Abstract
Background
Social media challenges (SMC) are activities individuals perform as content for social media, sometimes being “challenged” by others to join. Some of these challenges can cause injuries and even death. While SMC are frequently reported in media, peer-reviewed literature on SMC is limited and varied. Our objective was to conduct a scoping review of risky SMC to map the research area.
Methods
We conducted a comprehensive search of MEDLINE and PsycInfo® from 2000 through 2024, for articles about risky SMC, defined as SMC that have a reasonable likelihood of causing injury. The articles were excluded if the SMC involved intentional injury (e.g., cutting or suicide). Articles were screened and data were extracted. Descriptive statistics summarized article characteristics.
Results
A total of 1651 articles were identified; 54 met inclusion criteria. All articles were categorized as observational studies including reviews (26%), case reports or series (24%), or descriptive studies (22%). The first article about a risky SMC was from 2010 and article numbers increased annually since, with an increase from 1 article in 2010 to 12 in 2024. The most common social media platforms discussed were YouTube (52%) followed by TikTok (31%), both video-based platforms. The top risky SMC were the Cinnamon Challenge (33%) and Fire Challenge (24%). Injuries were mentioned in 89% of the articles including burns, poisoning, lung injury, and strangulation. Of the articles that discuss a specific injury case, reported outcomes include emergent medical evaluation (67%), permanent morbidity (29%), and death (33%). The majority (67.3%) of articles mention possible interventions including parent, school or provider education (57%), platform changes (17%), and legislation (13%). There were no descriptions of employed interventions.
Conclusions
Injuries from risky SMC have been reported in peer-reviewed literature and have increased annually over time. There is a need for more research and interventions to mitigate the harmful effects.
Supplementary Information
The online version contains supplementary material available at 10.1186/s40621-025-00647-0.
Keywords: Social media, Challenges, Injury, Online, Risky, Behavior
Introduction
Social Media (SM) refers to “forms of electronic communication…through which users create online communities to share information, ideas, personal messages, and other content” [1]. The first internet based social media network erupted in 1997 with Six Degrees, followed by platforms such as Friendster (2001) and Myspace (2003) [2, 3]. These platforms have since been replaced by behemoths such as Facebook (2004), YouTube (2005), Twitter (2006), Instagram (2010), and TikTok (2016) [2, 3]. Social media use has exploded over the past decade, with 83% of Americans reporting using at least one platform [4]. While SM has had benefits like widespread public health campaigns, well-recognized health concerns also emerged, culminating in a 2023 U.S. Surgeon General’s advisory on the deleterious impact of SM use among adolescents [5–9].
Among the negative consequences are physical injuries influenced by SM and particularly SM challenges (SMC). Social media challenges are events where people engage in behaviors shared on SM platforms while “challenging” others to participate. Challenges can vary from charity awareness (e.g., Ice Bucket Challenge) or health promotion activities (e.g., Push up Challenge), to risky events such as eating laundry pod packets (Tide Pod Challenge) or stealing cars (Kia Challenge). See Supplement A for full description of the discussed SMC. News reports about injuries from SMC started surfacing around 2010 [10]. Early reports highlight the Choking (or Blackout) Challenge, where individuals intentionally asphyxiate themselves or others to induce a brief state of euphoria, and the Cinnamon Challenge, where people try to swallow a spoonful of ground cinnamon quickly without water [11, 12]. This phenomenon led to a sharp increase in calls to U.S. poison centers reporting coughing, gagging, vomiting, and inhalation injuries [11]. From 2012–2014, at least 11 additional reported challenges emerged, including some that led to severe injuries and deaths. For example, the Cold Water Challenge in 2014 (swimming in an icy body of water) resulted in the death of a 16-year-old, and Neknomination (drinking a large amount of alcohol quickly in silly ways) in 2014 resulted in at least five deaths [10, 13]. YouTube was a common site of early challenge distribution, causing YouTube to ban “dangerous challenges and pranks” from their site in 2019 [14]. Despite this, users continue to participate in dangerous SMC including on new platforms such as TikTok, and media reports of deaths, like a 9-year-old who died of asphyxiation in 2023 after viewing Blackout Challenge videos on TikTok, also continue [15].
