The drink-drive limit should be slashed, while new legislation should also be introduced to allow random breath tests, according to a report for the Department for Transport (Dft).
The review, commissioned by then Transport Secretary Lord Adonis, recommends a reduction in line with the majority of European countries, from 80mg of alcohol in 100ml of blood, to 50mg.
This would save an estimated 168 lives in the first year, rising to 303 lives per annum after six years. It is estimated that around 430 road deaths are alcohol-related in the UK each year.
The study also recommends retaining the minimum 12-month ban and, after five years, a further review of whether new and/or young drivers should be subject to an even lower 20mg/100ml alcohol limit.
While many fear that younger drivers have switched to drug-driving, the review says data is patchy.
The review has called for drug breathalysers to be approved and introduced at the 'earliest practicable' date.
Police have been calling for such equipment for many years, but the Home Office has never given the necessary 'type approval' for their use.