RESOURCES  

Disclaimer:  These links are provided for informational purposes only. While Erik’s Cause may collaborate with some groups on shared mission projects, we do not endorse specific organizations, programs, or materials, and make no recommendation regarding their quality or effectiveness.  Inactive links have been removed.

ADVOCACY GROUPS

    • Erik's Cause - “Turning our Tragedy into Action to Combat Deadly Online Harms”

    • Fairplay - An independent voice standing up for what kids and families really need, free from the false promises of marketers and the  manipulations of Big Tech." 

    • Parents for Safe Online Spaces - Advancing safeguards to prevent online harms. We are 20 families bound together by the unimaginable: the loss of a child.

    • Parents Rise - “a survivor parent–led grassroots movement that transforms grief into action. We unite survivor parents, impacted families, and allies to demand tech accountability, advance systemic reform, and champion child-centered digital design"

    • National Center on Sexual Exploitation - “The National Center on Sexual Exploitation (NCOSE) exists to build a  world where people can live and love without sexual abuse and  exploitation."

    • Screen Time Action Network at Fairplay - "A coalition of practitioners, educators, advocates, and parents working to promote a healthy childhood by reducing the amount of time kids spend with digital devices."

    • Encode - "We fight for a future where artificial intelligence can fulfill its transformative potential."

    • Design It For Us - Advocating for policy for safer social media and online platforms for kids, teens, and young adults.

    • Molly Rose Foundation - Suicide prevention, targeted towards young people under the age of 25

    • Social Media Victims Law Center - "Empowering Parents to protect their Kids and Hold Social Media Companies Accountable

    • Alexander Neville Foundation - Provides education about fentanyl poisoning and the role of social media and illegal drug sales.

    • HEAT Initiative - "A collective effort of concerned child safety experts and advocates  encouraging leading technology companies to combat child sexual abuse on  their platforms."

    • Becca Schmill Foundation - "To fund and advocate for policies, programs and research that promote and safeguard the emotional well being of adolescents and young adults through education, lawmaking and legal action."

    • Talk More, Tech Less - A digital wellness and safety organization.

    • Matthew E. Minor Awareness Foundation, - "Committed to bringing awareness about the hidden dangers of the internet to our children and teens, such as cyberbullying, self-harm, cyberdares i.e. (Knock-out challenges/ Blackout Challenge) and helping families cope with grief after losing a loved one." 

    • Mothers Against Media Addiction (MAMA) - "A grassroots movement of parents fighting back against media addiction  and creating a world in which real-life experiences and interactions  remain at the heart of a healthy childhood." 

    • Common Sense, "Dedicated to helping all kids thrive in a world of media and technology."

    • Video Game Addiction - The team running this website is composed of both experts and advocates with varied and eclectic takes on this fast emerging public health issue.

    • ParentsTogether - Provides independent reporting and commentary on issues that affect kids and families, providing the latest research, policies, and trends so that busy parents  have the information they need to help their families thrive. 

    • The Carson J. Bride Effect - dedicated to exposing the harms of “Tiny Tech”—smaller, fast-growing apps that often slip under the radar but pose serious dangers to children.

    • Drug Awareness Foundation - dedicated to preventing addiction and drug-related deaths through education and awareness.

    • Englyn Roberts’ Foundation - mission is to educate parents, educators, and students about social media.

    • Jools Law - Jools’ Law is a British campaign which ensures that data is preserved so the truth can be found and big tech companies can be held accountable. 

    • Social Media Harms,  Advocacy for safer online platforms and stronger accountability.

    • Tech Oversight Project, Investigates Big Tech and promotes stronger oversight.

    • Center for Humane Technology, "Our mission is to align technology with humanity’s best interests. We  envision a world with technology that respects our attention, improves  our well-being, and strengthens communities."

    • Cyberbullying Research Center, "Dedicated to providing up-to-date information about the nature, extent,  causes, and consequences of cyberbullying among adolescents."

    • Center for Countering Digital Hate, "International not-for-profit NGO that seeks to disrupt the architecture of online hate and misinformation." 

    • ultraviolet, Fighting to make the internet safe for all women.

    Courtesy of SocialMediaHarms.org

  • Organizations that track lobbying, political spending, corporate influence, and techology policy.

    • Issue One, Tracks lobbying, influence campaigns, and policy efforts affecting technology regulation.

    • OpenSecrets, Nonpartisan database of lobbying, campaign contributions, and political spending.

    • FollowtheMoney, Tracks political contributions, lobbying and influence at the state level.