Though news outlets and platforms acknowledge the dangers of some SMC, peer-reviewed literature on this topic is limited, with no summary of current literature or key concepts. This study aims to describe the existing literature on risky SMC, including the sources and types of evidence; thus, a scoping review is the ideal methodology [16, 17]. Additional goals were to establish a definition of a risky SMC, as utilized in our criteria for article inclusion, and create a timeline of peer-reviewed literature on risky SMC to understand the evolution of the problem.
Methods
This review operated under the established framework for scoping studies by Arksey & O’Malley [16]. Our research question was: What is known from the existing literature about social media challenges that have a reasonable chance to cause harm? We then worked with a library scientist (Miller) to identify relevant studies. This study was deemed exempt by the Nationwide Children’s Hospital (NCH) Institutional Review Board. Patients and the public were not involved in the design, conduct, or reporting of the research.
Data sources and search strategy
We collected data from Ovid MEDLINE and PsycInfo®. Publication date parameters were set at January 1, 2000, through December 31, 2024. Results were filtered to English language publications only. Keywords, phrases, and database subject headings, when applicable, were included in the search strategy. An initial pilot run of the search strategy yielded all 8 of the team’s previously identified “test” articles. We used several sets of terms including “social media” and specific platforms, “challenge” and specific SMC names, as well as injuries and injury mechanisms. See Supplement B for a detailed visual representation of the general search strategy. The author group determined pertinent keywords to include such as the most popular SM platforms according to public polls, injury terms to represent common injury patterns consistent with prior reviews, and known popular challenges. We included designations to incorporate truncated and misspelled variations of a word. The Boolean operator OR was used to combine the terms in each set, and the Boolean operator AND was used to combine the sets of terms for overlapping results or articles that included both a social media term and a challenge, injury, or additional term/phrase.
Study selection
We included any peer-reviewed, full-length article, chapter, etc. identified in MEDLINE and PsycInfo® referring to risky social media challenges. We defined SMC as an activity in which individuals engage (1) to share as content (i.e., videos, photos, etc.) on a SM platform (i.e., YouTube, TikTok, Facebook, Instagram, Snapchat, etc.) or (2) to replicate content seen on SM. The individual may have been invited, or “challenged”, to participate via another online user or the participant may have seen the challenge (i.e., online, in the news, etc.) and chosen to participate without invitation. A risky SMC was defined as SMC activities that have a reasonable chance of causing pain, injury, death, or intoxication. We excluded articles that were not available in English, did not have full papers available for review, or discussed SMC involving intentional injuries (i.e., suicide, self-harm), motivated by mental health crisis, without discussion of risky SMC and unintentional injuries.
Two authors (Middelberg and Mason) independently screened all titles and abstracts for inclusion in Covidence. Covidence is a web-based collaboration software platform that streamlines the production of systematic and other literature reviews [18]. Disagreements were resolved by a third author (McKenzie). After initial screening, full texts were read by the original two authors, and any remaining exclusions were resolved through discussion.
Data extraction and synthesis
Two authors (Middelberg and Mason) independently extracted data from the studies into data extraction forms in an NCH REDCap database [19, 20]. Initial training on data extraction forms was performed with reviewers, followed by the completion of 6 double-coded articles, and an assessment of interrater reliability (K = 0.76). Double coded training articles were then reviewed together, and a consensus interpretation was agreed upon. These decision criteria were applied to all articles. Any unclear classification was discussed amongst the reviewers.
The following data were extracted from each study: publication year, type, study design, SM platforms mentioned, age of subjects discussed, specific risky SMC, SMC-related injuries, details of specific patient case(s) (including injuries, morbidity, mortality, and required medical treatment), and any proposed interventions. We reported summary statistics of each characteristic.
Results
A total of 1627 unique articles were identified (after the removal of duplicates) (Fig. 1). Following initial abstract and title screening, 11 articles were reviewed by a third reviewer for variability. Fifty-four articles met inclusion criteria and underwent full article data extraction (Supplement C).
Fig. 1.
