A LCOHOL IS PERHAPS THE MOST WIDELY USED PSYchoactive drug in the world. Its many health effects, both adverse and beneficial, have been well documented. For example, in 1998, alcoholrelated motor vehicle crashes claimed 15 935 lives in the United States, accounting for 38% of all traffic fatalities.1 Two articles 2,3 in this issue of THE JOURNAL highlight the particular circumstances of children who die in alcoholrelated motor vehicle crashes and shed some light on the relationships of these children to the alcohol-impaired drivers who caused their deaths.Quinlan and colleagues 2 from the Centers for Disease Control and Prevention examined the characteristics of children who were injured as passengers in alcohol-related motor vehicle crashes and the incidence of these crashes. Based on data from the Fatality Analysis Reporting System (FARS) for the years 1985-1996 and the General Estimates System for the years 1988-1996, the authors found that each year in the United States, alcohol-impaired driving resulted in more than 16000 injuries and claimed an average of 463 lives among child passengers aged 14 years and younger. Nearly two thirds (64%) of these fatally injured children and more than one-third (39%) of the children with nonfatal injuries were passengers in the same cars as the alcoholimpaired drivers. Moreover, children riding with alcoholimpaired drivers were less likely than other children to be wearing seat belts or be restrained in car seats.Margolis and colleagues 3 investigated the descriptive epidemiology of child fatalities from alcohol-related motor vehicle crashes in a broader context and using a different approach. In addition to passengers, Margolis et al included children younger than 16 years who, while walking or bicycling, were killed by drinking drivers. Unlike the study by Quinlan et al, 2 in which a well-established imputation method was applied to estimate the blood alcohol concentrations (BACs) for drivers without data on alcohol test results, alcohol involvement in the study by Margolis et al 3 was based solely on police assessment. Despite these differences in methods, the 2 studies found consistent and complementary results. Based on the analysis of FARS data for 1991-1996, Margolis et al 3 estimated that each year approximately 550 children younger than 16 years (437 passengers and 113 pedestrians or bicyclists) were killed in alcohol-related motor vehicle crashes, accounting for 20% of all traffic-related injury deaths in the same age group (26% of passenger fatalities and 11% of pedestrian or bicyclist fatalities); in 67% of the crashes, the fatally injured children were riding with the alcohol-impaired drivers.Three groups of alcohol offenders emerge from these studies 2,3 : (1) adult alcoholics, who often have prior drivingwhile-intoxicated (DWI) records and whose child victims are too often their own children; (2) underage drinkers, whose child victims are more likely to be their peer passengers and pedestrians or bicyclists; and (3) casual drinkers, who may not be alcohol-de...