The findings in this report are subject to at least seven limitations. First, BRFSS surveys only those aged ≥18 years, so alcohol-impaired driving episodes of younger drivers are not included, which underestimates episodes. Second, an increasing proportion of adults use wireless telephones exclusively; as of the second half of 2010, 28% of adults lived in wireless-only households.13 These adults are younger and report a higher prevalence of binge drinking compared with adults with landline phones.14 Given the association among binge drinking, younger persons, and alcohol-impaired driving, omitting wireless-only households likely results in underestimating alcohol-impaired driving episodes. Third, a social stigma is attached to alcohol-impaired driving; therefore, self-reports might be spuriously low. Fourth, self-reported alcohol-impaired driving as defined by the BRFSS survey cannot be equated to a specific BAC; however 85% of alcohol-impaired driving episodes were reported by persons who also reported binge drinking. Fifth, the alcohol-impaired driving prevalence estimates for 12 states and DC were potentially unstable because of small sample sizes and/or high relative standard errors. Therefore, this report included only the stable state estimates. Sixth, this report uses one month self-reported estimates of alcohol-impaired driving to calculate an annual estimate. However, BRFSS is administered year-round, eliminating potential bias from seasonal fluctuations in alcohol-impaired driving. Additionally, using a 5-week recall period to estimate injuries has been found to result in a more accurate estimate than longer recall periods.15 Finally, the CASRO response rate for the 2010 BRFSS was only 55%, which increases the risk for response bias; although the large sample size might decrease this risk.