Article Review Flowchart
All articles included in the review were found to be observational studies including reviews (n = 14, 25.9%), case reports (n = 13, 24%), descriptive studies (n = 12, 22.2%), content analysis (n = 6, 11.1%), opinion (n = 6, 11.1%), or mixed methods (n = 3, 5.5%) (Table 1). All articles were published between 2010 and 2024 (Fig. 2); no articles were identified during the earliest period of our search (2000 through 2009). The number of articles on risky SMC has increased annually since 2010, with an increase from 1 article in 2010 to 12 in 2024.
Table 1.
Article and social media challenge description
| Publication type | N = 54 (%) |
| Journal article | 53 (98.1) |
| Book chapter | 1 (1.9) |
| Type of study | |
| Review | 14 (25.9) |
| Case report(s) | 13 (24.1) |
| Descriptive studies | 12 (22.2) |
| Content analysis | 6 (11.1) |
| Opinion | 6 (11.1) |
| Mixed methods | 3 (5.6) |
| Social media platforms mentioned* | |
| YouTube | 28 (51.9) |
| TikTok | 17 (31.5) |
| 15 (27.8) | |
| Not mentioned | 12 (22.2) |
| 11 (20.4) | |
| 7 (13.0) | |
| Snapchat | 4 (7.4) |
| 2 (3.7) | |
| Tumblr | 2 (3.7) |
| Vine | 2 (3.7) |
| 2 (3.7) | |
| MySpace | 1 (1.9) |
| 1 (1.9) | |
| Age discussed* | |
| Child (< 12 years) | 21 (39.9) |
| Adolescent (12 to < 18 years) | 40 (74.1) |
| Adult (>/= 18 years) | 17 (31.5) |
| Not mentioned | 6 (11.1) |
| Prevention/intervention discussion* (yes) | 37 (67.3) |
| Parental, school, or medical provider education | 31 (57.4) |
| Platform changes | 9 (16.7) |
| Legislation | 7 (13.0) |
| Further work | 4 (7.4) |
| Restricting access to dangerous materials | 2 (3.7) |
| Warning labels | 2 (3.7) |
| Safety equipment | 2 (3.7) |
| Parental SM restriction | 2 (3.7) |
| Mentions a specific risky SMC (yes) | 50 (90.9) |
| Other SMC mentioned* | |
| Non-risky challenge | 10 (18.5) |
| Self-harm/Suicide challenge | 3 (5.6) |
| Legally-risky challenge | 1 (1.9) |
| Dangerous challenges*+ | |
| Cinnamon | 18 (33.3) |
| Fire | 13 (24) |
| Blackout/Choking/Strangulation | 11 (20.4) |
| Salt And Ice | 11 (20.4) |
| Tide Pod Challenge | 10 (18.5) |
| Benadryl | 9 (16.7) |
| Eraser | 7 (13.0) |
| Nutmeg | 5 (9.3) |
| Deodorant | 5 (9.3) |
| Orbeez | 4 (7.4) |
| Boiling Water | 4 (7.4) |
| Skull Breaker | 4 (7.4) |
| Kylie Jenner Lip | 3 (5.6) |
| Nekomination (Alcohol Abuse) | 2 (3.7) |
| Hot Pepper | 2 (3.7) |
| Condom/Condom Snorting | 2 (3.7) |
| Bright Eye/Bleach Eye | 2 (3.7) |
| Eat Salt | 2 (3.7) |
*Indicates a select all that apply question. Percentages may not sum to 100%
+Other challenges mentioned once: Nanging (nitrous oxide abuse), NyQuil Chicken, Sunscreen/sunburn, Tombstoning (jumping from a height into water), Nicsick, Fractal Wood Burning, Castor oil for eyesight, Dry cupping, Sugaring trend, Duct tape, Gallon, Bird Box, Mucus fishing, Eggsplosion, Beezin, Blow-drying eyelashes, Sun gazing, Cha cha slide, Cereal, Milk Crate, Outlet, Scalp popping, Throw it in the air, Kiki, Salt and food coloring, Pepper spray, Banana and sprite, Water, Car surfing, Food coloring ingestion
Fig. 2.
