Suicide Bombing Terrorism

Introduction

Theories laying out why terrorists use suicide bombings as an attack methodology are complex and literature on this topic is diverse with some of the most prominent hypotheses receiving mixed empirical support. ^1,2 A suicide bombing can simply be defined as an attack in which an individual knowingly takes their own life with the intention of killing others, while deploying an explosive device. ³ Suicide bombings share some universal fundamental characteristics: depending on the type of bomb and attack type, they can be inexpensive and effective, requiring little expertise and few resources to cause significant damage, and can be logistically relatively uncomplicated with guaranteed media coverage while showing a commitment to the cause. ^4–6

While suicide bombings in the context of warfare have existed throughout history, the first modern suicide bombing targeted the Iraqi Embassy in Beirut in December 15, 1981. ⁷ The tactic gained traction after Hezbollah targeted the US Marine Barracks and French Paratroopers in 1983, killing over 300. During the Al Aqsa Intifada, Palestinian groups used suicide bombings effectively, increasing the number of suicide bombings world-wide. There was an exponential rise in such attacks in the decade following the initiation of the War on Terror. ⁸ After the 2001 suicide terrorism attacks in the US on 9/11, and the subsequent military invasion in Afghanistan and Iraq, these events systematically transformed this once unique tactic of political violence into a prominent attack methodology for terrorist groups. ^9,10 The health care implications of terrorist attacks are a growing concern amongst Disaster Medicine and Counter-Terrorism Medicine (CTM) specialists. ¹¹

This study is an epidemiological examination of all terrorism-related bombings sustained from 1970-2019, comparing the rates of fatal injuries (FI) and non-fatal injuries (NFI) between suicide bombing attacks (SBA) versus non-suicide bombing attacks (NSBA).

Methods

Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). ¹² This database is open-access, with publicly available data collection methodology utilizing artificial intelligence that identifies events from news media around the world daily, as confirmed by human evaluation of the events by the National Consortium for the Study of Terrorism and Responses to Terrorism (College Park, Maryland USA). ¹³ The GTD defines terrorist attacks as: “The threatened or actual use of illegal...