Abstract
BackgroundFirearms are the most lethal method of suicide and account for approximately half of all suicide deaths nationwide. We describe associations between firearm purchasing characteristics and firearm suicide.MethodsData on all legal handgun transactions in California from 1996 to 2015 were obtained from the California Department of Justice Dealer’s Record of Sale database. Handgun purchasers were linked to mortality data to identify those who died between 1996 and 2015. To account for variation in timing and duration of observation time, analyses were stratified by birth cohort. The primary analysis focused on those aged 21–25 in 1996. A secondary analysis tested associations among those aged 50–54 in 1996. Using incidence density sampling, purchasers who died by firearm suicide (cases) were each gender-matched to 5 purchasers (controls) who remained at risk at the case’s time of death. We examined the characteristics of purchasers and transactions, focusing on the transaction closest in time to the case’s death. Data were analyzed with conditional logistic regression.ResultsThere were 390 firearm suicides among the younger cohort and 512 firearm suicides among the older cohort. Across both cohorts, older age at first purchase and the purchase of a revolver were associated with greater risk of firearm suicide. For example, among the younger cohort, those who purchased a revolver versus semiautomatic pistol had 1.78 times the risk of firearm suicide (95% CI 1.32, 2.40) in multivariable models. Other associations varied across cohorts, suggesting cohort or age effects in purchasing patterns.ConclusionsFindings add to the evidence on firearm suicide risk and may help inform prevention strategies and future research.
Highlights
Firearms are the most lethal method of suicide and account for approximately half of all suicide deaths nationwide
In this nested case–control study, we describe differences in handgun purchasing characteristics between purchasers who died by firearm suicide and those who did not
Handgun characteristics included category; caliber, classified into small (e.g., .22, .25, .32), medium (e.g., .38, .380, 9 mm), and large (e.g., .40, .44, .45, which included a small number of other and unknown caliber) based on a classification schema developed in previous work (Wintemute et al 1998; Wright et al 2005); and whether the gun was inexpensive or not, proxied by the manufacturer, which we identified as producing handguns in the bottom quantile of prices listed in the Blue Book of Gun Values (Fushing and Roy 2018)
Summary
Firearms are the most lethal method of suicide and account for approximately half of all suicide deaths nationwide. We describe associations between firearm purchasing characteristics and firearm suicide. Prior research has shown a clear association between the purchase of a firearm and risk for firearm suicide. Longitudinal data on firearm transaction records have not been systematically analyzed to determine whether specific characteristics of firearm purchasers and transactions can help identify important risk factors for firearm suicide. In this nested case–control study, we describe differences in handgun purchasing characteristics between purchasers who died by firearm suicide and those who did not. Our goal is to identify markers of risk that may help inform future research and new interventions to prevent firearm suicide
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