Introduction Graduated driver licensing systems typically require an extended learner permit phase, and create night-time driving or passenger restrictions for adolescent drivers. Restricted driving might increase the use of alternative transportation to replace driving and consequently increase crashes and injuries for passengers, bus riders, pedestrians, and bicyclists. This study examined whether graduated driver licensing increases non-driver fatalities among adolescents, and whether it reduces total traffic fatalities combining drivers and non-drivers. Methods Longitudinal analyses were conducted using data from the 1995-2012 U.S. Fatality Analysis Reporting System. Adjusted rate ratios were estimated for being fatally injured in a crash according to: (1) presence/absence of a graduated driver licensing system; and (2) four levels of graduated driver licensing systems (absent, weak, medium, strong). Analyses were conducted in 2015. Results Among adolescents aged 16 years, graduated driver licensing was not associated with increased passenger fatalities (adjusted rate ratio, 0.96; 95% CI=0.90, 1.03) or pedestrian and bicyclist fatalities (adjusted rate ratio, 1.09; 95% CI=0.85, 1.39), but was associated with an 11% reduction in total traffic fatalities. Among those aged 17 years, graduated driver licensing was not associated with increased fatalities as passengers, pedestrians, or bicyclists, and was not associated with reduced total traffic fatalities. Conclusions In general, graduated driver licensing systems were not associated with increased fatalities as passengers, pedestrians, bicyclists, and bus riders. Graduated driver licensing systems were associated with reduced total fatalities of adolescents aged 16 years.
