"It is important to emphasize that this can kill you the first time you do it," said Dr. Hatim Omar, chief of adolescent medicine at the University of Kentucky. "It is also practiced by 'good kids' who do not want to do drugs so they perceive that this is a 'legal' way to get high."
Even the name diminishes the serious health risks involved, doctors say, and may give kids and teens a false impression of its dangers.
"Having the word 'game' in the name works against us," Nystrom said.
To prevent injuries and deaths from the choking game, Nystrom and his colleagues said more pediatricians need to be educated about the game and its warning signs, such as bruising around the neck, headaches and bloodshot eyes.
Some school officials and parents like Rogg believe that kids should learn about the choking game in school alongside existing lessons about drugs, alcohol and safe sex.
"It's another part of the spectrum," Rogg said.
Through her organization, Erik's Cause, Rogg works with school districts in Southern California to develop school curricula and educational materials to teach children and parents that the choking game is deadly.
"If your kid doesn't know about it yet, a kid somewhere does," Rogg said. "Parents need to know about this. And kids need to really understand just what can happen to them."