Gun carrying among US adolescents: the mutual impact of violence experiences, safety concerns, and substance use behaviors.

OBJECTIVES: Youth firearm carriage significantly contributes to firearm-related injuries and deaths in the United States (US). This study examined the sex-specific patterns and cumulative effects of violence experiences, safety concerns, and substance use behaviors on youth firearm carriage.

STUDY DESIGN: Cross-sectional study.

METHODS: Based on a nationally representative sample (N = 13,526), the multigroup structural equation modeling (SEM) was used to examine the interplay of violence experiences (weapon threats, physical fights, and sexual violence), safety concerns, and substance use behaviors (cigarette, electronic vapor, alcohol, marijuana, and prescription opioid), and their direct, indirect, and total effects on youth gun carrying behavior.

RESULTS: About one in 50 females and one in 15 males reported firearm carriage in the past year. Sex-specific patterns existed. Among female adolescents, gun carrying was strongly correlated with violence experiences (standardized coefficient (β) = 0.77, P < 0.001), but no direct connection was observed with substance use behaviors. Among males, both violence experiences (β = 0.56, P < 0.001) and substance use behaviors (β = 0.26, P < 0.001) were significantly correlated with gun carrying. Although safety concerns did not show a direct effect on gun carrying, a significant indirect effect was observed via the pathway of violence experiences. Collectively, the three clusters of predictors explained about 59.9% of variance in gun carrying among females and 54.6% of variance among males.

CONCLUSIONS: Violence experiences have a robust impact on gun carrying behavior in both female and male adolescents. Effective violence prevention programs and sex-specific strategies (e.g., substance use intervention for males) are needed to reduce youth firearm carriage.