College Student Use of Transportation Networking Companies: An Opportunity to Decrease Substance-Impaired Driving

Abstract

Objective:

Examine use of transportation networking companies (TNCs) (e.g. Uber) among substance-using students in rural and urban college settings.

Participants:

Students at two large state universities were randomly selected and screened for substance use. Participants reported use of TNCs generally and after substance use and whether TNC use was on or near campus or in other environments.

Methods:

Data were evaluated using chi-square test, t-tests, and Fisher’s exact tests.

Results:

Most (85%) participants (n=99, 61% response rate) had used a TNC. Among students who used TNCs on/near campus, 98% of rural students used them after substance use compared to 85% of urban students (p=0.037). We did not detect differences in TNC use by gender or age.

Conclusions:

Results indicate that TNC use is common after college student substance use and may play a particularly important role in preventing impaired driving for rural campuses where existing transportation options are limited.

Substance-impaired driving remains a problem among college students. National data indicate that 12% of college students reported driving after substance use (alcohol, marijuana, or other drugs) in the 30 days prior to being surveyed.¹ Nearly 10% of college undergraduate students report driving after drinking alcohol in the past year.² Using the most recent data available, Hingson and colleagues estimated that in 2014, approximately 1,500 U.S. college students between the ages of 18 and 24 died from alcohol-related unintentional injuries, including motor vehicle crashes.³ Compared to females, males drive more frequently,⁴ drive while impaired more frequently,² and they are over-represented among drivers involved in motor vehicle crashes. In the general population, those residing in rural areas are also at highest risk of impaired-driving.⁵

Transportation Network Companies (TNCs) such as Uber and Lyft are mobile applications (apps) that connect drivers using their own vehicles directly with passengers who pay for rides via the app.⁶ In one study, researchers found that Uber’s entry into California cities was associated with a 3.6–5.6% decrease in alcohol-related motor vehicle fatalities (MVFs),⁷ but Brazil and Kirk (2016) found Uber’s deployment in the 100 most populated metropolitan areas had no effect on alcohol-related MVFs.⁸ Understanding use of TNCs and potential effect by age group (e.g. under or over 21 years) or by college attendance was beyond the scope of these studies, but could have implications for prevention of impaired driving. Furthermore, the role of TNCs role in safe transportation after substance use in non-urban areas remains unknown. In these areas, TNCs may increase access to safe transportation more than in urban areas with already robust public transit. With high rates of substance use on college campuses,^2,9 the role of TNCs may be especially useful in preventing motor vehicle crash injuries for this population. The aims of the present study were to describe the prevalence of TNC app use among substance-using college students and compare patterns in use of TNC apps across an urban and rural university setting.

Methods

Study participants were part of a larger on-going study of undergraduate students at two large state universities, one urban campus in Washington State and the one rural campus in Massachusetts. A random sample was drawn from university registrar lists and 1462 potentially eligible students were contacted by telephone and email for screening (45% response rate). Eligible students were: age 18–23 years, enrolled at one of the two included universities, recent users of alcohol, marijuana, or other drugs at time of enrollment, and owners of a mobile phone. A screening questionnaire was used and 264 eligible individuals were identified. A total of 207 individuals (78.4%) completed an in-person interview between January and December 2015. The study population consisted of 140 students (67.6%) from the rural campus and 67 from the urban campus. The interview included computer assessment of substance-related measures, including the AUDIT.¹⁰ After completing the interview, participants indicated on a form whether the research team could contact them in the future about opportunities to participate in related research. A total of 163 participants (78.4%) consented to being re-contacted. The research was approved by the Institutional Review Boards at the University of Massachusetts Amherst and Seattle Children’s Research Institute and was covered by a federal Certificate of Confidentiality.

Within 12 months of participation in the parent study, all 163 original participants who provided consent to be re-contacted were recruited for the present study. These students were invited by email and text-message to complete a brief online survey about TNCs. The online survey was conducted between December 7, 2015 and January 27, 2016. After reviewing an informed consent form and clicking a box to provide their consent, participants completed the survey which was designed to ascertain the individual’s lifetime use of TNCs, use of TNCs after substance use, and all locations where TNCs were used. To examine how rurality and the context of college life may influence TNC use, locations were categorized as within the campus setting (i.e. same town or city) or outside of it. Survey participants were entered into a raffle for a $40 gift card. We examined whether survey respondents from each University were demographically similar to individuals who had been invited to complete the second TNC survey but did not respond. Data were evaluated using descriptive statistics, t-tests, chi-square tests, and Fisher’s exact tests when cell sizes were below five.

Results

Of the 163 students who agreed to be re-contacted, 99 (60.7% response rate) completed the TNC survey. Slightly more than half of participants were female, 30.3% reported having a minority racial or ethnic background (i.e. were not White, non-Hispanic) and 69.7% attended the rural university (Table 1). A majority of respondents (59.6%) were under age 21 years, with no age differences across schools (p=0.817). The mean age was 20.2 years (SD=0.91) among Washington students and 19.9 years (SD=1.3) among Massachusetts students; an independent t-test indicated this was not a statistically significant difference across schools (p =0.073; 97 df).

