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Abstract
Despite broad support for policies requiring that prospective firearm owners receive training before acquiring a firearm, little is known about the scope and content of firearm training in the USA. Nationally representative surveys conducted in 1994 estimated that 56%-58% of the US firearm owners had received formal firearm training. We conducted a nationally representative survey in 2015 (n=3932; completion proportion=55%) to update those estimates and characterise training contents. 61% of firearm owners and 14% of non-owners living with a firearm owner reported having received formal firearm training. The most commonly reported combination of training topics was safe handling, safe storage and preventing accidents. 15% of firearm owners reported that their training included information about suicide prevention. The proportion of the US firearm owners with formal firearm training has not meaningfully changed since two decades ago. Training programme contents vary widely. Efforts to standardise and evaluate the effectiveness of firearm training are warranted.
- Firearm
- Surveys
- Training
- Suicide/Self?Harm
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Introduction
Most US citizens favour policies that would require prospective firearm owners to receive formal firearm training before becoming qualified for ownership,1 a position supported by medical and public health experts to promote firearm safety and practiced in several other high-income countries.2–4 Despite this broad support, little is known about the content of formal firearm training programmes, or even about the proportion of the US adults who have ever received formal (including military) firearm training. Indeed, in the peer-reviewed literature, the most recent estimates of the proportion of adult firearm owners with formal firearm training in the USA come from surveys conducted in 1994.5 6 In those surveys, 56%-58% of firearm owners reported having received formal firearm training. The current study uses data from a 2015 nationally representative survey of the US adults to update thoseestimates, characterise adults who reported having received firearm training, identify factors associated with the receipt of training and describe whether specific safety-related topics (eg, preventing firearm accidents, theft or suicide) were covered in the training.
Methods
Design and participants
We used data from a web-based nationally representative survey, designed by the investigators (DA and MM) to describe firearm ownership, storage and use in the USA, and conducted by the survey firm Growth for Knowledge (GfK) in April 2015. Respondents were drawn from GfK’s Knowledge Panel (KP), a rotating panel which includes approximately 55 000 US adults sampled on an ongoing basis.7 Invitations to participate were sent by email; one reminder email was sent to non-responders 3 days later. All panel members, except those serving in the US Armed Forces at the time of survey, were eligible to participate. To ensure reliable national estimates, firearm owners were oversampled from the KP. Additional details about the survey design and participants are available elsewhere.8 The Northeastern University Institutional Review Board approved the study.
Of the 7318 invited panel members who received the survey, 4165 began the survey and 3949 completed it, excluding 48 active-duty military personnel who began the survey but were ineligible to complete it. This yielded a survey completion proportion of 54.6% based on the formula recommended for calculating response proportion for web panels.9 Respondents were more likely than non-respondents to be younger, female, unmarried, less educated and living in metropolitan areas. Respondents were approximately as likely as non-respondents to live in a home with a firearm, but they were more likely to personally own a firearm. We excluded 17 respondents with missing responses to questions about formal firearm training, resulting in a final sample size of 3932 for this analysis.
Measures
For this analysis, our primary outcome measure was survey respondents' answers to two questions about formal firearm training. The first question asked: ‘Have you ever had any formal firearm training?’. Those who responded affirmatively were asked if the training included information on safe handling of firearms, safe storage of firearms, preventing firearm accidents, preventing firearm theft and suicide prevention. Respondents could choose all options that applied. Additional survey domains included, among others, respondent demographic characteristics, presence of children in the home, growing up in a firearm-owning household, political views, veteran status, firearm ownership status and characteristics related to firearm ownership (eg, type of firearm owned). Firearm ownership status was determined based on responses to two questions. The first question asked: ‘Do you or does anyone else you live with currently own any type of gun?’ Those who answered affirmatively were then asked: ‘Do you personally own a gun?’ Based on these responses, firearm ownership status for this analysis was classified into three prespecified subgroups of firearm owner, non-owner living with a firearm owner and non-owner not living with a firearm owner. Key survey questions related to this analysis are available in the online supplementary appendix.
Supplementary material 1
Statistical analysis
All statistical analyses were based on individual-level data. GfK provided final survey weights that combined presample and study-specific poststratification weights to account for oversampling and non-response. Weights were applied such that estimates from the survey are representative of the US adults aged ≥18 years. We calculated weighted percentages and their corresponding 95% CIs for each measure. To examine the association between firearm ownership characteristics and receipt of firearm training among firearm owners, we used multivariable Poisson regression models to obtain adjusted prevalence ratios. A prespecified set of covariates including age, sex, presence of children in household, urbanicity, region of residence and veteran status was used for adjustment in the models. All analyses were conducted in Stata V. 14 (StataCorp) using the ‘svy’ suite of commands.
