The US surgeon general on Tuesday issued a landmark advisory declaring gun violence a "public health crisis" and calling for wide-ranging firearm controls that have historically been quashed by stiff political opposition.

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 public role in health issues.

A similar report on tobacco in the 1960s was 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.

"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."

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.

But the influential NRA gun rights organization quickly slammed the advisory as "an extension of the Biden Administration's war on law-abiding gun owners."

"America has a crime problem caused by criminals," said Randy Kozuch, director the NRA's lobby arm, said on X.

- 48,000 killed each year --

The surgeon general's report said in 2022 over 48,000 people died as a result of firearms, disproportionately affecting Black Americans and men.

It added that suicides had increased by 20.1 percent from 2012-2022 and represented over half of gun-related deaths.

"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 to tackle gun deaths have been attacked in court as infringing on the constitutional right to own a firearm, enshrined in the Second Amendment.

"Many people I talked to around the country worry that this may be an intractable problem, that there's no way to solve it -- that is not true," Murthy told CNN.

"My hope (with) this advisory is that we can actually take it out of the realm of politics and put it into the realm of public health, which is where it belongs.

Murthy also hailed a 2022 gun safety package passed by Congress -- the most notable in decades -- that beefed up background checks and supported states passing so-called "Red Flag" laws, which allow for the seizure of weapons from people deemed high risk.

In a speech in Cleveland, Ohio, on Tuesday, Attorney General Merrick Garland said the legislation -- the Bipartisan Safer Communities Act -- had stopped 800 firearm purchases "by young people who are legally prohibited from obtaining guns."

Garland also said that the Justice Department that day had published an interim final rule allowing gun dealers to check an FBI database to see whether firearms being sold to them had been reported as stolen.

Such checks, however, remain voluntary, the Department of Justice said.