Miller 2000* - Miller TR, Levy DT. Cost-outcome analysis in injury prevention and control: Eighty-four recent estimates for the United States. Medical Care. 2000;38(6):562-82.

Dihn-Zarr 2001 - Dihn-Zarr TB, Sleet DA, Shults RA, et al. Reviews of evidence regarding interventions to increase the use of safety belts. American Journal of Preventive Medicine. 2001; 21(4S):48-65.

NHTSA-Hedlund 2008 - Hedlund J, Gilbert SH, Ledingham K, Preusser D. How states achieve high seat belt use rates. Washington DC: National Highway Traffic Safety Administration (NHTSA), US Department of Transportation (US DOT); 2008.

NHTSA-Nichols 2010 - Nichols J, Tippetts AS, Fell J, et al. Strategies to increase seat belt use: An analysis of levels of fines and the types of law. Washington DC: National Highway Traffic Safety Administration (NHTSA), US Department of Transportation (US DOT); 2010.

NHTSA-Chaudhary 2010 - Chaudhary NK, Tison J, Casanova T. Evaluation of Maine's seat belt law change from secondary to primary enforcement (Report No. DOT HS 811 259). Washington DC: National Highway Traffic Safety Administration (NHTSA), US Department of Transportation (US DOT); 2010.

Citations - Implementation Examples

* Journal subscription may be required for access.

GHSA-Seat belt laws - Governors Highway Safety Association (GHSA). Seat belt laws.

Date Last Updated

Jun 2, 2015