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

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. Cross-sectional study. 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. 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