Advertisement

Association of Adolescent Choking Game Activity With Selected Risk Behaviors

  • Joseph A. Dake
    Correspondence
    Address correspondence to Joseph A. Dake, PhD, MPH, Department of Health and Recreation Professions, MS 119, University of Toledo, 2801 West Bancroft St, Toledo, Ohio 43606.
    Affiliations
    Department of Health and Recreation Professions, University of Toledo, Toledo, Ohio (Drs Dake and Price; Ms Kolm-Valdivia); and Hospital Council of Northwest Ohio, Toledo, Ohio (Ms Wielinski)
    Search for articles by this author
  • James H. Price
    Affiliations
    Department of Health and Recreation Professions, University of Toledo, Toledo, Ohio (Drs Dake and Price; Ms Kolm-Valdivia); and Hospital Council of Northwest Ohio, Toledo, Ohio (Ms Wielinski)
    Search for articles by this author
  • Nicole Kolm-Valdivia
    Affiliations
    Department of Health and Recreation Professions, University of Toledo, Toledo, Ohio (Drs Dake and Price; Ms Kolm-Valdivia); and Hospital Council of Northwest Ohio, Toledo, Ohio (Ms Wielinski)
    Search for articles by this author
  • Margaret Wielinski
    Affiliations
    Department of Health and Recreation Professions, University of Toledo, Toledo, Ohio (Drs Dake and Price; Ms Kolm-Valdivia); and Hospital Council of Northwest Ohio, Toledo, Ohio (Ms Wielinski)
    Search for articles by this author

      Abstract

      Objective

      Previous research has recommended education for parents, teachers, and anticipatory guidance by pediatricians regarding participation in the so-called choking game, a potentially fatal behavior. The purpose of this study was to examine possible associations between selected demographic variables and risk behaviors with youth engagement in the choking game on the basis of secondary data analysis from a general adolescent health risk behavior survey.

      Methods

      Self-administered survey data from an adolescent needs assessment was used to assess choking game behavior between fall 2008 and fall 2009. The sample included 192 classrooms across 88 schools in a Midwestern state.

      Results

      Of the 3598 questionnaires distributed to middle and high school students, 3408 (95%) were returned completed. Participation rate in the choking game was 9%, with male participation (11%) greater than female participation (7%), and high school students (11%) more likely than middle school students (5%) to participate. Adjusted odds ratios found that the likelihood of middle school students engaging in the choking game were higher for older students, substance users, and those having lower grades. For high school students, adjusted odds ratios found that being older, substance use, and selected mental health issues (forced sex and attempted suicide) were most associated with choking activities.

      Conclusions

      Engaging in the choking game was highly associated with abuse of substances, suggesting that youth engage in the choking game for the thrill-seeking experience of brief euphoria, a drug-related feeling. To reduce the potentially fatal consequences associated with this behavior, pediatricians should screen youths and provide anticipatory guidance for higher-risk youths and their parents.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Macnab A.J.
        • Deevska M.
        • Gagnon F.
        • et al.
        Asphyxial games or “the choking game”: a potentially fatal risk behaviour.
        Inj Prev. 2009; 15: 45-49
        • Shlamovitz G.Z.
        • Assia A.
        • Ben-Sira L.
        • Rachmel A.
        “Suffocation roulette”: A case of recurrent syncope in an adolescent boy.
        Ann Emerg Med. 2003; 41: 223-226
        • Andrew T.A.
        • Fallon K.K.
        Asphyxial games in children and adolescents.
        Am J Forensic Med Pathol. 2007; 28: 303-307
        • Centers for Disease Control and Prevention
        Unintentional strangulation deaths from the “choking game” among youths aged 6–19 years, United States, 1995–2007.
        MMWR Morb Mortal Wkly Rep. 2008; 57: 141-144
        • Andrew T.A.
        • Macnab A.
        • Russell P.
        Update on the “choking game”.
        J Pediatr. 2009; 155: 777-780
        • Urkin J.
        The choking game or suffocation roulette in adolescence.
        Int J Adolesc Med Health. 2006; 18 ([editorial]): 207-208
        • McClave J.L.
        • Russell P.J.
        • Lyren A.
        • et al.
        The choking game: physician perspectives.
        Pediatrics. 2010; 125: 82-88
      1. Centers for Disease Control and Prevention. 2007 youth risk behavior survey. Available at: http://www.cdc.gov/HealthyYouth/yrbs/brief.htm. Accessed March 18, 2010.

      2. Centers for Disease Control and Prevention. YRBSS frequently asked questions. Available at: http://www.cdc.gov/HealthyYouth/yrbs/faq.htm. Accessed March 18, 2010.

        • Field A.
        Discovering Statistics Using SPSS.
        2nd ed. Sage, Thousand Oaks, Calif2009
        • Ramowski S.K.
        • Nystrom R.J.
        • Chaumeton N.R.
        • et al.
        “Choking game” awareness and participation among 8th graders—Oregon, 2008.
        MMWR Morb Mortal Wkly Rep. 2010; 59: 1-5
        • Byrd R.S.
        • Weitzman M.
        • Doniger A.S.
        Increased drug use among old-for-grade adolescents.
        Arch Pediatr Adolesc Med. 1996; 150: 470-476
        • Malek M.K.
        • Chang B.H.
        • Davis T.C.
        Fighting and weapon-carrying among seventh-grade students in Massachusetts and Louisiana.
        J Adolesc Health. 1998; 23: 94-102
      3. Centers for Disease Control and Prevention. Student health and academic achievement. Available at: http://www.cdc.gov/HealthyYouth/health_and_academics/index.htm. Accessed March 18, 2010.