The number of articles about risky social media challenges by year: 2000 to 2024 (n = 54)
The most common social media platforms discussed in the articles (n = 54) were YouTube (n = 28, 51.9%), followed by TikTok (n = 17, 31.5%), Facebook (n = 15, 27.8%), and Instagram (n = 11, 20.4%). Twelve articles (22.2%) did not reference a specific platform. The platforms mentioned in the articles have changed over time (Fig. 3). YouTube continued to be the most mentioned throughout the study period, but TikTok did not appear in articles until 2019 and increased over the next five years.
Fig. 3.
Social media platforms over time
Articles discussed SMC participation in children through adults (Table 1). The most frequent age group discussed was adolescents between the ages of 12 to 18 years (30.9%), followed by children aged < 12 years (38.2%). Several articles also discussed non-risky challenges (e.g., dance or charity challenges) (n = 10, 18.5%), self-harm or suicide challenges (e.g., Blue Whale challenge) (n = 3, 5.6%), and legal-risky challenges defined as those SMC likely to result in disciplinary ramifications (e.g., Kia Challenge) (n = 1, 1.9%) (Table 1).
The most frequently referenced risky SMC were the Cinnamon Challenge (n = 18, 33%), Fire Challenge (n = 13, 24%), Blackout/Choking/Strangulation Challenge (n = 11, 20.4%), and the Salt and Ice Challenge (n = 11, 20.4%) (Table 1). Other risky SMC discussed were related to dangerous ingestions and included the Tide Pod challenge (n = 10, 18.2%) and the Benadryl Challenge (n = 9, 16.3%).
The articles cited a variety of injuries from risky SMC. The vast majority (n = 48, 89.9%) of articles further tied injuries to a specific risky SMC (Table 2). Of these articles, the most common injuries included burns (n = 23, 47.9%), poisoning or overdose (n = 15, 31.3%), aspiration or lung injury (n = 10, 20.8%), and suffocation/strangulation (n = 9, 18.8%) (Table 2). Almost half (n = 24, 44.4%) of the articles also discussed an individual case where participation in a risky SMC caused an injury. Of those patient cases, the most common injuries were burns (n = 17, 70.8%) and poisoning or overdose (n = 6, 25%). The majority (n = 22, 91.7%) of the 24 cases resulted in the need for medical care, including 67% (n = 16) that required emergent medical evaluation, 29% (n = 7) that suffered permanent morbidity (e.g., permanent scarring or anoxic brain injury), and 33% (n = 8) that died. The challenges most associated with death were the Blackout/Choking/Strangulation challenges (n = 4), Benadryl challenge (n = 3), and the Fire challenge (n = 2).
Table 2.
Injury description
| Article discusses injuries directly due to a risky SMC | 48 (88.9) |
|---|---|
| Type of injury* (n = 48) | |
| Burn | 23 (47.9) |
| Poisoning/overdose | 15 (31.3) |
| Aspiration/lung injury | 10 (20.8) |
| Suffocation/strangulation | 9 (18.8) |
| Eye injury | 5 (10.4) |
| Neurologic injury | 5 (10.4) |
| Bruise | 4 (8.3) |
| Other | 4 (8.3) |
| Cut/Laceration | 3 (6.3) |
| Skin injury | 3 (6.3) |
| Broken bone | 2 (4.2) |
| Multiple injuries | 2 (4.2) |
| Arrhythmia | 2 (4.2) |
| Challenges associated with injury* (n = 48) | |
| Cinnamon | 17 (35.4) |
| Fire | 13 (27.1) |
| Blackout/Choking | 11 (22.9) |
| Salt/Ice | 10 (20.8) |
| Tide Pod | 9 (18.8) |
| Benadryl | 8 (16.7) |
| Orbeez | 4 (8.3) |
| Deodorant | 4 (8.3) |
| Nutmeg | 4 (8.3) |
| Skull Breaker | 4 (8.3) |
| Kylie Jenner | 3 (6.3) |
| Nekomination | 2 (4.2) |
| Article discusses a specific injury case due to a risky SMC | 24 (44.4) |
| Type of specific injury from a risky SMC* (n = 24) | |
| Burn | 17 (70.8) |
| Poisoning/overdose | 6 (25.0) |
| Suffocation/strangulation | 3 (12.5) |
| Bruise | 2 (8.3) |
| Skin injury | 2 (8.3) |
| Broken bone | 1 (4.2) |
| Type of medical intervention needed* (n = 22) | 22 (40.7) |
| Medical evaluation | 16 (66.7) |
| Specialist evaluation | 14 (58.3) |
| Hospital admission | 10 (41.7) |
| Surgical procedure | 7 (29.2) |
| Prolonged medical follow up (i.e., follow up past 2 months) | 6 (25.0) |
| Other | 3 (12.5) |
| Article discusses morbidity | 7 (13.0) |
| Type of morbidity discussed* (n = 7) | |
| Permanent scarring | 7 (100) |
