Objectives To determine if an association exists between the number of driving under the influence (DUI) convictions required to activate federal firearms prohibitions and annual firearm homicide and suicide rates by state.
Methods Ecological cross-sectional study of all US states from 2013 to 2017. We collected DUI law data from Thomson Reuters Westlaw database and firearm mortality data from the Centers for Disease Control and Prevention Vital Statistics programme.
Results Five states had laws such that one or two DUI convictions could result in prohibitions to firearms access according to federal law. Four states had no legal framework that would restrict firearms access because of DUI convictions; the remaining states could activate federal restrictions at three or more DUI convictions. Firearm-specific homicide (victimisations) rates were 19% lower among women in states where federal restrictions of firearms access occurred after one or two DUI offences (incidence rate ratio (IRR) 0.81; 95% CI 0.64 to 1.01) and 18% lower in states with firearm prohibitions after three or more offences (IRR 0.82; 95% CI 0.71 to 0.95) compared with the states with no legal framework for prohibiting firearms after DUI convictions. There was no association between number of DUI activations and overall, or firearm-specific, suicide among the entire population (men and women) or among only women, or only men.
Conclusions DUI penalties that activate federal firearms prohibitions may be one pathway to reduce firearm homicide of female victims.
- motor vehicle - non traffic
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Contributors RT, AR-R and FPR formulated the idea; MJH performed the analysis; AB and DB gathered data. RT wrote the manuscript. All authors contributed meaningfully in edits and re-writes.
Funding Supported by funding from the state of Washington.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study used publicly available de-identified data and thus was exempt from the Institutional Review Board at the University of Washington.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. All data on state laws were obtained from https://legal.thomsonreuters.com/en/products/westlaw. All mortality data were obtained from the CDC Vital Statistics Program. https://www.cdc.gov/nchs/nvss/index.htm.
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