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Evidence demonstrating the advantages of seat belts in improving safety of road travel is overwhelming and has resulted in government legislation. This study was performed to investigate compliance with this legislation by fast-moving traffic on British motorways, for which no previous data exists. Analysis of seat belt use by 2564 travellers in 1526 cars in October 1992 revealed the following rates of use: drivers 98%; front passengers 96%; rear seat passengers with available belts 53%. The overall low rate of rear seat restraint use was seen in all age groups except babies. When the study was repeated 8 months later, the rates of restraint amongst 3910 travellers in 1881 cars had not increased. In view of the continuing heavy death toll on British motorways and roads, there is an obvious need for measures to improve rear seat belt use. This would be most appropriately achieved by both enforcing and publicizing the current legislation.