Driver and passenger seatbelt use among U.S. high school students.

BACKGROUND In 2005, 40% of motor-vehicle occupant deaths in the group aged 16-19 years involved passengers. Although seatbelts can reduce crash mortality by 50% or more, little is known about the differences in driver-versus-passenger seatbelt use among teens. METHODS In 2007, data from the 2001 and 2003 Youth Risk Behavior Surveys were analyzed for 12,731 black, white, and Hispanic high school students aged >or=16 years reporting seatbelt use as both drivers and passengers. Seatbelt use was compared for driver- and passenger-seat positions, and stratified by age, gender, race/ethnicity, school grades, and histories of either drinking and driving or riding with a drinking driver. RESULTS Overall, 59% of students always used seatbelts when driving, but only 42% always buckled up as passengers. Across all covariate strata, passenger seatbelt use was significantly less prevalent than driver seatbelt use (p<0.001). A concordance analysis showed that only 38% of students always wore seatbelts both when driving and while riding as a passenger. Multivariate analyses indicated that, regardless of seat position, seatbelt use was lower for young men, blacks, students with poor grades, and students who reported either drinking and driving or riding with a drinking driver. CONCLUSIONS U.S. high school students aged >or=16 years are significantly less likely to wear seatbelts as passengers than as drivers. Interventions designed to promote seatbelt use among teens need to address this disparity.