title: Asphyxial games or "the choking game": a potentially fatal risk behaviour.
abstract: OBJECTIVE
  To determine the prevalence of knowledge about and participation in asphyxial games, sometimes called "the choking game", and how best to raise awareness of this risk-taking behaviour and provide preventive education.
  
  
  METHODS
  Questionnaire; collaborative research model; lay advocacy group/university researchers.
  
  
  METHODS
  8 middle and high schools in Texas (six) and Ontario (two). A recent death from playing the choking game had occurred in one Texas school, and two other fatalities had occurred within the state.
  
  
  METHODS
  Students in grades 4-12, aged 9-18 years.
  
  
  METHODS
  None.
  
  
  METHODS
  None.
  
  
  RESULTS
  Of 2762 surveys distributed, 2504 (90.7%) were completed. The mean (SD) age of the responders was 13.7 (2.2) years. 68% of children had heard about the game, 45% knew somebody who played it, and 6.6% had tried it, 93.9% of those with someone else. Forty percent of children perceived no risk. Information that playing the game could result in death or brain damage was reported as most likely to influence behaviour. The most respected source of a preventive education message was parents for pre-adolescents (43%) or victim/victim's family (36%) for older adolescents.
  
  
  CONCLUSIONS
  Knowledge of and participation in self-asphyxial behaviour is not unusual among schoolchildren. The age of the child probably determines the best source (parents or victim/victim's family) of preventive education.
authors.affiliation: Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. amacnab@cw.bc.ca
authors.forename: A J
authors.initials: AJ
authors.lastname: Macnab
authors.forename: M
authors.initials: M
authors.lastname: Deevska
authors.forename: F
authors.initials: F
authors.lastname: Gagnon
authors.forename: W G
authors.initials: WG
authors.lastname: Cannon
authors.forename: T
authors.initials: T
authors.lastname: Andrew
mesh_terms: D000293:Adolescent; D001237:Asphyxia / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011998:Recreation; D012309:Risk-Taking; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D013781:Texas / Q000453:epidemiology