Observational studyBMJ (Clinical research ed.)2020
State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses.
Observational study in BMJ (Clinical research ed.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Do Victimization and Hopelessness Relate to Suicidality Differently Across Sexual Orientation? Evidence from the 2015-2023 U.S. Youth Risk Behavior Surveys.Archives of sexual behavior · 2026Article
- Carrying Firearms and Suicide Risk Among Adolescents.JAMA network open · 2026Article
- A causal framework for evaluating drivers of policy effect heterogeneity using difference-in-differences.Health services & outcomes research methodology · 2026Article
- Evidence for Public Policies to Prevent Suicide Death in the United States.Annual review of public health · 2025Review
- The impact of the U.S federal minimum legal drinking age law on alcohol involved firearm suicide: a regression discontinuity approach.EClinicalMedicine · 2025Article
- Brooding, reflection, and anger rumination in late life suicidal behavior.Journal of affective disorders · 2025Article
- How firearm legislation impacts firearm mortality internationally: A scoping review.Health policy OPEN · 2024Article
- Firearm Purchaser Licensing Laws and Firearm Deaths among Adolescents and Emerging Adults.Youth & society · 2024Article
- Article
- Examining the Impact of Minimum Handgun Purchase Age and Background Check Legislation on Young Adult Suicide in the United States, 1991-2020.American journal of public health · 2024Article
- Long gun violence in California versus Texas: How legislation can reduce firearm violence.Surgery open science · 2024Article
- Association Between the New York SAFE Act and Firearm Suicide and Homicide: An Analysis of Synthetic Controls, New York State, 1999‒2019.American journal of public health · 2023Article
- Opportunities and challenges in using instrumental variables to study causal effects in nonrandomized stress and trauma research.Psychological trauma : theory, research, practice and policy · 2023Review
- How have firearm laws changed in states with unexpected decreases or increases in firearm homicide, 1990-2019?SSM - population health · 2023Article
- Adolescent Suicide-Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death.Current trauma reports · 2022Review
- Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: moderation by sex, race, and firearm involvement.Molecular psychiatry · 2021Article
- A Comprehensive Approach to Mental Health Promotion and Suicide Prevention for Colleges and Universities: Insights from the JED Campus Program.NAM perspectives · 2021Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the association between US state policies that establish age 18 or 21 years as the minimum purchaser age for the sale of handguns and adolescent suicide rate.
designRegression discontinuity and difference-in-differences analyses.
setting46 US states without policy changes between 2001 and 2017; Missouri and South Carolina, which lowered the age for handgun sales in 2007 and 2008, respectively; and West Virginia and Wyoming, which increased the age for handgun sales in 2010.
participantsAdolescents aged 13 to 20 years(554 461 961 from 2001 to 2017) in the regression discontinuity analysis, and adolescents aged 18 to 20 years (168 934 041 from 2002 to 2014) in the main difference-in-differences analysis.
main outcome measureSuicide rate per 100 000 adolescents.
resultsIn the regression discontinuity analysis, state policies that limited the sale of handguns to those aged 18 or older (relative to 21 or older) were associated with an increase in suicide rate among adolescents aged 18 to 20 years equivalent to 344 additional suicides in each state where they were in place between 2001 and 2017. In the difference-in-differences analysis, state policies that limited the sale of handguns to those aged 21 or older were associated with 1.91 fewer suicides per 100 000 adolescents aged 18 to 20 years (95% confidence interval -3.13 to -0.70, permutation adjusted P=0.025). In the difference-in-differences analysis, there were 1.83 fewer firearm related suicides per 100 000 adolescents (-2.66 to -1.00, permutation adjusted P=0.002), with no association between age 21 handgun sales policies and non-firearm related suicides. Separate event study estimates indicated increases in suicide rates in states that lowered the age of handgun sales, with no association in states that increased the age of handgun sales.
conclusionsA clear discontinuity was shown in the suicide rate by age at age 18 in states that limited the sale of handguns to individuals aged 18 or older. State policies to limit the sale of handguns to individuals aged 21 or older were associated with a reduction in suicide rates among adolescents. Increases in suicide rates were observed after states lowered the age of handgun sales, but no effect was found in states that increased the age of handgun sales.
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