Passenger Presence and the Relative Risk of Teen Driver Death



      This study examines the relative risk of death among crash-involved teenage drivers in relation to the number and ages of passengers present.


      We performed cross-sectional analysis of police-reported crashes in the United States in years 2016–2019 to estimate rate ratios for death among drivers aged 16–17 years by passenger composition (no passengers, one teen, ≥two teens, teens and adults aged 20–34 years, adults aged 20–34 years only, ≥one adult aged 35–64 years). Models were adjusted for confounding and effect modification related to driver, crash, and environmental factors.


      Crash-involved teen drivers carrying ≥2 teen passengers were twice as likely to die as teens driving alone. The driver was seven times as likely to die when carrying a mix of teen and young adult passengers compared with teens driving alone. Teen drivers' risk of death was lowest in the presence of an adult passenger aged 35–64 years. Carrying one teen passenger presents greater risk of death than driving alone for male teen drivers but not for females.


      When teen drivers crash, they are more likely to die if they are carrying teen and/or young adult passengers than if they are driving alone or with a mature adult. The results support the current graduated licensing policies restricting young novice drivers from carrying teenage passengers. Results also help to clarify why previous studies have found that young passengers are associated with increased risk of fatal crashes, but not nonfatal crashes: it appears that passengers may have an effect on crash severity.


