Firearms regulation and declining rates of male suicide in Quebec.

OBJECTIVES To examine whether significant changes in method-specific male suicide rates occurred in the province of Quebec after stronger firearms regulations were introduced in Canada in 1991; to ascertain whether more stringent firearms regulations influence firearms and total suicide trends among men and to determine whether different results are obtained according to the statistical methods used. STUDY DESIGN Descriptive analyses of time trends in method-specific suicide rates for men from 1981 to 2006 using Joinpoint regression models and pre-post firearms regulation analyses. SETTING Quebec (Canada). PATIENTS OR SUBJECTS: Men who have commited suicide aged 15-34, 35-64 and 65 years and over, based on the Quebec mortality database, 1981-2006. INTERVENTIONS A national firearms control initiative enacted in 1991. RESULTS The Joinpoint regression models suggest that firearm suicide rates declined towards the end of the 1990 s. Since 1996, the pace of decline was twice as great in men aged 15-34 years (annual percentage change (APC) -11.1%) compared with men aged 35-64 years (APC -5.6%). Total suicide rates also declined among men aged 15-34 and 35-64 years during this period. Pre-post firearms regulation Poisson regression analyses failed to detect the specific point in time when significant changes in the trend occurred. CONCLUSIONS Male firearm suicide rates declined following the introduction of restrictive firearms regulations in Canada. Whether this represents a causal relationship requires further study.