Steps must be taken to dissuade drivers from illegally using cellphones while behind the wheel to prevent the risk of injury to other motorists or pedestrians, says an editorial by two Canadian doctors.
And paradoxically, they write in this week's British Medical Journal, technology itself may provide the solution.
Dr. Barry Pless and son Dr. Charles Pless of Montreal say although there is still scientific uncertainty about the link between cellphone use while driving and the risk of collisions, the proliferation of mobile phones means distracted driving is undoubtedly on the rise.
A number of studies over the last two decades have had mixed findings as to whether conversing or texting on a mobile phone while driving boosts the risk of having a motor vehicle accident.
But the editorial argues that the potential for injuring or killing other people due to distracted driving means policy makers must not wait for "solid proof" before acting.
While hands-free cellphone use in the driver's seat is probably the least risky activity, followed by conversing with a phone to one's ear, "texting is most dangerous — terrifyingly so," said Barry Pless, professor emeritus of pediatrics and epidemiology at McGill University.
Public education campaigns may have some effect but are unlikely to stop all drivers from taking out their mobiles — a goal that has not even been achieved by legislation across Canada that bans the use of cellphones while behind the wheel, Pless said Tuesday from Montreal.
"So part of the responsibility lies with the law makers to make sure the penalties are severe," he said, noting that New York state has proposed legislation that would double a young driver's licence suspension from the current six months for texting while operating a vehicle.
"If you're a kid and you know you're going to lose your licence for a year ... and you have a reasonable expectation of being caught, then one hopes that you will be persuaded not to do it."
According to the Canadian Automobile Association website, provincial fines range from a high of $400 in P.E.I. and Newfoundland and Labrador, with the loss of three to four demerit points respectively, to a low of $115-$154 in Quebec, with three demerit points lost. Ontario's fine is $155 with no lost demerit points, the CAA site shows.
Pless said if a driver believes there's a good chance he or she won't be caught by police using a cellphone and the penalty isn't significant, "then who cares? Then you'll keep on."
Paradoxically, that leaves technology as the best solution for curbing the use of mobile technology, the editorial suggests.
That could include software that prevents texting while driving set as a factory default; mobile phone pull-out areas with free Wi-Fi access; automatic messages informing callers the recipient is driving; and a sensor such as a signal-jamming key that prevents cellphone reception in a vehicle.
"Ultimately, a technical solution is needed that blocks texting and conversations by drivers while permitting passengers to use their phones as they wish," the Plesses write.
"Until nudging works fully, regulatory bodies must be instructed to incorporate the best available technological preventive measures into all new mobile phones and cars."
Dr. Donald Redelmeier, a staff physician and researcher at Sunnybrook Health Sciences Centre in Toronto, co-authored a 1997 study that found talking on a cellphone while driving quadrupled the risk of having a collision.
Since then, he said, "the technology has become so much more popular and so much more affordable that there are now way more users on the horizon, thereby causing our initial study to somewhat underestimate the magnitude of risk."
As well, that study did not include texting while driving, which Redelmeier said is "enormously disruptive."
While educating drivers about the dangers of cellphone use behind the wheel is a useful adjunct for road safety, it cannot be the sole intervention, he said, and laws banning mobile communication while driving achieve only about a 70 to 80 per cent adherence rate in Canada and the U.S.
Economic incentives might increase that compliance, said Redelmeier, an internist who often treats patients severely injured in motor vehicle accidents. For instance, insurance companies could demand cellphone data from drivers following a crash, with the understanding rates would increase if the mobile technology had been in use at the time.
Still, he agreed that technology could be the answer, if it could be designed within certain limits.
"If you could find some way of preserving all of the useful emergency calls, the Good Samaritan reporting of mechanical breakdowns or criminal activity or medical emergencies, and then blocking these remarkably frivolous phone calls that are just not worth the risk, that would be great.
"As a physician, that would make sense to me."