Cost-effectiveness of regulations against using a cellular telephone whiledriving

Purpose: To evaluate the cost-effectiveness of regulations that prohibit us ing a cellular telephone while driving a motor vehicle. Design: Decision an alysis of risks and benefits related to cellular telephones and driving. Se tting: United States population in 1997. Measures: Health benefits measured as the quality-adjusted life years potentially saved. Financial benefits m easured as health care and other services potentially averted. Costs of reg ulation measured as the lost productivity derived from willingness to pay f or cellular telephone calls. Results: Under base-case conditions, cellular telephone calls in the United States each day accounted for about 984 repor ted collisions, 1,729 total collisions, 2 deaths, 317 persons with injuries , 99 lost years of life expectancy, 161 lost quality-adjusted life years, $ 1 million in health care costs, and $4 million in property damage and other costs. This reflected a total of about 35 million telephone calls while dr iving, 70 million calling minutes, and $33 million in total value to societ y. The estimated cost-effectiveness ratio for a regulation restricting cell ular telephone usage while driving was $300,000 per quality-adjusted life y ear saved, but ranged from $50,000 to $700,000 under alternative assumption s and interpretations of data. Regulations applied to teenage males could b e cost-saving to society if the value of a call fell below 37 cent per minu te. Conclusions: Regulations restricting cellular telephone usage while dri ving are less cost-effective for society than other safety measures. Nevert heless, regulations may be justifiable because the benefits and harms do no t always involve the individual who has the cellular telephone. Increasing the price of a call (or adding a supplementary tax) might decrease the numb er of discretionary calls, be cost-saving for society, and be life-saving f or individuals.