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Open Access

The effect of legislation on firearm-related deaths in Canada: a systematic review

Nick Bennett, Manolhas Karkada, Mete Erdogan and Robert S. Green; on behalf of the Heal-NS Research Program
June 07, 2022 10 (2) E500-E507; DOI: https://doi.org/10.9778/cmajo.20210192
Nick Bennett
Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
BSc
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Manolhas Karkada
Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
BSc
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Mete Erdogan
Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
PhD MHI
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Robert S. Green
Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
MD
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    Figure 1:

    Flow diagram of studies selected for inclusion in the review.

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    Table 1:

    Major pieces of firearms legislation in Canada (5)

    BillDescriptionRelevant dates
    C-51
    • Mandatory FACs required criminal record checks of all firearm purchasers and record-keeping systems

    • New definitions for prohibited and restricted firearms

    • Mandatory minimum sentences (1–14 yr consecutive sentence for use of firearm to commit indictable offence) and increased penalties for firearm homicides

    • Granted search and seizure powers

    Aug. 5, 1977: Bill received royal assent
    Jan. 1, 1978: All provisions came into effect except requirements for FACs
    Jan. 1, 1979: Requirements for FACs came into effect
    C-17
    • Changes to the FAC system:

    • Expanded application form and screening check

    • Required psychological questionnaire, photo identification, 2 references, spousal endorsement, 28-day waiting period, safety training

    • New definitions for prohibited and restricted weapons

    • New prohibitions and restrictions on many military and high-firepower guns and ammunition

    • New Criminal Code offences and increased penalties for firearm-related crimes

    • Clearly defined regulations for safe storage, handling and transportation of firearms

    Dec. 5, 1991: Bill received royal assent
    1992–1994: All provisions came into effect
    Jan. 1, 1994: Requirements for FAC applicant safety training and psychological questionnaire completion came into effect
    C-68
    • Creation of the Firearms Act, to take administrative and regulatory aspects of the licensing and registration system out of the Criminal Code

    • FAC system replaced with 2 new licensing systems (POLs and PALs), which required expanded screening of applicants

    • Registration of all firearms, including shotguns and rifles

    • Increased penalties for certain serious crimes using firearms

    • Authorization requirement for transportation of restricted or prohibited firearms

    Dec. 5, 1995: Bill received royal assent
    January 1996: Provisions requiring increased penalties for serious firearms crimes came into effect
    Dec. 1, 1998: The Firearms Act came into effect
    March 1998: Government passed the Firearms Act regulations
    Jan. 1, 2001: Requirements for POLs/PALs came into effect
    Jan. 1, 2003: Requirements for registration of all firearms including nonrestricted rifles and shotguns came into effect
    • Note: FAC = Firearm Acquisition Certificate, PAL = Possession and Acquisition Licence, POL = Possession Only Licence.

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    Table 2:

    Characteristics of included studies

    Study (year)LocationPopulationPeriodLaw(s)OutcomesStatistical methods
    Sproule and Kennett (1988) (24)CanadaAll1972–1982Bill C-51HomicideAnalysis of variance
    Mundt (1990) (25)Canada; United StatesAll1971–1988Bill C-51Homicide, suicide, accidental deathVisual inspection
    Rich et al. (1990) (26)Toronto; San DiegoMales1973–1983Bill C-51Suicidet tests, time series analysis
    Mauser and Holmes (1992) (27)Canada (excluding Newfoundland and Labrador, and 3 territories)All1968–1988Bill C-51HomicidePooled cross-section time series model
    Leenaars et al.* (1993,1994, 1996,1997, 2001, 2003) (18)– (23)CanadaAll1969–1985Bill C-51Homicide, suicidet tests, simple linear regression, multiple regression, interrupted time series
    Carrington and Moyer (1994a) (28)OntarioAll1965–1989Bill C-51Suicidet tests, time series analysis
    Carrington and Moyer (1994b) (29)CanadaAll1965–1989Bill C-51SuicideInterrupted time series
    Leenaars and Lester (1997) (30)CanadaAll1969–1985Bill C-51Accidental deatht tests, simple linear regression, multiple regression
    Bridges (2004) (31)CanadaAll1984–1998Bill C-17Homicide, suicidet tests, simple linear regression
    Caron (2004) (32)Abitibi-Témiscamingue, Que.All1986–1996Bill C-17Suicideχ2 and likelihood ratio tests
    Cheung and Dewa (2005) (33)CanadaAge 15–19 years1979–1999Bill C-17SuicideTime series models
    Caron et al. (2008) (34)QuebecAll1987–2001Bill C-17SuicideLinear regression, interrupted time series analysis, Pearson correlation coefficient analyses, multivariate analysis
    Gagne et al. (2010) (35)QuebecMales1981–2006Bill C-17SuicideJoinpoint analysis, Poisson regression analysis
    Blais et al. (2011) (36)CanadaAll1974–2004Bill C-51, Bill C-17, Bill C-68HomicideMultiple time series analysis
    Langmann (2012) (37)CanadaAll1974–2008Bill C-51, Bill C-17, Bill C-68HomicideInterrupted time series Poisson regression, ARIMA, Joinpoint analysis
    Linteau and Blais (2013) (39)QuebecAll1974–2006Bill C-68HomicideExtreme bounds analysis
    McPhedran and Mauser (2013) (38)CanadaAll1974–2009Bill C-68Homicide, domestic homicideARIMA, Zivot–Andrews structural breakpoint test
    Langmann (2020) (40)CanadaAll1981–2016Bill C-17, Bill C-68Homicide, suicideDifference in differences analysis, negative binomial regression
    • Note: ARIMA = autoregressive integrated moving average.

