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Objective: The objective of this study was to assess the frequency and determinants of road traffic accidents among drivers of Peshawar, Kohat, and Swat Districts, Khyber Pakhtunkhwa, Pakistan. Methods: A cross-sectional descriptive study was conducted by the Department of Community Medicine at Nowshera Medical College, Nowshera, from August 2023 to March 2024. After obtaining ethical approval, a total of 159 drivers were enrolled. A self-structured questionnaire was used to collect information regarding demographics & determinants of road traffic accidents. SPSS Software version 23.0 was used for data analysis, and finally, results were presented in tables. The chi-square test was used for statistical association. Results The prevalence of accidents was 59.75%. Moreover, 10.69% of drivers had an age < 18 years; 70.44% were tobacco smokers, 54.08% had < 5 years of driving experience, and 59.12% were illiterate. Additionally, 68.55% had a monthly income of less than 35000 PKR, 55.97% worked 7 days a week, and 27.04% had no valid driving license. Furthermore, 76.10% didn`t check their vehicles; 27.04% had no driving license, 65.41% used mobile while driving, 37.11% were using seat belts, and 30.82% were over-speeding. Conclusions The prevalence of accidents was moderate to high rate. The important determinants of road traffic accidents revealed a strong significant association with age, years of driving experience, literacy status, hours of sleep per day, tobacco & other drug addiction. Moreover, the use of mobile phones, availability of seat belts & their compliance, and over-speeding were important determinants, and thus, appropriate measures were needed to prevent and reduce the prevalence of road traffic accidents. Key Words Road Traffic Accidents: Drivers, Illiteracy, Tobacco Smoking, Seat Belts, Seat Belt, Mobile.

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