Driving following Kava Use and Road Traffic Injuries: A Population-Based Case-Control Study in Fiji (TRIP 14)

Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Robinson, Elizabeth; Herman, Josephine; McCaig, Eddie; Ameratunga, Shanthi · 2016 · Crossref

DOI: 10.1371/journal.pone.0149719

archive: archived pipeline: cataloged verified

Get this paper ↗ (DOI — opens at the source; we link to it, we don't host it)

Summary

This study investigates the association between kava consumption and the risk of serious injury-involved motor vehicle crashes in Fiji. While alcohol and other drugs are well-documented risk factors for road traffic injuries, little epidemiological evidence existed regarding kava, a traditional soporific beverage widely consumed in Pacific Island countries. Previous research was limited to inconclusive experimental studies using small therapeutic doses, whereas recreational use in the region involves significantly higher quantities. The authors aimed to determine if driving after consuming kava contributes to crash risk in a setting where such use is common. The researchers conducted a population-based case-control study on Viti Levu, Fiji, from July 2005 to December 2006. Cases consisted of drivers of four-wheeled motor vehicles involved in crashes resulting in death or hospitalization for at least 12 hours. Controls were recruited via a prospective two-stage cluster roadside survey designed to represent motor vehicle driving time in the study base. Data were collected using structured interviewer-administered questionnaires covering demographic characteristics, driving history, and substance use. The primary exposure variable was acute kava use, defined as consumption within the 12 hours prior to the crash or survey. Statistical analysis employed unconditional logistic regression to estimate odds ratios, adjusting for potential confounders such as age, gender, ethnicity, income, alcohol use, and road conditions. Among the 140 case drivers and 752 control drivers who completed interviews, 22.9% of cases and 4.3% of controls reported consuming kava in the preceding 12 hours. After adjusting for socio-demographic confounders, acute kava use was associated with a six-fold increase in crash odds (OR: 6.59; 95% CI: 2.88–15.09). Following further adjustment for usual kava frequency, acute alcohol use, time of crash, vehicle speed, and wet road conditions, the association remained significant with a four-fold increase in odds (OR: 4.70; 95% CI: 1.90–11.63). The population attributable risk was estimated at 18.37% (95% CI: 13.77–22.72), suggesting that nearly one-fifth of these serious crashes could be attributed to driving after kava use. No significant interaction was found between kava and concurrent alcohol use. Additionally, frequent usual kava use (several times a week to daily) was independently associated with increased crash risk (OR: 2.04; 95% CI: 1.10–3.79) after full adjustment. The findings indicate that driving following kava consumption is a significant risk factor for serious road traffic injuries in Fiji. This is the first epidemiological study to quantify this risk, highlighting a gap in road safety knowledge for Pacific Island nations. The authors conclude that road safety strategies should explicitly recommend avoiding driving after kava use, particularly in communities where recreational consumption is prevalent. They advocate for the application of the precautionary principle to inform policy, despite challenges in objectively measuring kava impairment.

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed.

Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• polydrug