This is a sub-category of deaths due to suicide and includes all intentional deaths by means of firearms as well as those where the intent was undetermined, but suicide was a possibility.

See also Map 20 Assault using firearms.

As with the other categories of death related to suicide shown here, many of the undetermined cases may have been actual suicide attempts, but without conclusive evidence such as an authentic suicide note. Alternatively, the death may have been truly accidental. In only one eighth of the cases under ICD-9 was a possibility of accident reflected in the cause recorded on death certification. That proportion has risen slightly in more recent years.

Only one in 20 of these deaths are of females, a pattern starkly illustrated in the age–sex bar chart. The map therefore effectively reflects the rate for males.

In terms of prevention, the rate of suicide (and also homicide) using firearms has been found to be related to access to firearms and the availability of firearms within the home. The safer storage of firearms – keeping them locked and unloaded – within the home can reduce the likelihood that they will be used as an impulsive method of suicide.

Another facet of access to suicide methods is occupation. The occupations with the highest rates of suicide using firearms are farmers, forestry workers, veterinarians and farm workers.

Singer-songwriter Kurt Cobain, author Ernest Hemingway and journalist Hunter S. Thompson died from this cause.