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        • Centers for Disease Control and Prevention
        Teen drivers: Get the facts.
        (Available at:)
        • Insurance Institute for Highway Safety
        Fatality facts 2018: Teenagers.
        (Available at:)
        • Ouimet M.C.
        • Pradhan A.K.
        • Brooks-Russell A.
        • et al.
        Young drivers and their passengers: A systematic review of epidemiological studies on crash risk.
        J Adolesc Health. 2015; 57: S24-S35
        • Tefft B.C.
        • Williams A.F.
        • Grabowski J.G.
        Teen driver risk in relation to age and number of passengers, United States, 2007-2010.
        Traffic Inj Prev. 2013; 14: 283
        • Chein J.
        • Albert D.
        • O'Brien L.
        • et al.
        Peers increase adolescent risk taking by enhancing activity in the brain's reward circuitry.
        Dev Sci. 2011; 14: F1-F10
        • Lambert A.E.
        • Simons-Morton B.G.
        • Cain S.A.
        • et al.
        Considerations of a dual-systems model of cognitive development and risky driving.
        J Res Adolesc. 2014; 24: 541-550
        • Steinberg L.
        A social neuroscience perspective on adolescent risk-taking.
        Dev Rev. 2008; 28: 78-106
        • Curry A.E.
        • Mirman J.H.
        • Kallan M.J.
        • et al.
        Peer passengers: How do they affect teen crashes?.
        J Adolesc Health. 2012; 50: 588-594
        • Simons-Morton B.
        • Lerner N.
        • Singer J.
        The observed effects of teenage passengers on the risky driving behavior of teenage drivers.
        Accid Anal Prev. 2005; 37: 973-982
        • Horrey W.J.
        • Wickens C.D.
        Examining the impact of cell phone conversations on driving using meta-analytic techniques.
        Hum Factors. 2006; 48: 196-205
        • Heck K.E.
        • Carlos R.M.
        Passenger distractions among adolescent drivers.
        J Safety Res. 2008; 39: 437-443
        • Chen L.H.
        • Baker S.P.
        • Braver E.R.
        • Li G.
        Carrying passengers as a risk factor for crashes fatal to 16- and 17-year-old drivers.
        JAMA. 2000; 283: 1578-1582
        • Simons-Morton B.G.
        • Ouimet M.C.
        • Zhang Z.
        • et al.
        The effect of passengers and risk-taking friends on risky driving and crashes/near crashes among novice teenagers.
        J Adolesc Health. 2011; 49: 587-593
        • Greenland S.
        Model-based estimation of relative risks and other epidemiologic measures in studies of common outcomes and in case-control studies.
        Am J Epidemiol. 2004; 160: 301-305
        • Graubard B.I.
        • Korn E.L.
        Survey inference for subpopulations.
        Am J Epidemiol. 1996; 144: 102-106
        • Zhang F.
        • Subramanian R.
        • Checn C.-L.
        • Noh E.Y.
        Crash report sampling system: Design overview, analytic guidance, and FAQs.
        National Highway Traffic Safety Administration, Washington, DC2019 (Report No. DOT HS 812 688)
        • Rueda-Domingo T.
        • Lardelli-Claret P.
        • Luna-del-Castillo Jde D.
        • et al.
        The influence of passengers on the risk of the driver causing a car collision in Spain. Analysis of collisions from 1990 to 1999.
        Accid Anal Prev. 2004; 36: 481-489
        • Padlo P.
        • Aultman-Hall L.
        • Stamatiadis N.
        Passengers and other factors affecting the safety of young and older drivers.
        Transp Res Rec. 2005; 1937: 7-13
        • Rice T.M.
        • Peek-Asa C.
        • Kraus J.F.
        Nighttime driving, passenger transport, and injury crash rates of young drivers.
        Inj Prev. 2003; 9: 245-250
        • National Center for Statistics and Analysis
        Traffic safety facts: Young drivers: 2018 data.
        National Highway Traffic Safety Administration, Washington, DC2020 (Report No. DOT HS 812 968)
        • Williams A.F.
        • Tefft B.C.
        Characteristics of teens-with-teens fatal crashes in the United States, 2005-2010.
        J Safety Res. 2014; 48: 37-42
        • Dishion T.J.
        • Owen L.D.
        A longitudinal analysis of friendships and substance use: Bidirectional influence from adolescence to adulthood.
        Dev Psychol. 2002; 38: 480-491
        • Brechwald W.A.
        • Prinstein M.J.
        Beyond homophily: A decade of advances in understanding peer influence processes.
        J Res Adolesc. 2011; 21: 166-179
        • Kandel D.B.
        Homophily, selection, and socialization in adolescent friendships.
        Am J Sociol. 1978; 84: 427-436
        • Andrews J.A.
        • Tildesley E.
        • Hops H.
        • Li F.
        The influence of peers on young adult substance use.
        Health Psychol. 2002; 21: 349-357
        • Mirman J.H.
        • Albert D.
        • Jacobsohn L.S.
        • Winston F.K.
        Factors associated with adolescents' propensity to drive with multiple passengers and to engage in risky driving behaviors.
        J Adolesc Health. 2012; 50: 634-640
        • Gardner M.
        • Steinberg L.
        Peer influence on risk taking, risk preference, and risky decision making in adolescence and adulthood: An experimental study.
        Dev Psychol. 2005; 41: 625-635
        • Monahan K.C.
        • Steinberg L.
        • Cauffman E.
        Affiliation with antisocial peers, susceptibility to peer influence, and antisocial behavior during the transition to adulthood.
        Dev Psychol. 2009; 45: 1520-1530
        • Steinberg L.
        • Monahan K.C.
        Age differences in resistance to peer influence.
        Dev Psychol. 2007; 43: 1531-1543
        • Mirman J.H.
        • Curry A.E.
        Racing with friends: Resistance to peer influence, gist and specific risk beliefs.
        Accid Anal Prev. 2016; 96: 180-184
        • Pradhan A.K.
        • Li K.
        • Bingham C.R.
        • et al.
        Peer passenger influences on male adolescent drivers' visual scanning behavior during simulated driving.
        J Adolesc Health. 2014; 54: S42-S49
        • Schiff M.A.
        • Cummings P.
        Comparison of reporting of seat belt use by police and crash investigators: Variation in agreement by injury severity.
        Accid Anal Prev. 2004; 36: 961-965
        • Miller T.R.
        • Gibson R.
        • Zaloshnja E.
        • et al.
        Underreporting of driver alcohol involvement in United States police and hospital records: Capture-recapture estimates.
        Ann Adv Automot Med. 2012; 56: 87-96