    • Public Citizen, Investigates corporate influence and advocates for consumer and public-interest protections.

    • Tech Transparency Project, Researches and reports on the practices and influence of major technology companies.

  RESEARCH  

Disclaimer:  These links are provided for informational purposes only. While Erik’s Cause may collaborate with some groups on shared mission projects, we do not endorse specific organizations, programs, or materials, and make no recommendation regarding their quality or effectiveness.  Inactive links have been removed.

ONLINE HARMS

PASS-OUT CHALLENGE

  • POST-2017 PEER-REVIEWED RESEARCH (2021–2025)
    Asphyxial challenges—often called the “choking game” or “blackout challenge”—are not new, but they remain a real and ongoing risk for youth. 

    WHAT RESEARCH SHOWS
    Recent studies continue to focus on why kids engage, how it spreads, and what oxygen restriction does to the body. One major gap remains: there is still no large-scale national data showing how many kids are participating today.

    WHY KIDS ENGAGE
    The strongest drivers remain peer pressure, impulsivity, boredom, thrill-seeking, and social reinforcement. Kids are often pulled in by curiosity and pressure rather than understanding the danger.

    MEDICAL IMPACT
    Even brief oxygen restriction can cause loss of consciousness, brain injury, long-term neurological damage, and death. This is a recognized pediatric health concern—not a harmless trend.

    ROLE OF SOCIAL MEDIA
    Social media increases visibility, sharing, and repetition of risky behavior. Platforms can amplify dangerous challenges faster than ever before.

    BROADER PUBLIC HEALTH CONCERN

    Research links participation to early adolescent risk-taking, later substance misuse, and broader patterns of unsafe behavior. This is not isolated behavior—it is part of a larger youth safety issue. 

    HOW NEW RESEARCH ALIGNS WITH OLDER RESEARCH
    The 2021–2025 research strongly confirms what earlier studies (2005–2017) already showed. Participation often begins in late elementary or middle school, peer influence is a major driver, and many children do not understand how quickly oxygen deprivation can cause brain injury or death.

    What has changed most is speed: older studies focused on schoolyard peer transmission, while newer studies show viral spread through TikTok, Snapchat, YouTube, and short-form content. Recording, sharing, and social validation increase repetition and normalization.

    BOTTOM LINE
    The newer research does not contradict the older research—it strengthens it. This is not a new issue. It is a persistent one, now amplified by modern digital environments. Awareness has increased, but exposure and risk remain.

  • CDC MMWR Report on the “Choking Game” (2008)

    Published on February 8, 2008, this CDC report marked the first time the Centers for Disease Control and Prevention formally acknowledged the “Choking Game” as a dangerous and potentially deadly youth behavior. The report remains historically significant because it brought national public health attention to an issue that had previously received little formal recognition.

    The study’s frequently cited figure of 82 reported deaths between 1995–2007 reflects only the extremely limited number of cases that met the report’s narrow inclusion criteria at that time. (See the study’s editorial notes acknowledging these limitations.) Since then, additional news reporting, case reviews, and research have suggested substantially higher numbers.

    Unfortunately, 18 years later, many media reports still reference the original CDC figure without acknowledging the study’s significant limitations, the likelihood of substantial underreporting, or the fact that there remains no formal national reporting or tracking system for pass-out challenge–related injuries and deaths in the United States.

    As a result, the true scope of these behaviors has likely long been underrecognized and underreported. Despite these limitations, the report itself was groundbreaking in formally recognizing pass-out challenges as a legitimate public health concern.

  • Official ICD-10-CM Code: Y93.85 — Activity, choking game

    Related activity descriptions include:

    • blackout game

    • fainting game

    • pass-out game

    In 2012, Patricia J. Russell, MD — physician, advocate, and Expert/Ally of Erik’s Cause — formally proposed the creation of an ICD-10-CM activity code related to injuries associated with the “Choking Game” and similar pass-out activities. Her proposal was endorsed by the American Academy of Pediatrics and approved by the ICD-10-CM Coordination and Maintenance Committee, ultimately taking effect in Fiscal Year 2017.

    The addition of this code marked an important step toward improving medical recognition, injury tracking, data collection, and prevention of these often underrecognized behaviors.

    Dr. Russell’s efforts followed years of advocacy after the 2005 death of her son, Colin, and included helping to bring national attention to the issue through the CDC’s landmark 2008 MMWR report, for which she served as a co-author.

