A, Proportion of attacks in the upper 75th percentile of total attacks. B, Fatalities from all attacks. All data are from the Global Terrorism Database.4
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Tessler RA, Mooney SJ, Witt CE, et al. Use of Firearms in Terrorist Attacks: Differences Between the United States, Canada, Europe, Australia, and New Zealand. JAMA Intern Med. 2017;177(12):1865–1868. doi:10.1001/jamainternmed.2017.5723
Although firearms are used in only a small proportion of terrorist attacks, these highly publicized events shed light on access to weapons and mass shootings. The sociopolitical and cultural context surrounding firearms, including the proportion of individuals owning guns, varies between countries.1 The United States has a higher rate of firearms deaths than other high-income countries.2,3 We compared the proportion of terrorist attacks committed with firearms in the United States with the proportion in other high-income countries. We also compared the lethality of attacks with firearms to those by other means.
We queried The Global Terrorism Database from 2002 to 2016.4 Maintained by the National Consortium for the Study of Terrorism and Responses to Terrorism at the University of Maryland, this database incorporates a methodology that includes both machine learning and manual review to abstract high-quality information from more than 1 million daily media reports published worldwide in over 80 languages. The database defines a terrorist attack as the “use of illegal force and violence by a non-state actor to attain a political, economic, religious, or social goal through fear, coercion, or intimidation.”4 For each attack, the location, type, and number of fatalities are collected. The database categorizes weapons as biological, chemical, explosive, fake weapons, firearms, incendiary (eg, arson), melee, sabotage equipment, vehicle (nonexplosive), other, and unknown.
To avoid calculating proportions in countries with few data points, we calculated the proportion of attacks involving firearms among countries in the top 75th percentile (10 attacks or more) over the study period. The number of fatalities per attack was calculated by weapon type. Of the 23 countries with at least 1 attack, 17 were in the upper 75th percentile of total attacks; the countries are listed in footnote “d” in the Table. We estimated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) per fatality in the attack with a Poisson distribution for attacks using firearms, vehicle/melee, incendiary, or biological/chemical weapons compared with explosives.
From 2002 through 2016, the database captured 2817 terrorist attacks in the United States, Canada, Western Europe, Australia, and New Zealand, of which 2403 (85.3%) were in Western Europe and 329 (11.7%) in the United States. The Table details the count of attacks by weapon used in country or region and year. Nearly all attacks (n = 2788, 99.0%) occurred in countries with 10 or more attacks. The types of attacks were as follows: explosives (n = 1379, 49.0%), incendiary (n = 1015, 36.0%), firearms (n = 260, 9.2%), vehicle/melee (n = 151, 5.4%), and miscellaneous (n = 88, 3.1%). In 2015 and 2016, compared with earlier years, there were notable increases in attacks involving vehicle/melee in the United States and Western Europe.
The Figure, A shows the proportion of firearms attacks among countries with 10 or more attacks, with the United States at 20.4% (n = 67) followed by the Netherlands at 14.3% (n = 3) (χ2 for all countries, P < .001). In the 2817 attacks, there were 1031 fatalities, of which 566 (54.9%) were attributed to firearms. The Figure, B shows the number of fatalities per attack by weapon type. Among all weapon types compared with explosives, the IRR per fatality was 4.75 (95% CI, 4.18-5.39) for attacks with firearms, 1.21 (95% CI, 0.91-1.59) for vehicle/melee, and 0.05 (95% CI, 0.03-0.08) for incendiaries.
Although firearms were used in fewer than 10% of terrorist attacks between 2002 and 2016, they accounted for about 55% of the fatalities. Among countries with 10 or more attacks, the proportion involving firearms in the United States was higher than in any other nation. Moreover, the risk of fatality was considerably higher in attacks committed with firearms than in attacks using other weapons. In the United States and other countries, government policies and legislative efforts to protect citizens from terrorism should consider the proportions and lethality of terrorist attacks committed with firearms.
Corresponding Author: Robert A. Tessler, MD, Harborview Injury Prevention and Research Center, 401 Broadway, Fourth Floor, Seattle, WA 98122 (firstname.lastname@example.org).
Accepted for Publication: August 23, 2017.
Published Online: October 6, 2017. doi:10.1001/jamainternmed.2017.5723
Author Contributions: Dr Tessler had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Tessler, Mooney, Witt, O’Connell, Jenness, Vavilala.
Acquisition, analysis, or interpretation of data: Tessler, Mooney, Witt, Jenness, Rivara.
Drafting of the manuscript: Tessler, Mooney, Witt, Vavilala.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Tessler, Mooney, Witt.
Administrative, technical, or material support: Mooney, Jenness, Vavilala.
Supervision: Vavilala, Rivara.
Conflict of Interest Disclosures: None reported.
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