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and deaths by about half, and seat belt laws and enforcement strategies have been proven to increase seat belt use.
Primary enforcement seat belt laws allow law enforcement officers to stop vehicles if a driver or passenger is not wearing a seat belt.
Secondary enforcement seat belt laws require law enforcement officers to have some other reason for stopping a vehicle before citing a driver or passenger for not using a seat belt.
The most comprehensive seat belt policy is a primary enforcement seat belt law that covers all occupants, regardless of where they are sitting in the vehicle.
CDC reports that, as of August 1, 2013,
- 17 states and the District of Columbia had a primary enforcement seat belt law covering all seating positions
- 16 states had a primary enforcement seat belt law covering only the front seats
- 17 states had a secondary enforcement seat belt law or no law
coupled with existing seat belt enforcement efforts. The publicity components of enhanced enforcement campaigns aim to increase public awareness of heightened enforcement.
and the importance of wearing a seat belt. Enhanced enforcement campaigns include supplemental patrols, an increased number of officers on patrol,
or targeted patrols, which aim to increase citations during regularly scheduled patrols.
Primary vs secondary seat belt laws.
How can this strategy result in health benefits?
- Improve safety
- Reduce motor vehicle-related injuries and fatalities
How has this worked in practice?
Demonstration of the “Trauma Nurses Talk Tough” Seat Belt Diversion and Increased Enforcement Program in North Carolina
North Carolina has a primary seat belt law and relatively high fines and fees. The North Carolina Governor’s Highway Safety Program implemented and evaluated a Trauma Nurses Talk Tough.
(TNTT) program in Robeson County to address persistently lower than average seat belt usage rates of around 80% in the county.
The study period ran from April 1, 2010 to June 30, 2011.
Where can I learn more?
CDC’s 2013 Prevention Status Report for Motor Vehicle Injuries provides statistics about seat belt laws and data and research supportive of seat belt laws and seat belt use.
The Guide to Community Preventive Services (the Community Guide):
What Works to Promote Health addresses laws mandating the use of seat belts.
enhanced enforcement programs, and studies of seatbelt effectiveness on the site Motor Vehicle-Related Injury Prevention: Use of Safety Belts
NHTSA sponsors Buckle Up campaigns and provides information and data to increase the use of seat belts and other occupant protection.
County Health Rankings and Road Maps
provides information on methods for making communities healthier, including a description of the connection between seat belt laws, enhanced enforcement, and health.
Beck LF, West BA. Vital signs: nonfatal, motor vehicle–occupant injuries (2009) and seat belt use (2008) among adults—United States. Morbidity and Mortality Weekly Report 2011;59:1681-6.
Centers for Disease Control and Prevention (CDC). Motor Vehicle Injuries PSR|2013. State, Tribal, Local, and Territorial Public Health Professionals Gateway.
Community Preventative Services Task Force. The Guide to Community Preventive Services (The Community Guide): Motor Vehicle-Related Injury Prevention
Sleet DA, Shults RA, Zaza S, Elder RW, Nichols JL, Thompson RS, Sosin DM, Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase the use of safety belts.
American Journal of Preventive Medicine 2001;21(4S):48-65.
Glassbrenner D, Starnes M. Lives saved calculations for seat belts and frontal air bags. Washington, DC: NHTSA, U.S. DOT. DOT HS 811 206; 2009.
Kahane C. Fatality reduction by safety belts for front-seat occupants of cars and light trucks. Washington, DC: NHTSA, U.S. DOT. DOT HS 809 199; 2000.
Miller TR, Levy DT. Cost-outcome analysis in injury prevention and control: Eighty-four recent estimates for the United States.
Medical Care 2000;38(6):562-82.
Shults RA, Elder RW, Sleet DA
Thompson RS, Nichols JL. Primary enforcement seat belt laws are effective even in the face of rising belt use rates. Accident Analysis and Prevention 2004;36(3):491-3.
Shults RA, Nichols JL, Dinh-Zarr TB, Sleet DA, Elder RW. Effectiveness of primary enforcement safety belt laws and enhanced enforcement of safety belt laws:
a summary of the Guide to Community Preventive Services systematic reviews. Journal of Safety Research 2004;35(2):189-96.
Thomas FD, Blomberg RD, Fairchild J, Cosgrove L. Demonstration of the Trauma Nurses Talk Tough seat belt diversion program in North Carolina. Washington, DC: NHTSA, U.S. DOT. DOT HS 811 873; 2014.
University of Wisconsin Population Health Institute. Enhanced seat belt enforcement programs
. County Health Rankings and Roadmaps; 2014.
Seat Belt Law – Summary
All drivers and passengers age 16 and older must wear their seat belts in both the front and back seats. Children less than age 16 are covered by the NC Child Passenger Safety law.
The seat belt law applies to all vehicles required by federal standards to have seat belts. In general, these are cars made after 1967 and light trucks, vans, and SUVs made after 1971.
The law requires use of the entire seat belt system present in the seat. Unless a seating position has a lap-belt-onlt seat belt, both the lap and shoulder belt must be properly worn. Placing the shoulder belt behind the back or under the arm is not allowed.
The following exemptions to the law exist:
- Vehicles not required to have belts. In general, these are cars made before 1968 and light trucks, vans, and SUVs made before 1972.
- Drivers of noncommercial motor vehicles with a professionally certified medical condition or mental phobia preventing use.
- Rural letter carriers and newspaper carriers while performing duties.
- Frequently stopping delivery vehicles if speed between stops does not exceed 20 mph.
- Vehicles with “Farm” license plates while being used for agricultural purposes in intrastate commerce.
- Any occupant of a motor home, as defined in G.S. 20-4.01(27)d2, other than the driver and front seat passengers.
- Backseat occupants of law enforcement vehicles while in custody.
- Passengers of residential garbage or recycling trucks during collection rounds.
- The driver of the vehicle is responsible for himself and all children less than sixteen.
- Passengers ages sixteen and older are responsible for themselves.
Drivers and Front Seat Occupants Ages 16 and Older.
- Penalty of $25.50
- Partial court costs
- No driver license or insurance points are assessed.
Rear Seat Occupants Ages 16 and Older
- Penalty of $10
- No court costs
- No driver license or insurance points are assessed.