In March 2011 a US insurance company, State Farm Insurance, announced the results of a study which showed 19% of drivers surveyed accessed the Internet on a smart phone while driving. In September 2010, the US National Highway Traffic Safety Administration (NHTSA) released a report on distracted driving fatalities for 2009. The NHTSA considers distracted driving to include some of the following as distractions: other occupants in the car, eating, drinking, smoking, adjusting radio, adjusting environmental control, reaching for object in car, and cell phone use. In 2009 in the US, there was a reported 5,474 people killed by distracted drivers. Of those 995 were considered to be killed by drivers distracted by cell phones. The report does not state whether this under or over represents the level of cell phone use amongst drivers, and whether there is a causal relationship.