Evaluation of the redesigned "Booze It & Lose It" campaign in North Carolina

Farmer, Charles M. / Eichelberger, Angela H. / Ezzell, Mark M. / Gianni, Thomas J.
Traffic Injury Prevention (TIP)
October 2025

Abstract
Objective: In 2023, the North Carolina Governor’s Highway Safety Program and the Insurance Institute for Highway Safety joined with local law enforcement and other partners to update the "Booze It & Lose It" campaign through a pilot project in western North Carolina. This article evaluates the effects of the revised Booze It & Lose It campaign on driver awareness and behavior and the numbers of serious roadway crashes.
Methods: Drivers were surveyed in both the pilot test communities and comparison communities in North Carolina to assess campaign awareness, beliefs, and self-reported behaviors. Police-reported crashes for 2015–2024 were used to examine the impact of the program on the rates of overall crashes, single-vehicle nighttime crashes, single-vehicle late-night crashes, and serious and fatal injury crashes using time-series regressions. Crash data were adjusted for seasonality and the possible effects of COVID-19.
Results: The percentage of drivers in the pilot counties who were very or somewhat familiar with Booze It & Lose It increased from 66% before the campaign to 68% after 1 year and 81% after 2 years, while the percentage in the comparison counties fluctuated from 76% to 72% after 1 year and 82% after 2 years. The estimated difference in trends across county groups is not significantly different (p = .0653). The pilot program was associated with a relative 4.3% increase in all crashes, a 1.1% decrease in single-vehicle nighttime crashes, a 6.9% decrease in single-vehicle late night crashes, and a 14.4% decrease in serious and fatal injury crashes, but none of these estimates are statistically significant.
Conclusions: Driving while impaired by alcohol remains an issue in North Carolina. If the revised Booze It & Lose It pilot program changed driver behavior and subsequent alcohol-related crash rates during these 2 years, the change was too small to confidently detect. There are, however, some encouraging signs. Awareness of the Booze It & Lose It program has rebounded to a level not seen since 2012. And crash types typically associated with alcohol are down. Maybe most importantly, the pilot program is continuing under local control.
Abstract Objective: In 2023, the North Carolina Governor’s Highway Safety Program and the Insurance Institute for Highway Safety joined with local law enforcement and other partners to update the "Booze It & Lose It" campaign through a pilot project in western North Carolina. This article evaluates the effects of the revised Booze It & Lose It campaign on driver awareness and behavior and the numbers of serious roadway crashes.
Methods: Drivers were surveyed in both the pilot test communities and comparison communities in North Carolina to assess campaign awareness, beliefs, and self-reported behaviors. Police-reported crashes for 2015–2024 were used to examine the impact of the program on the rates of overall crashes, single-vehicle nighttime crashes, single-vehicle late-night crashes, and serious and fatal injury crashes using time-series regressions. Crash data were adjusted for seasonality and the possible effects of COVID-19.
Results: The percentage of drivers in the pilot counties who were very or somewhat familiar with Booze It & Lose It increased from 66% before the campaign to 68% after 1 year and 81% after 2 years, while the percentage in the comparison counties fluctuated from 76% to 72% after 1 year and 82% after 2 years. The estimated difference in trends across county groups is not significantly different (p = .0653). The pilot program was associated with a relative 4.3% increase in all crashes, a 1.1% decrease in single-vehicle nighttime crashes, a 6.9% decrease in single-vehicle late night crashes, and a 14.4% decrease in serious and fatal injury crashes, but none of these estimates are statistically significant.
Conclusions: Driving while impaired by alcohol remains an issue in North Carolina. If the revised Booze It & Lose It pilot program changed driver behavior and subsequent alcohol-related crash rates during these 2 years, the change was too small to confidently detect. There are, however, some encouraging signs. Awareness of the Booze It & Lose It program has rebounded to a level not seen since 2012. And crash types typically associated with alcohol are down. Maybe most importantly, the pilot program is continuing under local control.