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Perceptions of firearm-related harm among US adults living in firearm-owning households: a nationally representative study
  1. Ali Rowhani-Rahbar1,2,
  2. Miriam Joan Haviland2,
  3. Deborah Azrael3,
  4. Matthew Miller3,4
  1. 1 Department of Epidemiology, University of Washington, Seattle, Washington, USA
  2. 2 Firearm Injury and Policy Research Program, University of Washington, Seattle, Washington, USA
  3. 3 Harvard Injury Control Research Center, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
  4. 4 Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
  1. Correspondence to Dr Ali Rowhani-Rahbar, Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; rowhani{at}


Decision-making on having firearms at home may be contingent on perceptions of the likelihood of their negative and positive outcomes. Using data from a nationally representative survey (n=4030) conducted during 30 July 2019 to 11 August 2019, we described how US adults living in firearm-owning households perceived the relative likelihood of firearm-related harm by injury intent (‘accidentally harm self or someone else with a gun’, ‘injure self on purpose with a gun’ and ‘injure someone else on purpose with a gun’) for groups at risk of compromised decision-making (children; adolescents and individuals with mental health issues, substance use disorders or cognitive impairment). We found that US adults living in firearm-owning households believe that unintentional firearm injuries are more likely than intentional self-inflicted or assault-related firearm injuries, despite evidence to the contrary. Prior evidence indicates that communicating risk in relative terms can motivate behaviour change; therefore, findings from this study might helpfully inform health communications around firearm safety.

  • firearm
  • suicide/self-harm
  • violence
  • behaviour change

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  • Contributors AR-R had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed to concept and design; acquisition, analysis or interpretation of data; critical revision of the manuscript for important intellectual content. AR-R contributed to drafting of the manuscript. MJH contributed to statistical analysis. MM and DA contributed to obtained funding.

  • Funding This study was funded by the Joyce Foundation (grant no. 18-38517) and the New Venture Fund (grant no. G00006104).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.