Warning To Parents: “Choking Game” is Popular, Dangerous

Reading time: 2 – 4 minutes

A new study published in the medical journal Pediatrics reports on the prevalence of youth participation in a dangerous strangulation game, commonly referred to as the “Choking Game” [1]. The game involves obstructing blood flow to the brain by tightening a scarf, rope or belt around the neck. When the belt is removed and blood returns to the brain, the participant experiences a euphoric high. The game, researchers report, is played purely for the purpose of experiencing a high; it is non-sexual in nature and is not the same as autoerotic asphyxiation.


Risks associated with participation in the “Choking Game” are numerous, and include the accumulation of significant damage to brain tissue with each instance of strangulation. Further, if a participant engages in choking while alone, there’s the great potential for unconsciousness to set in before the belt is removed, which subsequently leads to death.

In an attempt to determine the popularity of the game among middle school students, investigators surveyed 5,348 eighth graders in Oregon. They found that more than 6% of students had participated in the “Choking Game,” with roughly equal participation by both genders. The vast majority of participants played the game more than once. The authors also surveyed 11th graders, and found that 7.6% had participated in the game. Game participants were more likely than non-participants to be sexually active, have poor mental health, use other drugs or alcohol, and have been exposed to violence.

The authors conclude that the prevalence of the game and the fact that most participants are engaging in strangulation more than once indicate that children do not have adequate awareness off the dangers involved. They further suggest that healthcare providers for children and teens should be aware of the significant crossover between participation in the “Choking Game” and other risky behaviors. As such, those patients who are identified as engaging in risky behaviors might be appropriately targeted for education about the dangers of strangulation.

Parents, too, can watch for signs that their children are participating in the game. These include, but are not limited to: engaging in risky behaviors, marks on the neck, and complaining of frequent headaches. Even for those children who don’t appear to be at risk of participating in the “Choking Game,” parents might well be advised to initiate a dialogue about the game, whether the child has ever heard of it, and the associated dangers.


  1. Ramowski et al. Health Risks of Oregon Eighth-Grade Participants in the “Choking Game”: Results From a Population-Based Survey. Pediatrics. 2012 Apr 16. [Epub ahead of print]
About the Author

Kirstin Hendrickson, Ph.D., is a science journalist and faculty in the Department of Chemistry and Biochemistry at Arizona State University. She has a PhD in Chemistry, and studied mechanisms of damage to DNA during her graduate career. Kirstin also holds degrees in Zoology and Psychology. Currently, both in her teaching and in her writing, she’s interested in methods of communicating about science, and in the reciprocal relationship between science and society. She has written a textbook called Chemistry In The World, which focuses on the ways in which chemistry affects everyday life, and the ways in which humans affect each other and the environment through chemistry.