Table 1:

Sample demographics and substance use characteristics

	Rural Massachusetts campus (n=69)		Urban Washington campus (n=30)		Total (n=99)
	n	%	n	%	n	%	p-value
Female	37	53.6	19	63.3	56	56.6	0.522
Age < 21 years	40	58.0	19	63.3	59	59.6	0.817
Race/Ethnicity
White/Caucasian	56	81.2	20	66.7	76	76.8	0.051
Asian	9	13.0	9	30.0	18	18.2	0.059
Black/African American†	3	4.3	0	0.0	3	3.0	0.550
Hispanic/Latino*†	3	4.3	4	13.3	7	7.1	0.201
Other†	1	1.4	1	3.3	2	2.0	0.175
AUDIT score†							0.436
0-7 - harmful drinking unlikely	38	55.1	16	53.3	54	54.5
8-15 - potentially hazardous/harmful drinking	29	42.0	13	43.3	42	42.4
16+ - Likely alcohol problems	1	1.4	2	6.7	3	3.0
6 or more drinks per occasion, ≥2 times/week	14	20.3	4	13.3	18	18.2	0.358

Note:

^*asterisk indicates this variable was not mutually exclusive with others.

^†P-values from chi-squared test or Fisher’s exact test in instances when the expected frequency was less than 5.

Survey respondents did not differ from those who did not respond by race, gender, age above or below 21 years, binge drinking in the past year, or lifetime marijuana use (Table S1).

A majority (84.8%) of students had used a TNC (and Uber specifically) in their lifetime. Table 2 shows comparisons of TNC-related variables across universities. A higher proportion of students on the urban campus (83.3%) reported using TNCs on/near campus compared to the rural campus (66.7%) (p=0.048). Among students who used TNCs on/near campus, about 98% of rural students used them after substance use compared to 84% of urban students (p=0.030). Overall, a majority (76 of 99 students, or 76.8%) of students reported using a TNC to obtain a ride after alcohol or drug use.

Table 2:

Transportation networking company (TNC) use by college students in rural or urban campus locations

	Rural Massachusetts campus (n=69)		Urban Washington campus (n=30)		Total (n=99)
	n	%	n	%			p-value
Ever used any TNC	58	84.1	26	86.7	84	84.8	0.739
Ever used Uber	58	84.1	26	86.7	84	84.8	0.739
Ever used other TNC	4	5.8	14	46.7	18	18.2	<0.001
Ever used TNC on/near campus	46	66.7	25	83.3	71	71.7	0.048
Used any TNC after alcohol or drug use*	45	97.8	21	84.0	66	93.0	0.030
Only used TNC when away from campus†	12	17.4	1	3.3	13	13.1	0.101
Used any TNC after alcohol or drug use**†	9	75.0	1	100.0	10	76.9	0.569
Ever made Uber request from own phone	42	60.9	19	63.3	61	61.6	0.889
Ever made Uber request from friend’s phone	54	78.3	23	76.7	77	77.8	0.861

Note: TNC= transportation networking company; Other TNCs included Lyft and Flywheel.

^*asterisk indicates that this proportion is out of those participants who used a TNC on or near campus.

^**double asterisk indicates that this is out of those participants who only used a TNC when away from campus.

^†P-values from chi-squared test or Fisher’s exact test in instances when the expected frequency was less than 5.

Additional analyses (Table S2) revealed no statistically significant differences in the proportion of students who used or did not use a TNC after substance use by underage status (p=0.887) or gender of the respondent (p=0.996). A similar proportion of students under age 21 reported using a TNC after substance use (76.3%; 45 of 59 students) compared to those who were 21 or older (77.5%; 31 of 40 students). Of the 76 students who used a TNC after alcohol or drug use, 22.4% reported having 6 or more drinks 2 or more times per week compared to only 4.4% among those who did not use TNCs after substance use, but this was not statistically significant (p=0.064).

Comments

Results from this study indicate that the vast majority of substance-using college students in our study population have used a TNC and done so for transportation after an episode of substance use. Use of TNCs, generally, was higher among students on an urban campus compared to a rural campus. However, among those who used TNCs on or around their campus, TNC use for transport after using alcohol or drugs was higher for rural-campus students. Our findings are noteworthy because prior researchers have focused on TNC use in urban environments, but crashes and DUI offenses are more common in rural areas.^7,11

Previous researchers have suggested that TNCs may be a substitute for taxis or public transit, but not for impaired driving.⁸ In rural areas, especially college areas, this may not be the case; TNCs may add an important option for the large numbers of college students who use substances and need safe transportation. In rural campus communities, students may be more likely to use TNCs compared to rural residents, and help create a more robust market for TNC services overall. We would expect greater availability of TNCs in urban areas, which is consistent with our finding that use of TNCs for any purpose was higher on the urban campus. However, if TNC drivers in rural campus areas stay close to the campus to meet the demand for rides from students, that could help explain why we observed higher TNC use for transport after alcohol or drug use among rural campus students compared to urban students. Our study adds to the literature by indicating that TNCs play a role in safe transportation after substance use in rural areas in addition to urban centers.

Limitations

Although our sample is modest, survey participants were demographically similar to non-respondents within the population that agreed to be re-contacted. This study also offers geographic diversity. A limitation of this work is that we did not ask about specific substances used; how TNC use may vary after alcohol, marijuana, or other drug use is a worthwhile area for future study. We also did not ascertain use of other transportation such as taxis or buses, and did not assess impaired driving. We did not address whether it is the urbanicity of the campus setting or other factors about the included universities or students that explained observed differences between campuses. Future research to address these limitations, extend this work to other universities, and understand how students’ transportation decisions are made after substance use when TNCs are an available option are warranted.

Conclusion

Given the high prevalence of use among study participants, TNCs should be considered an option as college campuses and surrounding communities devise strategies to decrease impaired driving. Currently, there are policy debates in many U.S. and international locations about whether to allow TNCs and how to regulate them.^12,13 Safety of college and university students after episodes of substance use may be increased in areas where TNCs represent a transportation option and other options are more limited. Our findings should also motivate additional research about TNCs and their role in preventing impaired driving.

Abbreviations:

TNC

Transportation Networking Companies

DUI

Driving while under the Influence

Apps

Applications

AUDIT

Alcohol Use Disorders Identification Test