    • ↵* Data from multiple reports investigating the same legislation, population and outcome were collated.

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    Table 3:

    Evidence for the effect of legislation on firearm homicide by subgroups

    BillStudyEntire populationMalesFemales
    AllYounger*Older†
    Bill C-51Sproule and Kennett (1988) (24)BeneficialNot assessedNot assessedNot assessedNot assessed
    Mundt (1990) (25)IneffectualNot assessedNot assessedNot assessedNot assessed
    Mauser and Holmes (1992) (27)IneffectualNot assessedNot assessedNot assessedNot assessed
    Leenaars and Lester (1994, 1996,1997, 2001) (19)– (22)BeneficialBeneficialBeneficialBeneficial‡Beneficial
    Blais et al. (2011) (36)BeneficialNot assessedNot assessedNot assessedNot assessed
    Langmann (2012) (37)IneffectualNot assessedNot assessedNot assessedNot assessed
    Bill C-17Bridges (2004) (31)BeneficialNot assessedNot assessedNot assessedNot assessed
    Blais et al. (2011) (36)IneffectualNot assessedNot assessedNot assessedNot assessed
    Langmann (2012) (37)IneffectualNot assessedNot assessedNot assessedNot assessed
    Langmann (2020) (40)Not assessedIneffectualIneffectual§IneffectualIneffectual
    Bill C-68Blais et al. (2011) (36)BeneficialNot assessedNot assessedNot assessedNot assessed
    Langmann (2012) (37)IneffectualNot assessedNot assessedNot assessedNot assessed
    Linteau and Blais (2013) (39)BeneficialNot assessedNot assessedNot assessedNot assessed
    McPhedran and Mauser (2013) (38)Not assessedIneffectualNot assessedNot assessedIneffectual
    Langmann (2020) (40)Not assessedIneffectualIneffectual§IneffectualIneffectual
    • ↵* Age 15–34 years.

    • ↵† Age ≥ 60 years.

    • ↵‡ Assessed older men aged ≥ 65 years.

    • ↵§ Assessed younger men aged 15–29 years.

    • View popup
    Table 4:

    Evidence for the effect of legislation on firearm suicide by subgroups

    BillStudyEntire populationMalesFemales
    AllYounger*Older†
    Bill C-51Mundt (1990) (25)IneffectualNot assessedNot assessedNot assessedNot assessed
    Rich et al. (1990) (26)Not assessedBeneficialNot assessedNot assessedNot assessed
    Carrington and Moyer (1994a) (28)BeneficialNot assessedNot assessedNot assessedNot assessed
    Carrington and Moyer (1994b) (29)BeneficialNot assessedBeneficial‡IneffectualNot assessed
    Leenaars et al. (1993, 1996,1997, 2003) (18), (20), (21), (23)BeneficialBeneficialBeneficialBeneficial§Beneficial
    Bill C-17Bridges (2004) (31)BeneficialNot assessedNot assessedNot assessedNot assessed
    Caron (2004) (32)BeneficialBeneficialNot assessedNot assessedBeneficial
    Cheung and Dewa (2005) (33)Not assessedNot assessedBeneficial¶Not assessedBeneficial¶
    Caron and colleagues (2008) (34)IneffectualIneffectualNot assessedNot assessedIneffectual
    Gagné and colleagues (2010) (35)Not assessedBeneficialBeneficialIneffectual§Not assessed
    Langmann (2020) (40)Not assessedIneffectualIneffectual‡BeneficialBeneficial
    Bill C-68Langmann (2020) (40)Not assessedIneffectualHarmful‡IneffectualIneffectual
    • ↵* Age 15–34 years.

    • ↵† Age ≥ 60 years.

    • ↵‡ Assessed younger men aged 15–29 years.

    • ↵§ Assessed older men aged ≥ 65 years.

    • ↵¶ Assessed males and females aged 15–19 years.

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The effect of legislation on firearm-related deaths in Canada: a systematic review
Nick Bennett, Manolhas Karkada, Mete Erdogan, Robert S. Green
Apr 2022, 10 (2) E500-E507; DOI: 10.9778/cmajo.20210192

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The effect of legislation on firearm-related deaths in Canada: a systematic review
Nick Bennett, Manolhas Karkada, Mete Erdogan, Robert S. Green
Apr 2022, 10 (2) E500-E507; DOI: 10.9778/cmajo.20210192
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