Drivers' distraction because of mobile phone talking is dangerous and as well hazardous to close relationships
December 2010

Talking or texting behind the wheel is roughly equivalent to driving drunk.

It's time for physicians to talk to patients about driving while distracted, a problem that has risen to the rough equivalence of drunken driving thanks to the proliferation of phones that allow drivers to talk and text, Amy Ship, MD, a primary care physician at Beth Israel Deaconess Medical Center suggests.

Writing in the June 10 issue of the New England Journal of Medicine, Ship notes physicians routinely ask patients about habits associated with potential harm like the use of helmets, seatbelts, cigarettes, condoms, drugs and alcohol. And with data showing 28 percent of all accidents in the United States are caused by drivers talking on cell phones or texting, it's time to step into this issue too.

"When a doctor raises an issue while providing overall preventive care, the message is different from that conveyed by a public service announcement nestled between ads for chips and beer or a printed warning on a product box," she writes. "It's time for us to ask patients about driving and distraction."

While the absolute increase in the risk of collision attributable to distracted drivers is hard to assess, Ship says one study showed talking and driving posed a four time greater risk than undistracted driving. A second study suggested texting raised the risk of collision by a factor of 23.

"More than 275 million Americans own cell phones and 81 percent of them talk on those phones while driving. The adverse consequences have reached epidemic proportions."

Ship acknowledges that while there is little solid evidence that screening questions about drugs, alcohol smoking and other risks have any benefit, that fact has never stopped clinicians from making inquiries.

"As our technology evolves, our questions must be updated in keeping with the risks," she says.

In her own practice, where Ship queries all her patients annually on this issue, she occasionally encounters patients who wonder why talking on the phone, even with a hands-free device, is more dangerous than talking to a passenger.

"First is the obvious risk associated with trying to maneuver a phone, but cognitive studies have also shown that we are unable to multitask and that neurons are diverted differently depending on whether we are talking on a phone or talking to a passenger," she says.

But for the ultimate skeptic, Ship has a ready response:

"How would you feel if the surgeon removing your appendix talked on the phone – hands-free of course – while operating?"

Ultimately, Ship says, clinicians have an obligation to adapt to societal changes and update their model of preventive care.

"Primary care doctors are uniquely positioned to teach and influence patients: we should not squander that power. A question about driving and distraction is as central to the preventive care we provide as the other questions we ask. Not to ask – and not to educate our patients and reduce their risk – is to place in harm's way those we hope to heal."

One more reason not to use phone while driving: "Talking on your cell phone while driving may be hazardous to your close relationships" says University of Minnesota professor Paul Rosenblatt.  Warnings about the dangers of distracted driving while using a cell phone are prevalent these days, but cell phone use while driving may also put family relationships in jeopardy.

The same factors that make using a cell phone while driving more hazardous -- longer reaction times and impaired attention -- can also make family communication in that situation more risky, says Rosenblatt in an article in the current issue of Family Science Review.

The article, authored by Rosenblatt and graduate student Xiaohui Li, provides a speculative theoretical analysis on the topic. Rosenblatt is a family social science professor in the university's College of Education and Human Development.

"If we assume that the relationship risks involved in talking on a cell phone while driving are similar to the driving risks -- both tasks involve divided attention and distraction -- we can develop ideas about how a family relationship may be impaired," Rosenblatt says in the article.

For example, studies have indicated that cell phone use while driving leads to slower reaction times on the road. This could translate to the driver's cell phone conversation as well.

"A delay in the conversation could be a problem if the person (spouse or partner) on the other end of the conversation interprets the delayed reaction as an indicator of ambivalence, of not having a ready answer or of hiding something. This all leads to upsetting the partner," Rosenblatt says.

And, what if the driver misses important details of the conversation? This could lead to misunderstandings and more hard feelings, he says.

"In general, cell phone usage while driving might lead to missed relationship stop lights, slow reactions to dangerous relationship circumstances, loss of control of one's part of the interaction, and interaction mistakes that could lead to conflict, hurt feelings, misunderstandings, and possibly even serious damage to the relationship," Rosenblatt says in the article.

The partner who is not driving might be worried about the driver's safety and may cut a conversation short so the driver can concentrate, but the driver might interpret that in a negative way.

In addition to the relationship problems created by talking on cell phone while driving, a number of problems arise that both people have when one of them is driving while talking on a cell phone.

The lack of visual cues including gestures, facial expressions and posture creates challenges. Poor cell phone reception and the noise from the automobile and the road can all contribute to misunderstandings, he says.

In the article, Rosenblatt explores five hypothetical examples of possible relationship problems that could arise when a driver is talking with a family member via cell phone. The examples he explores include the partner asking the driver to run an errand; a family member calls with good news; a family member calls with bad news; arguments over the phone and apologies over the phone. Each of the scenarios can be wrought with frustration and misunderstanding.

Most relationships can manage the added difficulties related to cell phone use.

"However, for couples in which things have been so difficult that they both are considering ending the relationship, problems arising from a difficult phone conversation, may push their relationship to the tipping point," Rosenblatt says.

Bibliography - Sources

1. New England Journal of Medicine
2. Beth Israel Deaconess Medical Center
3. Harvard Medical School
4. University of Minnesota
5. Family Science Review