BACKGROUND: Many preadolescents and adolescents have been reported to take part in forced asphyxiation as a means of creating a feeling of being high without taking drugs. This activity goes by different names, including the Choking Game, Blackout, and Space Monkey. The limited epidemiological data suggest that about 6-11% of adolescents report having engaged in this behavior. METHODS: This study surveyed a predominantly Caucasian cohort of parents regarding their knowledge of the choking game and its associated risks, as well as their attitudes toward possible prevention efforts. RESULTS: Three quarters of parents responding reported being familiar with the choking game but considerably fewer (20%) reported having talked to their children about this activity. Ninety-six percent of parents reported knowing that unintentional death was a potential risk and ninety percent believe information about this activity should be included in school health curricula. CONCLUSIONS: Parents of adolescents in the United States appear to be quite knowledgeable about the Choking Game and its potential risks and are overwhelmingly supportive of prevention measures. The parents surveyed understood the importance of preventing children from engaging in the Choking Game, but may need specific help in how to talk to their children about it. Further work is needed to confirm that the proportion of parents identified as aware of this risk taking behavior is consistent across other populations and to urgently identify effective prevention efforts that can be integrated into existing health curricula.