Results
Approximately one in four US adults (23.9%; 95% CI 21.9% to 26.0%), and three in five firearm owners (61.4%; 95% CI 58.9% to 63.9%) reported having received formal firearm training. Among non-owners, 14.3% (95% CI 11.2% to 18.0%) of those living with a firearm owner, and 12.8% (95% CI 10.6% to 15.5%) of those not living with a firearm owner reported having received training. Receipt of formal firearm training varied by respondent characteristics (table 1). Among firearm owners, 66.3% (95% CI 63.4% to 69.1%) of males compared with 48.8% (95% CI 43.9% to 53.7%) of females had received training. Among firearm owners, those who owned both handguns and long guns, owned more than one firearm within each type of firearm (handgun and long gun), had a concealed carry weapon permit or had carried a loaded handgun in the past 30 days were more likely to have received training. Those who owned a firearm for protection only were generally less likely to have received training than those who owned a firearm for other or multiple reasons (eg, hunting/sporting among long gun owners; table 2).
Receipt of formal firearm training by firearm ownership status and selected characteristics
Associations between selected firearm ownership characteristics and receipt of formal firearm training among firearm owners
The most commonly reported combination of training topics was safe handling, safe storage and preventing accidents (table 3). Safe handling and suicide prevention were, respectively, the most and least commonly reported topic of training regardless of firearm ownership status (figure 1). Among firearm owners, 61.1% (95% CI 58.6% to 63.6%) had received training in safe handling, and 14.7% (95% CI 13.0% to 16.7%) had received training in suicide prevention.
Combination of different training topics among respondents who had received firearm training
Topics of formal firearm training by firearm ownership status.
Discussion
The proportion of the US firearm owners who report having received formal firearm training (61%) has not meaningfully changed since >20 years ago. To our knowledge, this study provides the first national estimates of the proportion of the US adults with formal firearm training among both firearm owners and non-owners in more than 20 years. Considering that firearm access is a well-established risk factor for firearm injury among all members of firearm-owning households,10 it is noteworthy that only 14% of non-owners living in firearm-owning households reported having received any firearm training. Our national estimates of the frequency with which training programmes cover specific safety-related content (eg, preventing accidents, theft or suicide) also has not been previously presented in the literature. Despite the link between firearm access and suicide,11 and the fact that about two-thirds of all firearm deaths in the USA are suicides,12 only one in seven firearm owners reported that the training they received included information about suicide prevention.
As with results from all self-reported surveys, our findings are potentially subject to recall and social desirability bias. Prior research suggests, however, that online panel surveys may reduce social desirability bias and yield more accurate estimates of respondent characteristics compared with telephone surveys.13 Our survey completion proportion (55%) was substantially greater than the proportion for typical non-probability opt-in online surveys which range from 2% to 16%.9 Fewer than 1% of respondents declined to answer our stem question about household firearm ownership, no one declined to answer the subsequent question regarding whether they personally owned a firearm and fewer than 0.5% declined to answer the firearm training question. We asked a limited number of questions about firearm training; future work extending our findings should focus on additional characteristics of training programmes including their timing, setting and duration.
In some other high-income countries (eg, Canada, Australia and Germany), an understanding of firearm safety, tested in a theoretical or practical training course, is required to legally own a firearm.4 14 For instance, classroom participation in the full Canadian Firearms Safety Course and passing a test are mandatory for first-time Possession and Acquisition License applicants in Canada.15 In contrast, the US adults can lawfully own firearms without receiving any formal training. While some form of training may be required in certain circumstances (eg, to obtain a CCW permit or hunting license), no national standards or requirements for firearm training in the USA exist. Individuals may receive firearm training through different means, such as attending classes at gun shops, hunting clubs or shooting ranges16; counselling at healthcare settings or community events17; taking online courses.18 Some firearm advocacy groups have developed curricula on safety practices as part of responsible firearm ownership.19–21 Systematic collection of information on the content of these training programmes to identify gaps, and an evaluation of their effectiveness to change behaviour and reduce injury, is warranted. Given the link between the availability of household firearms and the risk of suicide for all household members, increasing the number of training programmes that provide information about suicide prevention should also be encouraged.
What is already known on this subject
Most US citizens favour requiring training to qualify for firearm ownership, a position supported by medical and public health experts to promote firearm safety.
Nationally representative surveys conducted in 1994 found that 56%-58% of the US firearm owners had received formal firearm training.
What this study adds
Based on this nationally representative survey conducted in 2015 (n=3932), the contemporary proportion of the US firearm owners who report having received any formal firearm training (61%) has not meaningfully changed since >20 years ago.
Only 14% of non-owners living with a firearm owner report having received any formal firearm training.
Only 15% of firearm owners report having received formal training in suicide prevention.
Footnotes
Contributors ARR, DA and MM contributed to the study concept and design. DA and MM led the acquisition of data. All authors contributed to the interpretation of data. ARR drafted the manuscript. All authors contributed to the critical revision of the manuscript for important intellectual content. VHL led the statistical analyses. DA and MM obtained funding. JAS, DA and MM contributed to the administrative, technical or material support. ARR, DA and MM contributed to the study supervision.
Funding This study was funded by the Fund for a Safer Future and the Joyce Foundation.
Competing interests None declared.
Ethics approval The Northeastern University Institutional Review Board, Boston, Massachusetts, USA.
Provenance and peer review Not commissioned; externally peer reviewed.