EDITOR, - Leonard Evans refers to a rise in the rate of motorcycle deaths after repeal of motorcycle helmet legislation in about half of the United States.1 However, the rise in deaths per registered motorcycle was actually greater in the states that continued to enforce the use of motorcycle helmets. These and other data strongly indicate the futility of helmet legislation.2

Two scientific problems make it difficult to describe the effect of helmets on injuries to pedal cyclists. Firstly, people who voluntarily wear helmets tend to be different from those who do not; this confounds published studies of voluntary wearing so badly that the results cannot support arguments for helmet use. Secondly, modern road use intrinsically involves balancing risks, and people in pursuit of a goal have a strong tendency to compensate for one lowered risk by increasing exposure to other risks.2 Indeed, W Robert Pitt and colleagues' graph suggests an increase of non-head injuries due to cycle helmets.3

C Maimaris and …