By Lava R. Timsina, PhD; Nan Qiao, MPH; Alejandro C. Mongalo, BS; Ashley N. Vetor, MPH; Aaron E. Carroll, MD, MS; Teresa M. Bell,

Despite being unable to purchase firearms directly, many adolescents have access to guns, leading to increased risk of injury and death. We sought to determine if the National Instant Criminal Background Check System (NICS) changed adolescents’ gun-carrying behavior. We performed a repeated cross-sectional study using National Youth Risk Behavior Survey data from years 1993 to 2017. We used a survey-weighted multivariable logistic regression model to determine if the NICS had an effect on adolescent gun carrying, controlling for state respondent characteristics, state laws, state characteristics, the interaction between the NICS and state gun laws, and time. On average, 5.8% of the cohort reported carrying a gun. Approximately 17% of respondents who carried guns were from states with a universal background check (U/BC) provision at the point of sale, whereas 83% were from states that did not have such laws (P < .001). The model indicated that the NICS together with U/BCs significantly reduced gun carrying by 25% (adjusted relative risk = 0.75 [95% confidence interval: 0.566–0.995]; P = .046), whereas the NICS independently did not (P = .516). Conclusions: Adolescents in states that require U/BCs on all prospective gun buyers are less likely to carry guns compared with those in states that only require background checks on sales through federally licensed firearms dealers. The NICS was only effective in reducing adolescent gun carrying in the presence of state laws requiring U/BCs on all prospective gun buyers. However, state U/BC laws had no effect on adolescent gun carrying until after the NICS was implemented.carrying in the presence of state laws requiring U/BCs on all prospective gun buyers.

Pediatrics. 2020;145(1):e20191071

By Linda A Teplin, Nicholas S Meyerson, Jessica A Jakubowski, David A Aaby, Nanzi Zheng 1, Karen M Abram, Leah J Welty

In adulthood, 41.3% of males and 10.5% of females perpetrated firearm violence. Depending on the type of behavior during adolescence, between 44% and 67% of participants who had been involved with firearms before age 18 years perpetrated firearm violence as adults. All but 1 type of involvement before age 18 years was associated with firearm perpetration in adulthood . Notably, participants who had owned a firearm during adolescence had 9.0 (95% CI, 4.5-18.2; P < .001) times the odds of perpetrating firearm violence in adulthood. Victimization was also significant: adolescents who had been threatened with a weapon or injured by gunshot had 3.1 (95% CI, 2.0-4.9; P < .001) and 2.4 (95% CI, 1.2-4.9; P = .01) times the odds of perpetrating firearm violence in adulthood, respectively.

JAMA Network Open. 2021;4(2):e2034208. doi:10.1001/jamanetworkopen.2020.34208

By Nanzi Zheng , Karen M Abram , Leah J Welty , David A Aaby , Nicholas S Meyerson , and Linda A Teplin

Question What are the incidence rates of nonfatal firearm injury and firearm mortality in youths who have been involved with the juvenile justice system?

Findings This 25-year longitudinal cohort study (n = 1829) found that youths involved with the juvenile justice system had up to 23 times the rate of firearm mortality as the general population; rates varied by sex, race and ethnicity, and age. Sixteen years after detention, more than one-quarter of Black and Hispanic males had been injured or killed by firearms.

Meaning These findings suggest that reducing firearm injury and mortality in high-risk youths and young adults requires a multidisciplinary approach involving legal professionals, health care professionals, educators, street outreach workers, and public health researchers.