| Anoxic brain injury | 1 (14.3) |
| Article discusses fatality | 8 (14.8) |
| Challenges most frequently associated with death* (n = 8) | |
| Benadryl | 3 (37.5) |
| Blackout/Choking | 4 (50.0) |
| Fire | 2 (25.0) |
| Hot water | 1 (12.5) |
* Indicates a select all that apply question. Percentages may not sum to 100%
The majority (n = 37, 67.3%) of articles argued for prevention to be enacted (Table 1). This was most commonly a form of education (n = 31, 57.4% of the 54 articles), such as calling for parents or school officials to be aware of new challenges and counseling adolescents against their danger, or for medical providers to be mindful of trends on SM. Additional proposed interventions included changes to the SM platforms (n = 9, 16.7%), legislation (n = 7, 13.0%), and additional studies to evaluate SMC (n = 4, 7.4%). However, there were no articles that discussed or evaluated an employed intervention.
Discussion
This scoping review of risky SMC in peer-reviewed literature shows a relatively limited body of data with a recent escalation over the past decade, consistent with the newness of SM platforms and SMC. The increase in articles since 2021 is likely reflective of several factors: a growing interest in studying risky SMC, a greater recognition of injury patterns caused by risky SMC, and mounted SM use leading to increased risky SMC participation, particularly by young people. This study sought to describe the existing body of literature and identify gaps in knowledge-the most glaring of which is the lack of implemented interventions.
The literature is largely comprised of case reports, case series, and reviews of past evidence, though later studies also include evaluation of participants and content characteristics [21–24]. This corresponds with a new topic and an early stage of inquiry. Adolescents were the focus for most articles. Increasingly, adolescents have ubiquitous access to personal devices and the internet, as well as an expanding presence on social media [25–28]. This indicates risky SMC may be a new venue for an existing issue, adolescents engaging in high-risk behaviors. Typical adolescent development (such as a reduced capacity to self-regulate, increased impulsivity, limited understanding of consequences, and prioritization of peer acceptance) renders them particularly at risk of behaviors that cause injury [29–31]. Among the identified studies, several explore decision-making and risk taking mechanisms that could contribute to the participation in a SMC (risky and non-risky), such as the participant’s self-reported popularity and need to belong, as well as an expression of creativity or source of entertainment [21, 24, 32–34]. Further investigation into motivations is needed to better describe the problem and inform interventions.
Social media platforms TikTok and YouTube were the most mentioned in articles. Intuitively it stands to reason that video-based platforms provide a ripe environment for sharing filmed activities (such as SMC) widely. While other platforms were mentioned in articles they were not discussed as frequently. This is likely due to varying popularity across ages, YouTube and TikTok are the most utilized platforms by teens, while adults frequently use YouTube followed by Facebook and Instagram, as well as the type of content the platform supports, videos versus text or photos [4]. YouTube was one of the earliest available SM platforms, and found to be the only discussed platform in the first few years of risky SMC literature. However, in 2019 YouTube updated their community guidelines in an attempt to ban “dangerous challenges and pranks” [14]. The efficacy of guidelines such as these is difficult to measure, as users can often find ways around detection (such as purposely misspelling challenge names) [35, 36]. Furthermore, new platforms continue to emerge, providing a new outlet for content. TikTok started in the United States in 2018 but has quickly become the second most popular platform with teens and the second most frequently referenced in the risky SMC literature. While platforms have changed in policies and popularity, risky SMC reporting has grown.
