A newly published study from Johns Hopkins University highlights the prevalence of rifles and shotguns (long guns) used in rural suicides in Maryland.

Firearms are used in most fatal suicides in the U.S., mostly because they're accessible and lethal. Because long guns are less regulated than handguns and ubiquitous in rural areas, they're the weapon of choice for suicide in young and rural populations in Maryland, the authors write.

The study examined all 3,931 Maryland gun suicides from 2003 to 2018. In that time frame, 28.4% of gun suicides overall used long guns. In urban counties, long guns were used in 16.8% of gun suicides, but in rural counties the figure was 51.6%. After adjusting for demographics, intoxication and hunting seasons, suicide decedents from the most rural counties were 3.74 times more likely to use long guns than those in the most urban counties.

Long guns were also disproportionately used by the young in Maryland. Among those who died by suicide at age 18 or younger, 44.6% used long guns, compared to 20.2% among those 65 or older.

Because almost three-quarters of suicide attempts are made on impulse, easy access to firearms is a key factor. State laws that have reduced access to firearms by high-risk individuals have been shown to reduce suicide rates. Such measures include mandatory background checks and waiting periods as well as laws to keep guns at home locked away from children. "Long guns must be considered as part of access to lethal means or policy strategies in efforts to reduce the burden of firearm suicide," the authors write.