The advisory by Vivek Murthy, who was nominated by President Joe Biden, is the first such major report on gun violence from a surgeon general, whose office has limited authority but plays a significant role in public health issues.

A similar report on tobacco in the 1960s is viewed as a key first step to altering the perception of the substance's danger, ultimately leading to new regulations and a steep decline in consumption.

"Firearm violence is an urgent public health crisis that has led to loss of life, unimaginable pain, and profound grief for far too many Americans," Murthy said in a statement announcing the advisory.

"We don't have to continue down this path, and we don't have to subject our children to the ongoing horror of firearm violence in America. All Americans deserve to live their lives free from firearm violence, as well as from the fear and devastation that it brings."

The report cites government and other data that shows the United States is an extreme outlier on deaths and injuries from guns, especially for children.

Firearms in recent years have become the leading cause of deaths for Americans aged 1-19, above motor vehicles, the report said.

In 2022, 48,204 people died as a result of firearms, including suicides.

"It will take the collective commitment of our nation to turn the tide on firearm violence," Murthy said, calling for investments in research, community education programs, mental health support and tighter controls on buying guns.

The report also calls for mandating safe firearm storage, implementing universal background checks and banning assault weapons.

Biden and gun control activists have called for similar steps as the United States endures frequent mass shootings -- including in schools -- but reforms have been stymied for decades by opposition from the firearm lobby and Republican lawmakers.

Executive actions and state initiatives have been attacked in court as infringing on the constitutional right to own a firearm, enshrined in the Second Amendment.