Health Risks of Oregon Eighth-Grade Participants in the Choking Game: Results From a Population-Based Survey

• Published in: Pediatrics (Evanston) Vol. 129; no. 5; pp. 846 - 851
• Main Authors: RAMOWSKI, Sarah K, NYSTROM, Robert J, ROSENBERG, Kenneth D, GILCHRIST, Julie, CHAUMETON, Nigel R
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL American Academy of Pediatrics 01-05-2012
• Subjects: Adolescent; Airway Obstruction - epidemiology; Airway Obstruction - ethnology; Airway Obstruction - psychology; Biological and medical sciences; Brain - blood supply; Brain Ischemia - ethnology; Brain Ischemia - psychology; Child; Choking; Comorbidity; Cross-Sectional Studies; Ethnic Groups - psychology; Ethnic Groups - statistics & numerical data; Euphoria; Female; General aspects; Health aspects; Health behavior; Health Surveys; Humans; Hypoxia, Brain - ethnology; Hypoxia, Brain - psychology; Male; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - ethnology; Mental Disorders - psychology; Miscellaneous; Motivation; Multivariate analysis; Oregon; Pediatrics; Play and Playthings - psychology; Prevention; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk-Taking; Sex Factors; Strangulation; Substance-Related Disorders - epidemiology; Substance-Related Disorders - ethnology; Substance-Related Disorders - psychology; Teenagers; Youth; Oregon; United States; North America; America; Human; Participation; Pediatrics; risk assessment; adolescents; Injury; injury prevention and control; Check; Adolescent medicine; Trauma; Care; Result; Prevention; Play; Surveillance; preventive health care visits; Population-based survey; Adolescent; Risk factor; Health hazards; Lesion; Public health
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2011-2482

To examine the risk behaviors associated with participation in the "choking game" by eighth-graders in Oregon.
We obtained data from the 2009 Oregon Healthy Teens survey, a cross-sectional weighted survey of 5348 eighth-graders that questioned lifetime prevalence and frequency of choking game participation. The survey also included questions about physical and mental health, gambling, sexual activity, nutrition, physical activity/body image, exposure to violence, and substance use.
Lifetime prevalence of choking game participation was 6.1% for Oregon eighth-graders, with no differences between males and females. Of the eighth-grade choking game participants, 64% had engaged in the activity more than once and 26.6% >5 times. Among males, black youth were more likely to participate than white youth. Among both females and males, Pacific Islander youth were much more likely to participate than white youth. Multivariate logistic regression revealed that sexual activity and substance use were significantly associated with choking game participation for both males and females.
At >6%, the prevalence of choking game participation among Oregon youth is consistent with previous findings. However, we found that most of those who participate will put themselves at risk more than once. Participants also have other associated health risk behaviors. The comprehensive adolescent well visit, as recommended by the American Academy of Pediatrics, is a good opportunity for providers to conduct a health behavior risk assessment and, if appropriate, discuss the dangers of engaging in this activity.