The Distraction & Fatigue Thematic Report of the European Survey of Road Users’ Safety Attitudes (ESRA) has been published, as prepared by the Portuguese Road Safety Association, with the support of NTUA, containing a wealth of information on road safety in 39 countries across Europe, America and Asia-Oceania, based on the ESRA3 survey. This Thematic ESRA3 Report concerns distraction and fatigue in traffic. Self-declared mobile phone use while driving is prevalent across regions, with hands-free phone use being most common (51.0% in Europe22, 47.6% in America8, 44.3% in AsiaOceania6), while hand-held phone use and reading messages are less frequent but more common among men, younger drivers, and those with permissive attitudes; most road users view such behaviors as risky and unacceptable, with hands-free phone use seen as less risky, and enforcement perceptions and self-reported usage correlating with higher smartphone and internet use, indicating a gradual shift from hand-held to hands-free systems.