Between 1995 and 2007, at least 82 children and adolescents in the United States died as a result of playing the "choking game," according to a report released Thursday.
The choking game, which is also called the "pass-out game" or "space monkey," involves self-strangulation or strangulation by another with the goal of achieving a hypoxia-induced euphoric state.
The new findings, which appear in the Morbidity and Mortality Weekly Report for February 15, are based on a study conducted by the Centers for Disease Control and Prevention. Because no conventional data sets exist for choking game mortality, the Atlanta-based group analyzed media reports to generate an estimate.
The 82 deaths involved youth between 6 and 19 years of age with an average age of 13.3 years, the report indicates. Nearly 87% of the victims were male.
Between 1995 and 2004, no more than three choking game deaths were reported each year. In 2005, however, the number jumped to 22 and, in 2006, it reached 35. In the first 10 months of 2007, the number was down to 9. Exactly why these trends occurred is unclear, but the CDC believes they probably underestimate the true incidence.
Most of the choking game deaths occurred in children between 11 and 16 years of age. By contrast, the incidence of suicide from hanging or suffocation steadily increased in the 6-to-19 year age group.
Overall, 95.7% of choking game deaths occurred while the victim was alone. Nearly all parents (92.9%) said they were not even aware of the choking game until their child died.
"This report is an important first step in identifying the choking game as a public health problem," Dr. Ileana Arias, director the CDC's Injury Center, said in a statement. "More research is needed to identify risk factors that may contribute to kids playing the choking game and to determine what may help to reduce this type of behavior."