Suicide in the Home in Relation to Gun Ownership

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Abstract
As the author of a book on guns and violence,1 I was interested in the article by Kellermann et al. (Aug. 13 issue).2 The authors concluded that their case–control study offered "strong" evidence that the presence of guns increased the risk of suicide in the home, by a factor of 4.8. They failed to explain, however, how this effect could occur or how it could be this enormous. There is no evidence that guns precipitate suicidal thoughts, and suicide attempts with guns are only marginally more frequently fatal than attempts with likely substitute methods: the fatality rate is 85 percent for shooting, 80 percent for hanging, 77 percent for asphyxiation by carbon monoxide, and 75 percent for drowning.1 Since these methods involve even more widely available resources than guns, and thus substitution would be easy, how could guns have so large an impact?

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