Pediatricians' Experience with and Attitudes Toward Firearms. Results of a National Survey

Background: In 1992, the American Academy of Pediatrics issued statements calling for aggressive actions to reduce the dangers of firearms to children and adolescents, including removing handguns from homes with children and working toward a ban on the manufacture, sale, and private possession of handguns.

Objectives: To determine the extent to which pediatricians support these positions against firearms and to describe the demographic and practice determinants of their views.

Interventions: In 1994, data were obtained from 982 pediatricians involved in direct patient care in a national, random-sample survey of American Academy of Pediatrics members (response rate, 68.9%). This article focuses on 4 areas: (1) recent experience treating gun injuries, (2) attitudes toward legislation to reduce the availability of guns, (3) attitudes toward gun safety counseling by pediatricians, and (4) current gun safety counseling practices. Wherever possible, chi 2 and t tests were used to compare responses to a similar 1988 survey of American Academy of Pediatrics members. Logistic regression was used to examine the multivariate relationships between the outcome variables and demographic and practice characteristics of the responding pediatricians.

Results: Almost 1 in 5 pediatricians treated a gun injury in the past 12 months. In 1988, 86.5% of pediatricians supported restricting the sale and possession of handguns; in 1994, support for such legislation increased to 92.5% (P < .01). Also in 1994, 76% supported banning the sale or possession of handguns. Most respondents (82%) believe anticipatory guidance on firearm safety can reduce injury and death; 95% support asking parents to unload and lock firearms, and 66% support encouraging parents to remove handguns from the home. Current counseling practices lag behind attitudinal support of anticipatory guidance on firearm safety (eg, half of respondents report never identifying families with firearms in the home). Demographic factors as well as professional experience were found to affect attitudes (eg, women, older pediatricians, and those who did not own guns were more likely to support gun-control legislation; and pediatricians who have recently treated gun injuries and those practicing in the inner city are more likely to counsel families about gun safety).

Conclusions: The data indicate that practicing pediatrician overwhelmingly agree that handguns in the home are hazardous and that steps should be taken to reduce this hazard through legislation and patient counseling. They support the policies on firearms and handguns of the American Academy of Pediatrics; most support even the strongest recommendation, which is a ban on handguns. A substantial lag between attitudes that favor counseling about firearms and reported practices indicates the need for further training in and evaluation of firearm counseling in office settings.