Concerns raised at Princeton Board of Health about ‘the choking game’ (updated)

Black out. Space monkey. The pass out game. The choking game. These are all names for a game teens sometimes play where they shut off oxygen flow to the brain by either pressing a thumb or hand tightly on the neck, tying something around the neck, hyperventilating by holding their breath, or putting a plastic bag over the head until they get a sensation of being dizzy or high.

Sometimes the risky and dangerous game is played solo, and sometimes in a group. Children choke each other or apply pressure to another child’s body. Experts say the sensation is addictive and harmful. The cutting off of oxygen can lead to brain damage, neurological disabilities and even death.

Some middle school students in Princeton are reportedly playing the game and posting videos on social media. A member of the local board of public health raised concerns Tuesday night at the board’s public meeting about a report that some students are playing the game.

Local officials are being proactive in addressing the issue. Dr. George DiFerdinando, chairman of the Princeton Board of Health, contacted a nurse at the John Witherspoon Middle School Wednesday to discuss the game.

“They have heard the story too but  they don’t know who the youngsters are either,” he said, stressing the importance of getting the message out to parents and young people that they can hurt or even kill themselves playing the game.

“This game has been around for a while,” said DiFerdinando, a former acting commissioner and deputy commissioner for the New Jersey Department of Health and Senior Services and former medical director for the New York State Health Department.

“The important thing is to get the message out that there are plenty of reports of young people either hurting themselves or killing themselves doing this,” he said. “People can really hurt themselves doing this.”

Signs to look for include bloodshot eyes, mood swings, disorientation, frequent and sometimes severe headaches, bruises or marks around the neck, a curiosity about asphyxiation, and ropes, plastic bags, or neckties tied in knots left in the bedroom.

Warn your child that the game can cause strokes, seizures, retinal damage, brain damage or even death. Be firm and serious in your talks. Most kids have no clue how dangerous this game is or how the brain is effected by a lack of oxygen, says speaker and author Dr. Michele Borba. Monitor children’s bedrooms, especially if you notice locked doors and demands for privacy.

Following is a letter sent by the John Witherspoon Middle School principal to parents on Thursday:

February 23, 2017

Dear JW Families:

This week at the Princeton Board of Health meeting, there was a discussion on an activity that some youth are participating in called the “choking game.” The game is also known by several other names, including Space Monkey, the Fainting Game, and Black Out. In short, kids are persuading one another to perform a choking-like act, causing the person to temporarily lose consciousness.

While this is not a new phenomenon and does not appear to be gaining popularity in Princeton, there have been reports of a few instances of this activity that did involve students from JW. Conversations have been had with the families of the students involved about the dangers posed by engaging in this act. Because of the increased attention that has recently been brought to this activity, the JW school nurse will be visiting every homeroom next week to discuss the serious health risks of engaging in this act.

I have included here a link to a resource that details the signs parents should look for that may indicate a student is engaging in this “game.” I want to iterate that JW is committed to working closely with parents to keep kids safe.

With highest regards for our partnership, and in the best interests of our students,

Jason Burr



  1. I rem playing this “game” more than 2o years ago in junior high. No one ever died. I can’t believe this is considered newsworthy. Lmao

    1. This is called survival bias. Sure, vast majority of participants don’t get seriously hurt. But I have no reason to doubt the statistics that some do.

      Is it newsworthy? Well, the fact that kids do stupid things that may hurt them is not news to anybody. The knowledge of which specific things they do may be useful to some parents.

      1. Good point. We are often told that the probability of a bad thing happening is exceedingly low; e.g., the odds of being murdered in a terrorist attack are the same as being struck by lightening or killed by a shark. From the viewpoint of any one individual, this is, indeed, comforting. But for responsible leaders charged with keeping their people safe – whether it’s a school principal or the President of the United States – the probability isn’t quite so low. Mr. Burr is right to be proactive. He has to worry about the safety of 1000 children; not just one.

  2. Well, I don’t spend *all* my time agitating about schooling… I also am a crisis volunteer at Womanspace. I do not want to get into breaking confidentiality, but let me assure you, people who think they might be fine immediately thereafter have a history of ending up dead a few days later. It is nothing more than luck of the draw.

    More “adult” communities have even adopted guidelines on using this (which for LE purposes is strangling; choking is on a piece of food by accident). You may or may not heard of the phrase “safe, sane, and consensual.” Not only is this a topic for people far beyond middle school years, but if a community of people who deal in giving and receiving pain say it’s unsafe, perhaps it’s wise to listen.

    1. To clarify my first paragraph: domestic violence victims who were choked/strangled, but thought they’d be OK.

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