Second Amendment rights advocates were swift to react with concern after the nation’s top doctor issued an advisory stating that gun violence in the United States has become a crisis.

Surgeon General Dr. Vivek Murthy, on Tuesday, declared that gun violence is a public health crisis, citing the fact that in the last ten years “firearm violence has become the number one cause of death among children and adolescents, more than car accidents or drug overdoses.”

“Today, for the first time in the history of our office, I am issuing a Surgeon General’s Advisory on Firearm Violence. Firearm violence is a public health crisis in America that poses a serious threat to the health and well-being of our country,” Dr. 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. All Americans deserve to live their lives free from firearm violence, as well as from the fear and devastation that it brings. It will take the collective commitment of our nation to turn the tide on firearm violence,” he said.

The advisory — which isn’t much more than a word of caution absent legislation from Congress addressing firearms — lays out an approach to reducing gun violence, including “implementing community violence prevention programs and firearm risk reduction strategies, improving access to mental health care for those exposed to or at risk for firearm violence, and expanding research funding to inform and evaluate our prevention strategies.”

The National Rifle Association, the nation’s largest gun rights group, responded with alarm and warned this action is just another infringement on constitutionally protected activities. Randy Kozuch, the group’s Executive Director, took aim at the Surgeon General’s boss.

“This is an extension of the Biden Administration’s war on law-abiding gun owners. America has a crime problem caused by criminals. The reluctance to prosecute and punish criminals on the part of President Biden and his allies is the primary cause of that. That’s a simple fact,” Kozuch said in a statement shared on the social media.

Gun violence prevention groups responded with praise, saying enough is enough.

“When gun violence is the leading cause of death for children and teens in America, it must be declared a public health crisis and treated as such. We thank Dr. Vivek Murthy for this historic step toward ending gun violence,” the group Moms Demand Action said in social media postings.

“Gun violence is a public health crisis. We’re thankful to the Surgeon General for not just recognizing it as such today — but outlining how we treat it as such with an evidence-based plan to reduce gun violence,” the group Everytown for Gun Safety wrote.

The announcement comes on the two year anniversary of the Bipartisan Safer Communities Act, the most significant piece of firearms legislation signed into law in decades. According to the White House, the law is working.

“Six of the nine deadliest shootings in the U.S. since 2018 were carried out by people 21-years-old or younger. To address this, President Biden’s Bipartisan Safer Communities Act requires enhanced background checks for people under the age of 21. So far, these enhanced checks have stopped 800 sales to individuals under age 21 who are prohibited from purchasing firearms – resulting in 25% additional denials to individuals under 21,” the Biden Administration said in a statement.