Based on drivers` self-reports, the frequency of never using seat belts was twice as high in states with higher secondary law enforcement than in states with primary enforcement laws (Beck and Shults, 2009). States that move from secondary laws to primary enforcement laws experienced a median increase in observed belt use of 14 percentage points (Shults et al., 2004). In the European Union, seat belts were only mandatory in vehicles under 3.5 tonnes, until a 2003 directive made them mandatory in all vehicles in 2006. The Directive also clarified the seat belt for children and made it mandatory to deactivate the airbag for the use of rear-facing child restraint systems. There are some exceptions for five Member States — Belgium, Denmark, France, Sweden, Spain — and the United Kingdom.  Half of motorists killed in 2019 (49%) and 53% of passengers killed in 2019 used seat belts. Only 29% of rear seat occupants aged 13 and over, who were fatally injured, were tethered. Myth. For occupants of SUVs, pickup trucks and vans, seat belts reduce the risk of fatal injuries to the driver and passenger by 60%. Thirty-four states and the District of Columbia have a primary application. Primary enforcement laws allow a police officer to stop and quote a motorist simply because he or she is not using a seat belt.
In states where enforcement is secondary, the police can only enforce the law if the motorist has first been arrested for another offense. New York State passed in 1984 under the leadership of John D. USA, an orthopedic surgeon who dedicated his career to improving vehicle safety, the first law in the United States to make seat belt use mandatory.  Depending on a driver`s condition, failure to wear a seat belt in the front seat is either a primary or a secondary offense, except in New Hampshire, where there is no law requiring people over the age of 18 to wear a seat belt. In the front seat, the driver and each passenger must wear a seat belt, one person per seat belt. In some states, such as New York, New Hampshire and Michigan, rear seat belts are not mandatory for people over the age of 16. Drivers and passengers 16 years of age or older can be fined up to $50 each if they are not fastened to the seat belt. A 2008 study published in the Journal of Health Economics found that mandatory seat belt laws in the United States „significantly increased seat belt use among high school-aged teens by 45 to 80 percent“ and „significantly reduced fatalities and serious injuries from fatal accidents by 8 and 9 percent, respectively.  The authors note that these „findings suggest that if all states primarily enforced seat belt laws, regular seat belt use among youth would be almost universal and the number of teen deaths would decrease by about 120 per year.“  A counterpoint to the libertarian view is that by reducing deaths and serious injuries, mandatory seat belt use and enforcement of seat belt laws result in significant social benefits.
For example, an analysis by the Centers for Disease Control and Prevention found that in 2010, non-fatal injuries to motor vehicle occupants cost the United States $48 billion in medical expenses and lost labor.  An example is a driver without a seat belt who kills or injures another road user because he slips from the correct sitting position and cannot regain control of the vehicle in slippery conditions. Another notable scenario is that in the event of an accident, the rear passengers are pushed forward, accidentally injuring the driver or passenger. A study from the University of Wisconsin showed that victims of car accidents who did not wear seat belts cost on average 25% more to the hospital (and to the state in the case of the uninsured).  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. HS DOT 811,873; 2014. The struggle for seat belt laws in America in the 1980s reflected widespread criticism of government regulation in a free society. The controversy first flared up in 1973 when NHTSA required all new cars to include low-cost technology called the „seat belt locking mechanism,“ which prevented a vehicle from starting when the driver was not strapped. Member States shall require that all occupants aged three years and over of vehicles in service of categories M2 and M3 use the safety systems provided for during their seat, both at the front and at the rear.
Seat belts reduce the risk of serious injury or death in an accident. Research has shown that the risk of fatal injuries to car occupants in the front seat is reduced by 45% when pelvic straps and shoulder straps are used (NHTSA, 2017). The risk of moderate to severe injury is reduced by half. For those occupying the front seats of SUVs, vans and pickup trucks, the use of shoulder straps and shoulder straps reduces the risk of fatal injuries by 60% and moderate to serious injuries by 65%. If you are pregnant, make sure you know how to position your seat and wear a seat belt to maximize your safety and that of your unborn child. Read our recommendations below or see the instruction diagram version of our seat belt recommendations for pregnant drivers (PDF 497 KB). L. Beck and West, 2011, also reviewed data on injuries sustained by motor vehicle occupants under the 2001-2009 National Electronic Injury Monitoring Program – All Injuries (NEISS-AIP). The data are at the national level and do not allow comparisons between states with and without primary enforcement of seat belt laws, but show a 15.6% decrease in the violation rate, from 1,193.8 violations per 100,000 inhabitants in 2001 to 1,007.5 in 2009. . . .