Lifetime Prevalence of Nonfatal Firearm Victimization, Offensive Gun Use, and Defensive Gun Use in a National Sample of US Adults

Importance: Firearm-related encounters have the potential for high risk of injury, but few studies have estimated the prevalence and co-occurrence among offensive gun use (OGU), defensive gun use (DGU), and nonfatal firearm victimization (NFV) in the same national probability sample. Objective: Estimate the lifetime prevalence of OGU, DGU, and NFV, their co-occurrence, and demographic correlates in a nationally representative sample of US adults.Design, Setting, and Participants: This study used data from the National Firearms, Alcohol, Cannabis, and Suicide (NFACS) survey, a probability-based sample of 7034 adults living in the US, that was in the fielded from May 27 to September 2, 2025. Main outcomes and measures: Primary outcomes were any lifetime occurrence of OGU, DGU, or NFV. Results: Lifetime prevalence was 5.2% (95% CI 4.5%-6.0%) for OGU, 12.6% (95% CI 11.5%-13.7%) for DGU, and 31.5% (95% CI 30.0%-33.0%) for NFV. Weighted to the US population, we estimate 13.9 million adults have used a gun offensively, 33.3 million defensively, and 83.3 million have experienced NFV in their lifetime. For each domain, most respondents (~80%) only reported incidents in which a gun was not discharged. There was a high rate of co-occurrence between OGU and DGU (OR = 33.8, 95% CI 22.7-40.9), and between NFV and OGU (OR = 5.3, 95% CI 3.9-7.2) and DGU (OR = 4.5, 95% CI 3.7-5.6). Gun usage and/or NFV was associated with older age, male sex, Black race, lower income and education, gun ownership, military service, and having a job that required carrying a firearm.Conclusion and Relevance: A large minority of Americans have had a victimization experience with firearms while a smaller but still significant proportion have used a gun for defense. It is important then that public policies minimize firearm-related harm while maintaining their societal benefits.