While alcohol-related fatalities have decreased overall since 1982, recent statistics indicate that alcohol-related fatality numbers remains higher than they were in the mid-1990s. This interim report presents the preliminary findings of a study designed to increase the effectiveness of the administrative and criminal justice systems in reducing the number of breath test refusals. Methodology involved a review of administrative and criminal penalties for breath test refusal and a review of breath test data from all States, the District of Columbia, and Puerto Rico. Case studies of five States with breath test refusal rates above the national average were also carried out in Connecticut, Maryland, Florida, Louisiana, and Oklahoma. The findings show that State laws vary widely in terms of administrative and criminal penalties for breath test refusal; in some States the administrative penalties for refusal are more stringent than for failing the test. Six of the eight States showing significant reductions in refusals during the study period had very restrictive license suspension laws for refusals that do not permit hardship or work permits during the suspension period. Case study findings indicate that in Florida, the consequences for refusal are less severe than the consequences for failing the test and in Louisiana, refusing the test actually benefits the criminal cases of offenders arrested for driving while intoxicated. In Oklahoma, the penalties for refusing the test are the same as for failing the test and thus, most repeat offenders refuse the test because it benefits their criminal case. In Connecticut and Maryland, on the other hand, first-time offenders generally receive less severe penalties for failing the test. The final step of the current study is to develop, implement, and evaluate countermeasures to deal with the problem of breath test refusal. Tables, figures, references, appendixes