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Background  Because Saudi Arabia (SA) has struggled with the burden of Road Traffic Injuries (RTIs) for decades, a new automated citations system was implemented in 2018 to improve compliance with seatbelt and mobile phone laws. Therefore, the purpose of this study is to evaluate the impact of the system on the prevalence of seatbelt and mobile phone use among drivers in Riyadh. This is an observational study conducted between 2017 and 2018. A Pre-Post evaluation was employed to determine the impact of a camera detection system on seatbelt and mobile phone use. Two research coordinators collected the observations at several highways and inner intersections around Riyadh ( n  = 3400). We evaluated differences in the prevalence of seatbelt and mobile phone use across the two time periods using a chi-2 test. In addition, we evaluated the association between the new intervention and traffic violation using a logistic regression model.    Results  The overall seatbelt compliance increased significantly from 33.9% (95% CI = 31.7–36.2) to 75.8% (95% CI = 73.7–77.8;  P  < 0.01). In addition, mobile phone use declined significantly from 13.8% (95% CI = 12.2–15.5) to 9.8 (95% CI = 8.8–9.1;  P  < 0.01). We found the detection system to be associated with a significant increase in seatbelt use and also a significant decline in mobile phone use while driving. After implementing the intervention, drivers were 6.1 times (OR = 6.1, 95% CI = 5.2–7.0) more likely to wear seatbelts than before the technology went into effect. Similarly, drivers observed after implementing the cameras were 32% (OR = 0.68, 95% CI = 0.55,0.84) less likely to use mobile phones while driving than those seen prior to the intervention.    Conclusions  This study found a significant reduction in traffic violations following the implementation of a camera detection system in Riyadh. This positive impact is evidence for the role preventative structural strategies play to improve traffic safety and reduce RTI in SA. Therefore, these findings may facilitate further support for policymakers that public health interventions play a significant role to improve traffic safety. Seatbelt and mobile phone use while driving should continue to be monitored, and traffic police may evaluate whether increasing the fine is associated with a significant reduction in traffic violations and associated crashes.

injury epidemiology.

The effectiveness of introducing detection cameras on compliance with mobile phone and seatbelt laws: a before-after study among drivers in Riyadh, Saudi Arabia