{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:40:40Z","timestamp":1791229240032,"version":"4.1.0"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Inj Prev"],"published-print":{"date-parts":[[2009,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives:<\/jats:title>\n                  <jats:p>To determine the prevalence of knowledge about and participation in asphyxial games, sometimes called \u201cthe choking game\u201d, and how best to raise awareness of this risk-taking behaviour and provide preventive education.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Questionnaire; collaborative research model; lay advocacy group\/university researchers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects:<\/jats:title>\n                  <jats:p>Students in grades 4\u201312, aged 9\u201318 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention:<\/jats:title>\n                  <jats:p>None.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures:<\/jats:title>\n                  <jats:p>None.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>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\u2019s family (36%) for older adolescents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>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\u2019s family) of preventive education.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ip.2008.018523","type":"journal-article","created":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T16:32:39Z","timestamp":1233678759000},"page":"45-49","source":"Crossref","is-referenced-by-count":38,"title":["Asphyxial games or \u201cthe choking game\u201d: a potentially fatal risk behaviour"],"prefix":"10.1136","volume":"15","author":[{"given":"A J","family":"Macnab","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Deevska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Gagnon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W G","family":"Cannon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Andrew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,2,3]]},"reference":[{"key":"2025092504044618000_15.1.45.1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2003.49"},{"key":"2025092504044618000_15.1.45.2","doi-asserted-by":"publisher","DOI":"10.1136\/ip.7.3.231"},{"key":"2025092504044618000_15.1.45.3","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/PAF.0b013e318148bdb2","article-title":"Asphyxial games in children and adolescents.","volume":"28","author":"Andrew","year":"2007","journal-title":"Am J Forensic Med Pathol"},{"key":"2025092504044618000_15.1.45.4","unstructured":"Scott SM Wiebe RA . Near-hanging and choking injury. In: Levin D L Morriss F C , eds. Essentials of pediatric intensive care. 2nd edn. New York: Churchill Livingstone, 1997:999\u00e2\u0080\u00931001."},{"key":"2025092504044618000_15.1.45.5","first-page":"141","article-title":"Unintentional strangulation deaths from the \u00e2\u0080\u009cChoking Game\u00e2\u0080\u009d among youths aged 6\u00e2\u0080\u009319 years, United States, 1995\u00e2\u0080\u00932007.","volume":"57","author":"Centers for Disease Control and Prevention","year":"2008","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025092504044618000_15.1.45.6","unstructured":"Statistics Canada. Death by cause: external causes of morbidity and mortality, age group and sex, Canada, annual (number), Table 102\u00e2\u0080\u00930540 CANSIM (database). http:\/\/cansim2.statcan.ca\/cgi-win\/CNSMCGI.PGM?LANG\u00e2\u0080\u008a=\u00e2\u0080\u008aEng&Dir-Rep\u00e2\u0080\u008a=\u00e2\u0080\u008aCII\/&CNSM-Fi\u00e2\u0080\u008a=\u00e2\u0080\u008aCII\/CII_1-eng.htm (accessed 3 Dec 2008)."},{"key":"2025092504044618000_15.1.45.7","doi-asserted-by":"crossref","unstructured":"McFaull SR . Injuries associated with playing asphyxiation games among children and youth. The Canadian Hospitals Injury Reporting and Prevention Progam (CHIRPP), 1990\u00e2\u0080\u00932005. Proceedings of the Canadian Injury Prevention and Safety Promotion Conference, Toronto, 2007. 35\u00e2\u0080\u009336.","DOI":"10.1037\/e509012013-181"},{"key":"2025092504044618000_15.1.45.8","unstructured":"Ontario Student Drug Use and Health Survey. http:\/\/www.camh.net\/research\/osdus.html (accessed 19 Nov 2008)."},{"key":"2025092504044618000_15.1.45.9","unstructured":"Telecom Association. http:\/\/www.telecomassociation.com\/pubs\/chokinggamereport\/news.asp (accessed 19 Nov 2008)."},{"key":"2025092504044618000_15.1.45.10","unstructured":"Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying cause mortality files, United States, 1992. Hyattsville, MD: National Center for Health Statistics, 1994."},{"key":"2025092504044618000_15.1.45.11","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/adc.72.1.6","article-title":"Suffocation, choking and strangulation in childhood in England and Wales: epidemiology and prevention.","volume":"1","author":"Nixon","year":"1995","journal-title":"Arch Dis Child"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ip.2008.018523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T11:04:55Z","timestamp":1758798295000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/ip.2008.018523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,2]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2009,2,3]]},"published-print":{"date-parts":[[2009,2]]}},"alternative-id":["10.1136\/ip.2008.018523"],"URL":"https:\/\/doi.org\/10.1136\/ip.2008.018523","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,2]]}}}