The rise in adolescent handgun carriage over the past decade represents a significant public health concern. Using nationally representative data, this study examines risk factors associated with handgun carriage among U.S. adolescents. We used data on adolescents aged 12–17 years from the 2021 and 2022 National Survey on Drug Use and Health ( n = 20,869), with past-year handgun carriage defined as a binary variable. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) to determine factors associated with handgun carriage across adolescent age groups (12–13 years, 14–15 years, 16–17 years). The average prevalence of adolescent past-year handgun carriage was 4.0%. Across age groups, past-year violence and selling illicit drugs were associated with handgun carriage. There was variation among age groups between substance use and handgun carriage; handgun carriage was associated with alcohol use in 12–13 year-olds (OR: 4.22, 95% CI: 1.50,11.83), and cannabis (OR: 2.04, 95% CI: 1.06,3.93) and illicit drug use (OR: 3.28, 95% CI: 1.11,9.68) in 14–15 year-olds. Suicidality was only associated with handgun carriage for ages 12–13 years (OR: 2.49, 95% CI: 1.29,4.79). Understanding risk factors of handgun carriage among different stages of adolescence can enhance preventive efforts aimed at reducing handgun carriage. • Past-month alcohol use is positively associated with adolescent handgun carriage. • Illicit drug selling is positively associated with adolescent handgun carriage. • Violent behavior is positively associated with adolescent handgun carriage. • Suicidality is positively associated with adolescent handgun carriage. • Rurality is associated with increased odds of adolescent handgun carriage.
Booty et al. (2026) studied this question.