Project Summary: Firearms are a major source of preventable morbidity and mortality in the United States, contributing to over 45,000 deaths in 2020 and leading to substantial costs to society. Recent analyses estimate that one-third of firearm decedents had consumed alcohol, while other studies have demonstrated an association between alcohol use and firearm-related suicide. The intersection between firearms and alcohol use is a topic that has received relatively little attention to date, but policy interventions that address that intersection have wide public support and may offer new directions for tackling the large and growing burden of firearm-related harms. One challenge is how to address these problems without unduly burdening the large number of gun owners who are unlikely to harm themselves or others. Consistent with priorities established in the Institute of Medicine/National Research Council Report Priorities for Research to Reduce the Threat of Firearm-Related Deaths, this study will identify public policies that target the intersection of alcohol and firearms and provide a rigorous evaluation of their potential impacts on firearm-related homicide, suicide and unintentional deaths over the 2010 to 2022 period. To accomplish these objectives, the study will identify and analyze the scope and content of legal texts related to state laws that explicitly target alcohol impairment/use and firearm sales, ownership and use. The potential impact of these laws will then be assessed using state-level data from the National Vital Statistics System (NVSS) while controlling for the rest of the firearm and alcohol policy context within states. The role of potential effect modifiers such as age, sex, and race/ethnicity will then be assessed for each outcome, including intimate partner homicide, using individual- level data from the National Violent Death Reporting System (NVDRS). The multidisciplinary team of attorneys, engineers, public administration and public health scholars will employ legal research, content analysis, rigorous machine learning and causal inference methods, as well as multi-level and inverse-probability regression analyses to objectively and rigorously examine the scope of these laws, assess their impact (if any) on firearm-related deaths, and identify any factors that may moderate their effects over a long time period. In addition to publishing findings from the analyses, the study team will produce an interactive web-based tool for public use that allows users to understand the alcohol, firearm and alcohol-related firearm policies in their states, as well as visualize firearm-related deaths in their states over the time period. This proposal is responsive to RFA-CE-23-006 Funding Option A.

Project narrative: This study provides a rigorous and impartial evaluation of the potential impact of state alcohol-related firearm laws on firearm-related homicide, suicide and unintentional deaths using content analysis of state statutes, machine learning techniques, and casual inference methods. Additional analyses will investigate whether these laws may have impacts on the incidence of intimate partner homicide. Results from this study will provide robust evidence to assess the potential import of these approaches to reducing the burden of firearm-related deaths in the U.S. without unduly burdening the large number of gun owners who are unlikely to harm themselves or others.