State firearm laws and rates of suicide in men and women

Background: To evaluate the associations of state laws restricting firearms and incidence rates of suicide in men and women using a cross-sectional design. Methods: States were divided into three categories based on the restrictiveness of their firearm laws: restrictive (n = 8); modest (n = 22); and unrestrictive (n = 20). State suicide incidence rates stratified by gender were compared using Poisson regression analyses that controlled for measures of race/ethnicity, income, and urbanization. Analyses were based on 2000 census data and state suicide data from 1999 and 2000. Results: In the analysis of women, compared to states with restrictive firearm laws, there were higher suicide incidence rate ratios (IRR) in states with modest (IRR = 1.64; 95% confidence interval [CI], 1.34-2.01) and unrestrictive laws (IRR = 1.55; 95% CI, 1.23-1.95). The analysis of men showed comparable results: modest firearm laws (IRR = 1.51; 95% CI, 1.27-1.79); unrestrictive firearm laws (IRR = 1.49; 95% CI, 1.23-1.82). Conclusions: Results support the hypothesis that state restrictions on firearms have the potential to reduce the suicide rate. Findings do not support a hypothesis that greater firearm restrictions are associated with the substitution of alternative methods of suicide. Firearms appear to be a comparable exposure for suicide in men and women. Although men are more likely to use firearms in suicide than women, this difference may merely reflect more frequent gun ownership among men.