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Deadly 'Choking Game' Appeals to Young Teens

< Apr. 18, 2012 > -- Many more young teens take part in the "choking game," a potentially lethal activity, than experts had thought.

According to a new study, about 6 percent of eighth-graders have played the "game," in which participants use a rope or belt to cut off blood and oxygen to the brain for a brief "high."

"Six percent is quite a few kids," says Dennis Woo, M.D., at UCLA Medical Center in Santa Monica, Calif.

Researchers also found that of the teens who participated in the activity, two-thirds of them played it more than once and about a quarter had done it more than five times.

Immediate impact

Kids who play the choking game can lose consciousness in seconds, the CDC says. Within three minutes of continued strangulation, basic body functions such as memory, balance, and the central nervous system can fail. Death can occur shortly after that, the CDC says.

Eighty-two children and teens died from the choking game between 1995 and 2007, the latest statistics available from the CDC. That number was drawn from media reports of the deaths and so is likely lower than the actual total, the agency says. Most of those who died were playing the game alone.

For those who don't die, the CDC says that long-term effects can include:

  • Seizures, from lack of oxygen

  • Concussions, from falls

  • Broken bones, from falls

  • Hemorrhage of the eye

Teen survey

For the study, published in this week's Pediatrics, researchers looked at data from the 2009 Oregon Healthy Teens survey of nearly 5,400 eighth-graders. The teens, ages 12 to 15, answered questions about the choking game and about their physical health, sexual activity, exercise, nutrition, body image, substance abuse, and exposure to violence.

Among the findings: Kids who played the choking game were more likely to be sexually active and abuse drugs or alcohol. Girls who played the game were more likely to gamble and have poor nutrition. Boys who played the game were more likely to have been exposed to violence.

"Males and females seem to participate equally [in the game]," says lead researcher Robert Nystrom at the Oregon Public Health Division in Portland.

The researchers make a distinction between the choking game and autoerotic asphyxiation, which involves sexual intercourse. They also point out that referring to the activity as a "game" downplays its seriousness. Other experts have recommended calling it a "strangulation activity."

What parents can do

For parents, the best advice is to be aware of your children's friends and what they're doing, Dr. Woo says. Be alert to behavior changes, such as suddenly not doing well in school, because that might indicate they are getting involved in risky behaviors.

Nystrom adds that parents need to be aware of the warning signs of the choking game. That could include marks on the neck, red dots around the eyelid (reflecting hemorrhage) and unexplained headaches.

For more information on health and wellness, please visit health information modules on this website.

When Teens Need Help

All teens need daily support and guidance, but some need extra help. Early intervention is crucial in reducing the damage that serious problems might cause. Signs your child might need help include:

  • Spending a lot of time alone

  • Sudden drop in school performance

  • Drastic mood swings or changes in behavior

  • Separation from longtime friends

  • Lack of interest in hobbies or social and recreational activities

  • Drug or alcohol abuse

If talking with your teen doesn't improve the situation, seek support and guidance from school staff or mental health professionals.

Always talk with your health care provider to find out more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

CDC - The Choking Game

CDC - Young Teens

Pediatrics - Health Risks of Oregon Eighth-Grade Participants in the "Choking Game"