Perceptions of Drinking and Drink Driving: a Mixed Method Study Assessing Risky Behavior Among Injury Patients and the Factors Influencing Drink Driving in Moshi, Tanzania

Alcohol is a leading risk factor for injury. Road traffic injuries are a leading killer, but perceptions of drinking and drink driving in Tanzania are unclear. This research aims to define how perceptions of drinking influence risky driving behavior at Kilimanjaro Christian Medical Center in Moshi, Tanzania. This mixed methods study incorporated the Alcohol Adapted Perceived Discrimination-Devaluation scale (PDD) and the Alcohol Use Disorders Identification Test (AUDIT) among 96 injury patients regardless of their alcohol use prior to injury. Results were reported as medians and IQRs with Kurskal Wallis tests. Additionally, focus groups with injury patients, their families, and community members (n = 63) were conducted and analyzed in parallel using an inductive thematic content analysis approach. Of the 96 injury patients surveyed, 53 used alcohol and 17%(n=9) of those self-reported driving after ingesting 3 or more alcoholic drinks (SRDD). SRDD’s average AUDIT score (median=11) was significantly different from those who denied drink driving (median=6, p= 0.03). The PDD showed a high overall stigma, particularly discrimination, against those who use alcohol; but, the PDD was similar for drinkers and abstainers from alcohol (median=2.7 and 3.1, respectively). Thematic content analysis highlighted an ‘inability to change those that drink drive, ‘disapproving of drink driving’, and a ‘necessary police enforcement on drink driving.’ While stigma is present in Tanzania against those who use alcohol, it does not impact the choice to drink and drive, and was not stronger in drinkers or abstainers. Overall, there appears to be a community-wide disapproval of drinking and driving coupled with feeling unable to change this risky behavior.