Spain is placed among the European countries with a highest rate of road accidents. The highest risk of suffering a crash is between 15 and 24 years old. Spanish data show a worrying prevalence of DWI (driving while intoxicated) and its consequences, especially among youngsters. Frequency of DWI and magnitude of association with injuries and attributable risk are addressed, trying to measure the key elements which may built the epidemiological basis for successful prevention policies. From a Public Health point of view the focus should be on the alcohol consumption and drunk driving via health promotion and along the three levels of prevention. Primary prevention addressed to the main population has the advantage of including a much broader spectrum, but it loses strength. Assessing the efficacy and effectiveness of prevention campaigns is quite difficult. Secondary prevention focuses on risk population and allows concentrating efforts and addressing much more direct and adapted messages. Taking into account that attributable risk (AR) is of 67-98 per cent in injured people and of 20-40 per cent in drinkers, a reduction of 6-30 per cent in new alcohol-related crashes might be obtained if those DWI should abstain. Secondary / tertiary prevention concentrates on those who are at the highest risk or already damaged. It considerably reduces the target spectrum, but it allows performing a much stronger intervention and in a teachable moment. Moreover, it also allows a scientific research design and proper evaluation.