A majority of U.S. adults say it’s at least sometimes appropriate for doctors to discuss guns with patients during check-ups, a nationwide survey finds.

While just 23 percent of people surveyed thought it was always OK for doctors to ask about guns, another 14 percent said this was usually appropriate and an additional 30 percent considered it reasonable in some situations.

Overall, people who didn’t own firearms were more supportive of doctors bringing up the topic, compared to gun owners.

“I think that some gun owners may have had (or heard of) negative experiences with doctors who were judgmental or offensive, and some may worry that doctors are trying to confiscate guns,” said lead study author Dr. Marian Betz of the University of Colorado Anshutz Medical Campus in Aurora.

“Conversations about gun safety between providers and patients should be nonjudgmental, educational, and focused on improving the health and safety of the patient and those around him or her,” Betz added by email. “Unfortunately, the larger political debate over gun control laws can spill over into healthcare settings.”

In 2014, there were more than 33,000 gun deaths in the U.S., most of which were suicides, and an additional estimated 81,000 non-fatal firearm injuries, researchers note in the Annals of Internal Medicine.

Previous research has found many gun owners keep at least some of their guns unlocked and loaded, even when children live in the home, Betz and colleagues note.

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But doctors often don’t discuss guns with patients, due in part to time constraints and inadequate training on how to broach the subject, they add.

To assess whether patients would be open to these conversations, researchers examined data from a nationally representative online survey of about 3,900 adults conducted in April 2015.

On average, participants were about 49 years old. Roughly half were men and around 30 percent had at least one child under the age of 18 living at home.

About 45 percent said there had been at least one firearm in their home during childhood.

Most weren’t gun owners, but 23 percent said they owned firearms and an additional 12 percent said they lived with a gun owner.

Half of the adults surveyed were unsure whether having a gun in the home would make the home safer or more dangerous; they thought it depended on the circumstances. The rest of participants were roughly split between thinking guns enhanced safety or posed a danger.

One limitation of the study is that the survey didn’t ask patients about the context of gun discussions with doctors, the authors note. For example, a parent with young children or a patient at risk for suicide might need a different conversation about guns than other people, the authors point out.

“This conversation is all about context,” said Dr. Eric Fleegler, a specialist in emergency medicine at Boston Children’s Hospital who wasn’t involved in the study.

Guns should be on a list of routine uncomfortable questions doctors ask patients during routine check-ups, the same way physicians may ask about things like sex or smoking or drug use, Fleegler said in a phone interview.

“In context, a doctor doesn’t just walk right into the exam room and ask you about guns,” Fleegler added.

It’s understandable that patients may resist counseling, but doctors should still be aware of specific situations when it’s important to have the discussion anyway because firearms might pose a greater risk to patients or people they live with, said Ziming Xuan, a public health researcher at Boston University who wasn’t involved in the study.

For example, parents of young children need to know kids might try to play with firearms left loaded and unlocked. And having guns in the home can increase the risk of suicide attempts for people who have severe mental illness.

Whenever patients have guns in the home, doctors need to cover safety basics like making sure any firearms are locked up and stored unloaded, Xuan added by email.

“We need to think of gun safety as both an individual and public health issue,” Xuan said.