OTHER CHALLENGES

    • The field now studies “risky online challenges” broadly

    • Includes:

      • dares

      • viral stunts

      • ingestion challenges

      • risky trends

     THESE BEHAVIORS FOLLOW PREDICTABLE PATTERNS

    Across studies, they are driven by:

    • Peer pressure / social validation

    • Algorithm amplification

    • Impulsivity + teen brain development

    • Desire for attention / likes / views 

    THE RISKS ARE REAL AND MEASURABLE

    Research links these challenges to:

    • Physical harm (injury, poisoning, etc.)

    • Mental health effects

    • Increased likelihood of other risky behaviors

     THE BIGGEST INSIGHT 

    The research has shifted from “specific dangerous trends” to understanding how and why ALL risky challenges spread online

     “It’s not just one dangerous challenge — it’s a system.
    The same forces — peer pressure, algorithms, and impulse —
    drive ALL of them.”

     KEY GAP:  EVEN WITH ALL THIS RESEARCH:

    • There is no consistent tracking of specific challenges

    • Trends appear and spread faster than research can study them

  • Risky Social Media Challenges: A Scoping Review, 2000–2024 (2025) https://pmc.ncbi.nlm.nih.gov/articles/PMC12771851/

    • One of the most comprehensive modern reviews

    • Defines social media challenges as:  activities performed and shared online, often with peer encouragement

    • Identifies a wide range of harmful challenges (not just choking-related), including:

      • ingestion (e.g., substances)

      • physical risk/stunts

      • self-harm–adjacent behaviors

    • Concludes these challenges are a growing public health concern

    Online Risk Behavior in Adolescents: A Systematic Review (2025) https://journals.sagepub.com/doi/10.1177/15248380251343194

    • Categorizes online risks into:

      • content risks (what kids see)

      • contact risks (who they interact with)

      • conduct risks (what they do online)

    • Places dangerous challenges in the “conduct risk” category

    • Links these behaviors to negative health and behavioral outcomes 

    Psychological & Behavioral Drivers (Why Kids Do These Challenges)

    Risk Factors for Problematic Social Media Use in Youth (2025) Risk Factors for Problematic Social Media Use in Youth: A Systematic Review of Longitudinal Studies | Adolescent Research Review | Springer Nature Link

    • Identifies key drivers behind risky online behaviors:

      • peer influence

      • emotional distress

      • desire for validation

    • Notes that problematic use is linked to:

      • depression, anxiety, and low self-esteem

     Public Health & Government-Level Research

    U.S. Surgeon General Advisory on Social Media and Youth Mental Health (2025) Social Media and Youth Mental Health | HHS.gov

    • States we cannot conclude social media is safe for youth

    • Notes:

      • ~95% of teens use social media

      • 3 hours/day doubles risk of mental health issues

    • Calls for urgent research into harmful content types, including challenges

    Real-World Trends & Perception Data

    Pew Research Center Teens, Social Media and Mental Health (2025) Social Media and Teens’ Mental Health: What Teens and Their Parents Say | Pew Research Center

    • 48% of teens say social media is mostly negative for people their age (up from 32%)

    • Shows growing awareness among teens themselves

    • Important context: Kids often think it affects others more than themselves

    • Erik's Cause - “Turning our Tragedy into Action to Combat Deadly Online Harms”

    • Fairplay - An independent voice standing up for what kids and families really need, free from the false promises of marketers and the  manipulations of Big Tech." 

    • Parents for Safe Online Spaces - Advancing safeguards to prevent online harms. We are 20 families bound together by the unimaginable: the loss of a child.

    • Parents Rise - “a survivor parent–led grassroots movement that transforms grief into action. We unite survivor parents, impacted families, and allies to demand tech accountability, advance systemic reform, and champion child-centered digital design"

    • National Center on Sexual Exploitation - “The National Center on Sexual Exploitation (NCOSE) exists to build a  world where people can live and love without sexual abuse and  exploitation."

    • Screen Time Action Network at Fairplay - "A coalition of practitioners, educators, advocates, and parents working to promote a healthy childhood by reducing the amount of time kids spend with digital devices."

    • Encode - "We fight for a future where artificial intelligence can fulfill its transformative potential."

    • Design It For Us - Advocating for policy for safer social media and online platforms for kids, teens, and young adults.

    • Molly Rose Foundation - The aim of the Molly Rose Foundation is suicide prevention, targeted towards young people under the age of 25

    • Social Media Victims Law Center - "Empowering Parents to protect their Kids and Hold Social Media Companies Accountable

    • Alexander Neville Foundation - provides education about fentanyl poisoning and the role of social media and illegal drug sales.

