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Correspondence to Dr Garen J Wintemute, Violence Prevention Research Program, Department of Emergency Medicine, School of Medicine, University of California, Davis, Western Fairs Building, Sacramento, CA 95817, USA; [email protected]
Introduction
Firearm violence is an important cause of death and injury worldwide. In the USA, there were 21 334 firearm suicides and 10 945 firearm homicides in 2014.1 Firearm violence frequently involves alcohol; among men in the USA, alcohol-attributable deaths from firearm violence essentially equal those from MVCs.2
Cross-sectional and case–control studies have identified acute alcohol intoxication and a history of alcohol abuse as important risk factors for committing interpersonal and self-directed violence with firearms.2 3 Longitudinal studies in the general population have established pre-existing alcohol abuse as an independent risk factor for future violence, even when potential confounders are taken into account.4–9 There are no comparable studies specifically of firearm owners, though risk factors for violence are obviously of interest in a population with universal access to lethal weapons.
We report here the results of a longitudinal study of the association between prior convictions for alcohol-related crimes, chiefly driving under the influence (DUI), and risk for subsequent criminal activity among legal purchasers of handguns in California. This is a secondary analysis of data for a study, originally published in 1998, of prior criminal activity as a predictor of future violence among handgun purchasers.10 In that study, purchasers with convictions only for non-violent crimes had a fivefold or greater increase in risk for future violence, compared with purchasers with no prior criminal history. The category ‘non-violent crimes’ included DUI and other alcohol-related crimes.
A substantial research literature has established that DUI offenders have a high prevalence of excessive alcohol consumption and alcohol use disorders.11 12 Similarly, many studies have found that individuals with DUI convictions are more likely than others to engage in criminal activity of other types, including violent and weapon-related crimes.13–19 Those studies found that the magnitude of the increase is directly related to the number of DUI convictions, but others have not.20 In this study, our primary hypothesis is that among persons who legally purchase handguns, those with prior convictions for DUI and other misdemeanour alcohol-related crimes will be at increased risk of subsequent arrest for...