Introduction: Effective drunk-driving policies are not adopted consistently in many countries. To understand how drinking behaviors influence national drunk-driving policymaking, the associations between drunk-driving policies and country-level drinking volumes and patterns were examined. Methods: Data for 194 countries were obtained from the WHO 2012 Global Information System on Alcohol and Health. Country-level drinking behaviors were measured using average drinking volumes and patterns of drinking scores based on six attributes of risky drinking. Drunk-driving policies were categorized into preemptive measures (random breath testing, breath alcohol concentration limits for driving a vehicle, and sobriety checkpoints), penalties (community service, short- or long-term detention, fines, suspension or revocation of license, and vehicle impoundment), mandatory treatment, and ignition interlock. Data analysis was conducted in 2017. The percentages of each policy adoption were examined in countries with different drinking behaviors. The internal consistencies of preemptive measures were calculated using Cronbach's α. A structural equation model was established to examine the associations between drinking behaviors and drunk-driving policy categories, after adjusting for national income levels and general alcohol policies. Results: Mandatory treatment and preemptive measures were less commonly adopted than penalties were. The adoption of preemptive measures had a low consistency level, and the consistency level decreased with drinking pattern riskiness. Risky drinking patterns were negatively associated with mandatory treatment policy. Conclusions: Drinking patterns are associated with national drunk-driving policymaking. Accessible medical treatment and comprehensive preemptive measures should be advocated in countries with risky drinking patterns.
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