Federal health officials say at least 82 youths have died from the so-called "choking game.
The figures are the first government count of fatalities from the tragic fad.
In the game, children use dog leashes or bungee cords wrapped around their necks or other means to temporarily cut blood flow to their head. The goal is a dreamlike, floating-in-space feeling when blood rushes back into the brain.
Estimates based on a few local studies show as many as 20% of teens and preteens play the game. But the count compliled by the U.S. Centers for Disease Control and Prevention in Atlanta show nearly all the deaths were youths who played alone.
The CDC started the research after receiving a letter last year from a Tacoma, Washington, physician who said her 13-year-old son died from playing the game in 2005.
The CDC counted cases from news reports and advocacy organizations in the years 1995 through 2007, totaling 82 fatalities of children ages 6 to 19.
They did not include deaths in which it was unclear if the death was from the choking game or if it was a suicide.
They also did not include deaths that involved autoerotic asphyxiation, which is self-strangulation during masturbation and is said to be mainly done by teenage boys or men.
The 82 deaths were spread across 31 states. The CDC found nearly 90% were boys, at an average age of about 13.
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