The lack of an adult seat belt law in New Hampshire: Live free and die?

New Hampshire (NH) is the only state with no adult seat belt law. The lack of a restraint law may stem from a reluctance to infringe on individual freedoms. Dartmouth-Hitchcock Medical Center (DHMC) is located in NH, only 4 miles from the Vermont (VT) border. As a result, residents of both states are well represented in the Emergency Department (ED) population. This provided an opportunity to investigate the relationship between opinions, behaviors and the presence or absence of a restraint law. Adult DHMC ED patients were surveyed with respect to seat belt use in states with and without restraint laws, risk taking behaviors, and feelings of infringement on personal freedom. The results demonstrated no difference in restraint use between NH and VT residents while traveling in a state with a seat belt law. However, significantly fewer NH residents reported restraint use when traveling in a state without a seat belt law. These dissimilarities were not explained by differences in risk taking behaviors or by differences in feelings of infringement on freedom. This suggests that actual seat belt use reflects adherence to the law rather than concerns over personal freedom. This may inspire a reassessment of the acceptability of an adult restraint law in New Hampshire.