    • HEAT Initiative - "Heat Initiative is a collective effort of concerned child safety experts and advocates  encouraging leading technology companies to combat child sexual abuse on  their platforms."

    • Becca Schmill Foundation - "To fund and advocate for policies, programs and research that promote and safeguard the emotional well being of adolescents and young adults through education, lawmaking and legal action."

    • Talk More, Tech Less - a digital wellness and safety organization. For over a decade, we have trained communities & schools on healthy and safer tech use.

    • Matthew E. Minor Awareness Foundation, - "a 501(c)(3) Non-Profit Organization committed to bringing awareness about the hidden dangers of the internet to our children and teens, such as cyberbullying, self-harm, cyberdares i.e. (Knock-out challenges/ Blackout Challenge) and helping families cope with grief after losing a loved one." 

    • Mothers Against Media Addiction (MAMA) - "a grassroots movement of parents fighting back against media addiction  and creating a world in which real-life experiences and interactions  remain at the heart of a healthy childhood." 

    • Common Sense, "Dedicated to helping all kids thrive in a world of media and technology."

    • Video Game Addiction - The team running this website is composed of both experts and advocates with varied and eclectic takes on this fast emerging public health issue.

    • ParentsTogether - a 501(c)(3) nonprofit organization providing independent reporting and commentary on issues that affect kids and families. We cover the latest research, policies, and trends so that busy parents  have the information they need to help their families thrive. 

    • Social Media Harms,  dedicated to spreading awareness regarding online harms and to promote federal and state regulations that require technology companies to design products with the highest possible privacy and safety features by default.

    • Tech Oversight Project, dedicated to reigning in Big Tech for the damages they’ve caused by urging lawmakers to support  comprehensive legislation on antitrust, online safety, safety, privacy and artificial intelligence.

    • Center for Humane Technology, "Our mission is to align technology with humanity’s best interests. We  envision a world with technology that respects our attention, improves  our well-being, and strengthens communities."

    • Cyberbullying Research Center, "dedicated to providing up-to-date information about the nature, extent,  causes, and consequences of cyberbullying among adolescents."

    • Center for Countering Digital Hate, "International not-for-profit NGO that seeks to disrupt the architecture of online hate and misinformation." 

    Courtesy of SocialMediaHarms.org

DIGITAL FOOTPRINT

DIG DEEPER

Disclaimer:  These links are provided for informational purposes only. While Erik’s Cause may collaborate with some groups on shared mission projects, we do not endorse specific organizations, programs, or materials, and make no recommendation regarding their quality or effectiveness.  Inactive links have been removed.

RESEARCH ARCHIVES

  • This archived collection contains peer-reviewed research and published studies related to pass-out challenges and related behaviors. While much of the research dates back to the early 2000s, these studies remain among the most frequently cited and foundational works in understanding the risks, warning signs, prevalence, and prevention of these behaviors.

    1.      Psychosocial Profiles and Motivations for Adolescent Engagement in Hazardous Games (2025); Peer influence, boredom, impulsivity, and self-harm tendencies PubMed Article

    •      Self-Asphyxial Behaviour in Adolescents (2022, The Lanclet Child & Adolescent Health); Recognized pediatric health concern linked to adolescent brain development and risk-taking PubMed Article

    •      Adolescent Experiences with Self-Asphyxial Behaviors and Problematic Drinking in Emerging Adulthood (2021); Links participation to early adolescent risk-taking and later alcohol misusePubMed Article

    •      Education Professors on “The Choking Game” and Other Social Media Challenges (2025)  How social media increases exposure, visibility, and engagement Texas A&M Article

    •      Guilheri J, Andronikof A, Yazigi L. The "Choking Game": A new craze among Brazilian children and young people. Psychophysiological, behavioral and epidemiological characteristics of 'asphyxial games'. Cien Saude Colet. 2017 Mar; 22(3):867-878. English and Portuguese.

    •      Ibrahim AP, Knipper Sh, Brausch AM, Thorne EK. Solitary Participation of the "Choking Game" in Oregon. Pediatrics. 2016 Dec:138(6).

    • Impact of Education on School-aged Children’s Knowledge of and Participation in “The Choking Game”, Journal of Nursing & Health Sciences, Butler, K., Raingruber, B., et al., RRJNHS, Volume 2, Issue 2, June 2016.

