This article explores reasons that may support a decision by young drivers to drink and drive. Forty focus group discussions on driving and traffic safety were conducted with 316 volunteers 18 to 22 years of age in 10 cities in the United States and two cities in Canada. The audiotaped discussions identified some factors that may influ ence young peoples' decisions to drink and drive, such as inappropriate knowledge about alcohol and driving, lack of decision making skills, and the tendency to ignore the increased risk of drinking and driving. While some respondents drove intoxicated because they were unaware of the dangers, others rationalized their drinking and driv ing behavior. Improved understanding about the nature and extent of the factors influ encing young drivers' decisions to drink and drive is essential to planning effective health education programs.