Abstract
BackgroundAlcohol and firearms are commonly involved in suicide in the United States. State alcohol and firearm policies may impact alcohol and firearm related suicide, yet little is known about these relationships. This study examines relationships between state alcohol and firearm policies and suicides involving alcohol, guns, or both, and explores interactive policy associations.MethodsAlcohol policies were assessed with the Alcohol Policy Scale. Firearm policies were assessed using the Gun Law Scorecard from Giffords Law Center. Suicide data from the National Violent Death Reporting System in 2015 covered 22 states. State- and individual-level GEE Poisson and logistic regression models assessed relationships between policies and firearm- and/or alcohol-involved suicides with a 1-year lag.ResultsIn 2015, there were 8996 suicide deaths with blood alcohol concentration test results in the 22 included states. Of those deaths, alcohol and/or firearms were involved in 5749 or 63.9%. Higher alcohol and gun law scores were associated with reduced incidence rates and odds of suicides involving either alcohol or firearms (adjusted incidence rate ratios [IRR] 0.72 (95% CI 0.63, 0.83) for alcohol policies, 0.86 (95% CI 0.82, 0.90) for firearm policies). Relationships were similar for suicides involving both alcohol and firearms, and there was an interactive effect, such that states with restrictive policies for both had the lowest rates of suicides involving alcohol or guns.ConclusionsMore restrictive alcohol and firearm policies are associated with lower rates and odds of suicides involving alcohol or firearms, and alcohol and firearms, and may be a promising means by which to reduce suicide.
Highlights
Alcohol and firearms are commonly involved in suicide in the United States
Data on suicides came from the Centers for Disease Control and Prevention’s National Violent Death Reporting System (NVDR S) [15,16,17], which is a census of violent deaths occurring in participating states from sources including death certificates, law enforcement reports, toxicology reports, and coroner/medical examiner records
State alcohol policies were operationalized with Alcohol Policy Scale (APS) scores, which measure the restrictiveness of the alcohol policy “environment” in each state based on 29 individual alcohol policies, described previously [11]
Summary
Alcohol and firearms are commonly involved in suicide in the United States. State alcohol and firearm policies may impact alcohol and firearm related suicide, yet little is known about these relationships. This study examines relationships between state alcohol and firearm policies and suicides involving alcohol, guns, or both, and explores interactive policy associations. Suicide is a leading cause of death in the U.S, and rates have increased by approximately 30% during the past two decades [1]. The relationship between alcohol consumption, excessive alcohol use and suicide has several mechanisms. In the U.S, higher rates of firearm ownership and gun availability are associated with increased rates and odds of suicide, among males [8,9,10]
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