    • The Choking Game and YouTube:  An Update, Global Pediatric Health, Defenderfer, E., Austin, J., Davies, W.H., January-December 2016, vol. 3, March 2016

    •      Cortes C, Godeau E, Ehlinger V, Brehin C, Claudet I. [Choking games among 2nd and 3rd graders]. Arch Pediatr. 2016 Jan 23(1); 45-52. Epub Ahead of Print: 28 Nov, 2015.

    • Albuhairan F, AlMutairi A, Naeem M, Almneef M. Non-sucidal self-strangulation among adolescents in Saudi Arabia. Case series of the choking game. J Forensic Leg Med. 2015 Feb; 30: 43-45.

    • Re L, Birkhoff JM, Sozzi M, Andrello L, Osculati AM. The choking game: A deadly game. Analysis of two cases of "self-strangulation" in young boys and review of the literature. J Forensic Leg Med. 2015 Feb; 30: 29-33. 

    • Macnab AJ, Triviax D, Andrew . Risk - taking behavior in adolescents. `Chance only favors the prepared mind'. Arch Dis Child 2015; 100:1101-1102. Epub Ahead of Print: 14 Aug, 2015. 

    • Body Electric: The art of healthy choices, East Central Illinois teen survey report. 2012

    • Prevalence and associated harm of engagement in self-asphyxial behaviors in young people ("choking game") a systematic review, Archives of Disease in Childhood, Busse H, Harrop T, Gunnell D, doi 10.1136/archdischild 2015-308187

    • The Choking Game. Crime Victim’s Institute. Criminal Justice Center. Sam Houston State University. January 2012

    • Ulrich NJ, Goodkin HP. The choking game and other strangulation activities in children and adolescents. In: UpToDate, Middleman, AB (Ed), UpToDate, Waltman, MA, 2011.

    • Noirhomme-Renard F, Gosset C. [The "choking game" and asphyxial games: epidemiological and clinical data]. Rev Med Liege. 2011 Sep;66(9):485-90.

    • Maine Integrated Youth Health Survey. 2011 MYIS high school report. July, 2012. Available at: (pg 15).

    • Ramowski SK, Nystrom  RJ, Rosenberg KD, Gilchrist J, Chaumeton NR. Health risks of eighth-grade participants in the "choking game": Results from a population-based survey. Pediatrics. 2012 May; 129 (5): 846-51

    • Baquero F, Mosqueira M, Fotheringham M, Wahren C, Catsicaris C. [The choking game in adolescence, between experimentation risk.] Arch Argent Pediatr. 2011 Feb; 109(1): 59-61

    • Brausch AM, Decker, Kristina M, Hadley AG. Risk of suicidal ideation in adolescents with both self-asphyxial risk-taking behavior and non-suicidal sel-injury. Suicide Life Threat Behav. 2011 Aug; 41(4): 424-34.

    • Bernacki JM, Davies, WH. Prevention of the choking game: parent perspectives. J Inj Violence Res. 2011 Jul; 4(2): 73-8.

    • Ashraf G, Sathyranarayan S. Cross-section study on awareness of choking game among primary care and emergency physicians. Pediatric and Human Development, Michigan State University. Pediatric Academic Societies and Asian Society for Pediatric Research. 2011 Apr; Abstr # 236.

    • Baquero F, Mosqueira M, Fotheringham M, Wahren C, Catsicaris C. [The choking game in adolescence, between experimentation and risk.] Arch Argent Pediatr. 2011 Feb; 109(1): 59-61. 

    • Sauvageau A. The choking game: a misnomer. Pediatr Emerg Care. 2010 Dec; 25(12): 965.

    • Dake JA, Price JH, Kolm-Valdivia N, Wielinski M. Association of adolescent choking game activity with selected risk behaviors. Acad Pediatr 2010 Nov-Dec; 10(6): 410-416.

    • Galloway, D. Parent’s Role in Improving the Health of Adolescents. N C Med J. 2010; 71(4):383-385.

    • Barbería-Marcalain E, Corrons-Perramon J, Suelves JM, Crespo Alonso S, Castellá-García J, Medallo-Muñiz J. [The choking game: a potentially lethal game.] An Pediatr (Barc) 2010 Jul 31. [Epub ahead of print]

    • Merrick J, Merrick-Kenig E. The choking game revisited. Int J Adolesc Med Health. 2010 Apr-Jun;22(2):173-5.

    • Egge MK, Berkowitz CD, Toms C, Sathyavagiswaran L. The choking game: A cause of unintentional strangulation. Pediatr Emerg Care. 2010 Mar;26(3): 206-208.

