for suicide than in the United States (14 percent vs. 55–60 percent, Beautrais et al., 1996). Conversely, if a gun was not in the home, it was used as a method of suicide quite infrequently. Furthermore, in a study by Kellermann et al. (1992), only 3 percent of those who completed suicide had bought a gun within 2 weeks of the suicide. Wintemute et al. (1999) examined the standardized mortality rates (SMRs) of purchasers of handguns in California, who are registered by state law, and found an extremely high rate of suicide right after purchase. However, the rates remained elevated for the 6 years of analysis. This suggests that firearms are purchased for the purpose of completing suicide even though most of the suicides occurred some time after the purchase. Together, these data strongly suggest that it is the immediate gun availability that conveys the risk for firearms suicide, and supports method restriction as one means to prevent firearms suicide.

Method of storage and the type and number of guns modify suicide risk substantially. Higher risk is associated with handguns than with long guns, loaded guns than unloaded guns, and unlocked than locked guns (see Table 8-2, Brent et al., 1993; Kellermann et al., 1992). Long guns convey an increased risk to males, but not females, and handguns convey a particularly increased risk for females (Brent et al., 1993). Furthermore, in adolescents, long guns, but not handguns, convey an increased risk in rural areas (OR’s 4.5 vs. 1.0), while in urban areas, this situation is re-