The aim of this review study is to compile and analyse the state of knowledge

regarding the effects of measures, both legislative and noncompulsory, taken

to increase the use of cycle helmets. The results are based mainly on studies

from 1990-2002 found in literature databases. The overall conclusion is that

a considerable increase in helmet use by cyclists could be achieved by

noncompulsory measures, but the use levels are not as high as those achieved

by legislation. Most of the positive effects of noncompulsory measures are

due to multistrategy programmes at municipal and regional level, where the

programmes mostly comprise informational and educational activities in

combination with discounts on helmets or reward systems. There is however

great variation in the level of helmet use that has been achieved; the

observed helmet use which most of the measures achieve seldom exceed 50 % for

children/young people and ca 25-30 % for adult cyclists. However, cycle

helmet laws in combination with informational and educational activities

leads to significantly higher helmet use compared to noncompulsory measures

alone. Helmet use often reach 80-90 % on average. Several studies show that

helmet laws reduce head injuries among bicyclists. In Australia, for

instance, number of fatalities among cyclists decreased by 45 % in average

two years after their helmet laws compared to two years before. The effect of

cycle helmet laws on cycling is much debated, but results from studies are

not unambiguous. Several studies, however, indicates that a cycle helmet law

may result in a reduction in cycling by young people and in a certain, but

temporary, reduction in cycling by younger children. On the other hand,

cycling by adults is probably not influenced.