    • CDC. “Choking Game” awareness and participation among 8th graders---Oregon, 2008. MMWR 2010 Jan 15; 59(01); 1-5.

    • Language matters: unintentional strangulation, strangulation activity, and the “choking game”. Arch Pediatr Adolesc Med Katz, KA, Toblin RL. 2009; 163:93.

    • Ontario Student Drug and Health Survey, 2009. Centre for Addiction and Mental Health. CAMH

    • McClave JL, Russell PJ, Lyren A, O’Riordan MA, Bass NE. The choking game: physician perspectives. Pediatrics 2010; 125:82-7 [E Pub-ahead of print December 14, 2009].

    • Andrew TA, Macnab A, Russell P. Update on "the choking game". J Pediatr. 2009 Dec;155(6):777-80.

    • The Choking Game and YouTube: A Dangerous Combination. Clin Ped Linkletter M, Gordon K, Dooley J., 2009; [E Pub-ahead of print July 13, 2009].

    • Asphyxial games or “the choking game”: a potentially fatal risk behavior. Inj Prev Macnab AJ, Gagnon F, Cannon WG, Andrew TA, 2009; 15(1): 45-9.

    • Williams County Youth Health Risk Behavioral Survey, 2009, Bryan, OH; Williams County Family and Children First Council (see page 34 of the pdf file)

    • Thomas, SP. A deadly game for boys. Issues Ment Health Nurs. 2009 May; 30(5):287.

    • Ulrich NJ, Bergin AM, Goodkin HP. The choking game: self-induced hypoxia presenting as recurrent seizurelike events. Epilepsy & Behavior 2008; 12(3): 486-488.

    • Toblin RL, Paulozzi LJ, Gilcrist J, Russell PJ. Unintentional strangulation deaths from the “choking game” among youths aged 6-19 years- United States, 1995-2007. J safety Res 2008;39(4):445-8.

    • CDC. Unintentional Strangulation deaths from the “choking game” among youths aged 6-19 years: United States, 1995-2007. MMWR Morb Mortal Wkly Rep. 2008; 57(6):141-144.

    • Andrew TA, Fallon KK. Asphyxial games in children and adolescents Am J of Forensic Med and Pathology 2007 Dec; 28 (4): 303-307.

    • Ontario Student Drug and Health Survey, 2007. Centre for Addiction and Mental Health. CAMH Available at: http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/eBulletins/ebv9n3_MHReportHighlights_2007OSDUHS.pdf

    • Ho LY, Abdelghani WN. Valsalva retinopathy associated with the choking game. Semin Ophthalmol. 2007 Apr-June; 22(2): 63-5.

    • Hageman, Jr The choking game and autoerotic Asphyxiation. Illinois Pediatrician, spring, 2006; 24: 8-9.

    • Lynch DA. The “Choking Game” A deadly fame is resurfacing. Adolescent Shorts. 2006 May-June; 8(3).

    • Urkin J, Merrick J. The choking game or suffocation roulette in adolescence. Int J Adolesc Med Health 2006, Apr-June; 18 (2): 207-208.

    • The choking game”: self strangulation with a belt and a clothes rack. Ceylon Med J, Senanayake MP, Chandraratne KA, de Silva DU, Weerasuriya DC. 2006, Sept; 51(3):120.

    • Williams County Youth Health Risk Behavioral Survey, Fall 2006. Bryan, OH: Williams County Partnerships for Success; 2007 (page 23 document/28 PDF file)

    • Gicequel JJ, Bouhamida K, Dighiero P. Ophthalmologic complications of the asphyxiophylic scarf game in a 12 year old child J Fr Ophthalmol 2004; 27: 1153-5.

    • Chow, KM. Deadly game among children and adolescents. Ann Emerg Med 2003; 42(2): 310.

    • Shlamovit GZ, Assia A, Ben-Sira L, Tachmel A. “Suffocation roulette”: a case of recurrent syncope in an adolescent boy. Ann Emerg Med 2003; 41(2): 223-6.

    • Le D, Macnab AJ. Self strangulation by hangingfrom cloth towel dispensers in Canadian schools. Inj Prev 2001; 7(3) 231-233

    • "Choking Game" Awareness and Participation Among 8th Graders --- Oregon, 2008

    • Howard P, Leathart GL, Dornhorst AC, Sharpey-Schafer EP. The “Mess Trick” and the “Fainting Lark”. Br Med J 1951, Sept 1; 2(4730): 548-549