Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Repeal of the concealed weapons law and its impact on gun-related injuries and deaths

Ginwalla, Rashna MD; Rhee, Peter MD, MPH; Friese, Randall MD; Green, Donald J. MD; Gries, Lynn MD; Joseph, Bellal MD; Kulvatunyou, Narong MD; Lubin, Dafney MD; O’Keeffe, Terence MBChB; Vercruysse, Gary MD; Wynne, Julie MD; Tang, Andrew MD

Journal of Trauma and Acute Care Surgery: March 2014 - Volume 76 - Issue 3 - p 569–575
doi: 10.1097/TA.0000000000000141
AAST 2013 Plenary Papers
Editor's Choice

BACKGROUND Senate Bill 1108 (SB-1108) allows adult citizens to carry concealed weapons without a permit and without completion of a training course. It is unclear whether the law creates a “deterrent factor” to criminals or whether it escalates gun-related violence. We hypothesized that the enactment of SB-1108 resulted in an increase in gun-related injuries and deaths (GRIDs) in southern Arizona.

METHODS We performed a retrospective cohort study spanning 24 months before (prelaw) and after (postlaw) SB-1108. We collected injury and death data and overall crime and accident trends. Injured patients were dichotomized based on whether their injuries were intentional (iGRIDs) or accidental (aGRIDs). The primary outcome was any GRID. To determine proportional differences in GRIDs between the two periods, we performed χ2 analyses. For each subgroup, we calculated relative risk (RR).

RESULTS The number of national and state background checks for firearms purchases increased in the postlaw period (national and state p < 0.001); that increase was proportionately reflected in a relative increase in state firearm purchase in the postlaw period (1.50% prelaw vs. 1.59% postlaw, p < 0.001). Overall, victims of events potentially involving guns had an 11% increased risk of being injured or killed by a firearm (p = 0.036) The proportion of iGRIDs to overall city violent crime remained the same during the two periods (9.74% prelaw vs. 10.36% postlaw; RR, 1.06; 95% confidence interval, 0.96–1.17). However, in the postlaw period, the proportion of gun-related homicides increased by 27% after SB-1108 (RR, 1.27; 95% confidence interval, 1.02–1.58).

CONCLUSION Both nationally and statewide, firearm purchases increased after the passage of SB-1108. Although the proportion of iGRIDs to overall city violent crime remained the same, the proportion of gun-related homicides increased. Liberalization of gun access is associated with an increase in fatalities from guns.

LEVEL OF EVIDENCE Epidemiologic study, level III.

From the Division of Trauma and Emergency General Surgery (R.G.), University of Virginia School of Medicine, Charlottesville, Virginia; Division of Trauma, Surgical Critical Care and Emergency General Surgery (P.R., R.F., D.J.G., L.G., B.J., N.K., T.O., G.V., J.W., A.T.), University of Arizona College of Medicine, Tucson, Arizona; Division of Trauma (D.L.), Memorial Regional Hospital, Hollywood, Florida.

Submitted: August 31, 2013, Revised: November 18, 2013, Accepted: November 21, 2013.

This study was presented at the 72nd annual meeting of the American Association for the Surgery of Trauma, September 18–21, 2013, in San Francisco, California.

Address for reprints: Rashna Ginwalla, MD, Rwanda Human Resources for Health, Program, Division of Trauma and Emergency General Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908; email:

© 2014 Lippincott Williams & Wilkins, Inc.