{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:16:46Z","timestamp":1790612206479,"version":"4.1.0"},"reference-count":55,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG3K1131"],"award-info":[{"award-number":["CMRPG3K1131"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003711","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 110\u20102314\u2010B\u2010182A\u2010037"],"award-info":[{"award-number":["MOST 110\u20102314\u2010B\u2010182A\u2010037"]}],"id":[{"id":"10.13039\/501100003711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Background and aims<\/jats:title>\n Drunk\u2010driving accounts for a significant portion of traffic crashes in Taiwan. From 2008 to 2013, both the Taiwan Legislative Yuan and the federal administrative agencies collaborated to increase drunk\u2010driving penalties. This study aimed to determine whether these sanction changes are associated with changes in the incidence of drunk\u2010driving and subsequent hospital admissions.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Exploratory retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Taiwan.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n All traffic crashes involving drunk\u2010driving violations and every involved individual from 2003 to 2019 in Taiwan.<\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n Interrupted time series analysis (ITSA) method was used to examine the effects of the three policy interventions in January 2008, December 2011 and June 2013. The numbers of drunk\u2010driving crashes, drunk\u2010driving casualties, drunk\u2010driving\u2010related admissions, drunk\u2010driving\u2010related major traumas, drunk\u2010driving\u2010related deaths and drunk\u2010driving\u2010related medical expenses in different time segments were compared to evaluate the effect of each policy intervention. All three policy initiatives increased drunk\u2010driving penalties, and there were no intervening policy changes that reduced said penalties.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n From January 2003 to January 2008, the numbers of all drunk\u2010driving\u2010related outcomes gradually increased. After the first penalty adjustment, the reported number of drunk\u2010driving crashes had a sudden decrease (1632 in January 2008 to 1374 crashes in February 2008,\n \u03b2<\/jats:italic>\n \n 2<\/jats:italic>\n <\/jats:sub>\n \u00a0=\u2009\u22120.146,\n P<\/jats:italic>\n \u00a0<\u20090.001), but the overall trend continued upward (\n \u03b2<\/jats:italic>\n \n 3<\/jats:italic>\n <\/jats:sub>\n \u00a0=\u2009\u22120.001,\n P<\/jats:italic>\n \u00a0=\u20090.111). However, after the second policy intervention, drunk\u2010driving crashes began trending downward rapidly (\n \u03b2<\/jats:italic>\n \n 5<\/jats:italic>\n <\/jats:sub>\n \u00a0=\u2009\u22120.021,\n P<\/jats:italic>\n \u00a0<\u20090.001). Finally, after the third adjustment, the trend of drunk\u2010driving crashes continued to decrease, but the slope became significantly milder (\n \u03b2<\/jats:italic>\n 7<\/jats:sub>\n \u00a0=\u00a00.009,\n P<\/jats:italic>\n \u00a0<\u20090.001). Most of the target outcomes followed a similar trend as the drunk\u2010driving crashes, except for the number of deaths caused by drunk\u2010driving, which demonstrated a statistically significant decline after the first adjustment (\n \u03b2<\/jats:italic>\n \n 3<\/jats:italic>\n <\/jats:sub>\n \u00a0=\u2009\u22120.006,\n P<\/jats:italic>\n \u00a0=\u20090.007).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Increasing the fine and maximum incarceration periods for drunk\u2010driving in Taiwan appears to be associated with a reduction of the number of drunk\u2010driving crashes and other related outcomes; however, the decrease in drunk\u2010driving crashes diminished over time, especially after the third sanction change in 2013.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/add.70285","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T14:15:25Z","timestamp":1765980925000},"page":"1166-1178","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The correlation between sanction adjustments and drunk\u2010driving violations and related outcomes in Taiwan: A nationwide interrupted time series analysis"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6489-3723","authenticated-orcid":false,"given":"Ling\u2010Wei","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Trauma and Emergency Surgery Chang Gung Memorial Hospital, Linkou Medical Center Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010An","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Chang Gung Memorial 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Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Yuan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Chang Gung Memorial Hospital, Linkou Medical Center Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Ching","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Chang Gung Memorial Hospital, Linkou Medical Center Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Olin","sequence":"additional","affiliation":[{"name":"Alexander Blewett III School of Law, University of Montana MT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Shiang","family":"Yang","sequence":"additional","affiliation":[{"name":"New Taipei City Police Department Taipei City 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