A telephone survey was conducted in four countries in November 1998 to compare drivers in the United States with those in Australia, Canada, and the United Kingdom regarding their attitudes toward seat belts and belt use laws. More than 90 percent of the 2251 respondents said they thought seat belts are effective, but self-reported belt use was significantly lower in the United States than in the other countries. Respondents in Australia and the United Kingdom had similar views about what they thought were important reasons for using seat belts and had the highest self-reported use. Reasons given for using belts by Canadian and US respondents were quite similar to one another, yet US respondents had significantly lower self-reported use rates, a difference thought to be due to vigorous enforcement of the law in Canada. US drivers were less likely than Australian and UK drivers to say they used belts out of habit, to avoid a ticket, or because it is required by law and more likely to say they used belts for situational reasons. US drivers were least likely to be in favor of belt use laws. Canadian drivers reported the most experience being checked by police for belt use and were most likely to think that nonusers would be caught. US drivers in primary enforcement jurisdictions were more likely than those in secondary jurisdictions to think that drivers not using belts would be caught and more likely to say they always used belts. Results of this survey indicate that seat belt use in the United States could be increased by adoption of primary enforcement laws and highly visible enforcement programs of the type used in Canada, and that seat belt use could be increased in all countries by increasing the penalties for nonuse.