One of the first recorded challenges was the cinnamon challenge, dating as far back as 2001, which was pre-streaming video. The oldest video channel video dates back to 2006 relative to this challenge,9 which involves taking a teaspoon of cinnamon orally and keeping it in one’s mouth for as long as possible without taking in fluids. After a bit of time, the spice triggers a gag reflex in response to a caustic sensation in the mouth and throat.10 Within time, the response is that the person must spit out the cinnamon—causing a cough and expulsion of the cinnamon into the air that can then be inhaled. This challenge was acknowledged in a study in Pediatrics in 2013, which addressed the concerns of choking, aspiration, and pulmonary damage, together with the number of calls to US poison control centers and emergency department visits and hospitalizations for teens requiring ventilator support for collapsed lungs.10,11
Duct tape challenge
This challenge encourages the use of duct tape to tape a person’s extremities together, or to an inanimate object such as a chair or wall, and the “challenge” is to remove oneself from the tape while being recorded. Risks are encountered if oral or nasal passages are taped shut, and suffocation can occur. Removal of the tape can remove skin layers and cause superficial infections. Musculoskeletal injuries can occur as the person is attempting to break free from the bondage and who could then fall onto a hard surface. Fractures, muscle sprains, and additional injuries can occur as a result of the fall. A teen in Washington state had a fractured orbit and traumatic brain injury as well as loss of vision after being taped and falling to the ground.12 Emotional and psychological risks can also occur as a person could experience anxiety, claustrophobia, and fear, which can lead to a panic attack.13 A number of online videos are available for viewing this challenge, many involving a person who is trying to imitate or seek pleasure in watching the effects of this challenge on the (taped) person.
In 2012, a phenomenon started in which teens would inhale a condom into their nasal passage to pull out through their mouth. Risks included potential choking hazards and aspiration of the condom. In 2015, this challenge was reinvented with the filling of a condom with water and dropping it over a person’s head. Rather than exploding, the latex material forms a bubble of water over the person’s head, potentially suffocating him or her.14 Challengers have to leave the condom in place long enough to take a video or picture. Condoms are thicker than ordinary balloons and can stretch more than balloons. Together with the weight of water, the risk of aspiration and suffocation is greater. Videos supporting this challenge are numerous, but teens do not understand the full effects of the risks associated with placing a latex condom over their heads.
Salt and ice challenge
The chemical processes within this challenge make this especially painful. As water freezes at 32° F, adding salt causes the freezing point to decrease to as low as 0° F. When ice is applied, energy is pulled from the skin and causes second-degree burns and frostbite.15 Within the competition, the challenge is to keep the ice on as long as possible, which causes deeper tissue damage. Within a few hours, the blisters appear. Risks include skin infection and may require the use of pain medication and antibiotics. Skin grafting and scarring are long-term effects of this challenge.