CDC Warns of Choking-Game Deaths

Choking Game Killed at Least 82 Youths From 1995 to 2007

Reviewed by Louise Chang, MD on February 14, 2008
From the WebMD Archives

Feb. 14, 2008 -- The CDC today warned parents, teachers, and health care providers about the so-called choking game, which has killed at least 82 U.S. youths since 1995.

"The choking game involves intentionally trying to choke oneself or someone else with one's hand or a noose to attain a brief euphoric state or high. If the strangulation is prolonged, which is something that can happen very quickly, death or a serious injury can result," explains Robin Toblin, PhD, MPH, of the CDC's National Center for Injury Prevention and Control.

The CDC found 82 media reports of choking-game deaths in the U.S. from 1995 to 2007. The kids who died were 13 years old, on average, and 87% were boys. Nearly all of their parents weren't aware of the choking game before their child died.

Warning Signs of the Choking Game

The CDC urges parents, teachers, and health care workers to learn the possible warning signs of the choking game:

  • Discussion of the game, including other names for it, such as "pass-out game" or "space monkey"
  • Bloodshot eyes
  • Marks on the neck
  • Severe headaches
  • Disorientation after spending time alone
  • Ropes, scarves, and belts tied to bedroom furniture or doorknobs or found knotted on the floor
  • The unexplained presence of dog leashes, choke collars, and bungee cords.

"If parents believe their child is playing the choking game, they should speak to them about the life-threatening dangers associated with the game and seek additional help if necessary," Toblin said at a news conference.

Rise in Choking Game Deaths

"Three or fewer choking game-related deaths per year were reported in the news media from 1995-2004," says Toblin. "However, there was a jump to 22 reports of deaths in 2005 and 30 reports in 2006. In 2007 there was a sharp decrease, with nine deaths occurring in the first 10 months."

It's not clear if choking game deaths are down or if they're getting less media coverage.

The choking game isn't new. "What is new now is that children are playing alone and that they're using ligatures [nooses]," says Toblin.

She notes that kids appear to be learning the choking game from each other and that the CDC doesn't expect its report -- and publicity about the report -- to increase children's choking-game deaths.

Deaths weren't included in the study if they were linked to autoerotic asphyxiation, which the CDC defines as a practice of choking oneself during sexual stimulation.

Deaths also weren't included in the study if it wasn't clear whether the child was trying to commit suicide. Youth suicides by hanging or suffocation tend to peak at age 19, whereas choking-game deaths peak at 13, "so these really seem to be different phenomenon," says Toblin.

The CDC relied on media reports for the study because choking-game deaths aren't noted on death certificates.

The findings appear in the Feb. 15 edition of the CDC's Morbidity and Mortality Weekly Report.

Show Sources


CDC, Morbidity and Mortality Weekly Report, Feb. 15, 2008; vol 57: pp 141-144.

Robin Toblin, PhD, MPH, National Center for Injury Prevention and Control.

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