Forty-eight different SMC were mentioned in the 54 articles. These challenges range from seemingly low-risk activities to obviously dangerous. For example, the Cinnamon Challenge, while this may not have obvious dangers, it has been linked to inhalation and lung injuries [11, 37–40]. Some challenges do not start off seeming dangerous, but evolve as content online becomes more and more sensationalized. For example, the Kiki Challenge is a dance challenge to a popular song. The action evolved to include doing the dance next to a driverless, slow-moving car. As those participating began escalating the challenge, injuries became more likely [41]. The Benadryl and Fire Challenge, however, quite obviously convey danger. The Benadryl Challenge is intentionally overdosing on a medication that can be lethal in an attempt to capture footage of oneself hallucinating, and the Fire Challenge is applying flammable liquids to one’s body then setting it on fire [42–45]. The risky SMC most associated with mortality in the reviewed studies involve those that convey obvious risk such as the Benadryl, Blackout/Choking/Strangulation, and Fire Challenges.
While the problem of risky SMC is evident from media reports and literature and there are several discussed solutions, no articles employ or evaluate interventions. The most common prevention suggestion was education. This included calls for parents, providers, or schools to “be aware of challenges” and warn teens. A unique issue for education on risky SMC compared to other teen high-risk activities or behaviors (e.g., tobacco cessation) is that not all challenges look the same. Ideally education would target critical thinking about online content in general. Additionally, education and warnings are less effective injury prevention strategies when compared to things like barriers (e.g., access to electronic devices or SM platforms) [46]. The second and third most mentioned interventions were SM platform changes and legislation. External interventions to a platform are challenging. Social media platforms are largely self-regulated due to section 230 of the Communications Decency Act of 1996 which determined that social networking sites cannot be liable for user-generated content [47, 48]. One article evaluated various criminal liability and litigation cases involving risky SMC [47]. Individuals have been held liable for violence or theft/destruction associated with a challenge (e.g., the devious lick challenge where participants steal or damage items from schools), but platforms have not. Such as the case against TikTok after the death of a 10-year-old who died from the Blackout Challenge, TikTok was deemed immune under section 230 [47]. Some states have attempted SM regulations such as age verification or parental consent [49]. Additional prevention calls included changing a specific products like place a warning label about ingestion dangers on laundry pod packaging, secure medications like diphenhydramine, or require safety googles if using a gel blaster. These are limited by identifying a challenge after its risen in popularity, and whether it has an involved product to restrict. Intervention development is dependent on understanding the problem better, like motivations at play and whether risky SMC behavior is analogous to other topics in injury prevention. This study helps identify the gaps in that knowledge for future study.
The strength of this review is that we performed a sensitive search for studies that discussed SM, injuries, and challenges. In doing so, we were able to confidently capture all studies that focused on risky SMC that result in unintentional injuries. Of note, we did not focus on the broader topic of the mental health effects from social media, including intentional self-harm acts propagated online. As a result, we are not presenting a complete landscape of injuries precipitated by SM influence, but rather those injuries where injury is not the intention of the act. Those that participate in SMC that center intentional self-harm content may have different drivers, and therefore different needs for effective prevention.
This study has several limitations. For instance, limitations of the search strategy such as (1) the inclusion of two databases as compared to an even broader search incorporating non-peer reviewed sources, (2) generalizability beyond countries who are likely to publish peer-reviewed articles available in English, and (3) the timeline of our search, though broad to show the literature body over time, encompasses significant and expeditious changes to internet and social media use for the average human. As a result, definitions and terminology may change rapidly and could have limited our search. Additionally, there may be risky SMC that do not rise to the level of media attention and go under recognized by researchers and, similarly, low-risk challenges that unexpectedly cause injury but are not reported.
Conclusions
There is a limited but growing body of peer-reviewed literature on risky SMC, including popular past challenges, associated injuries and fatalities, and the platforms involved. Articles on risky SMC are increasing, whether from increased engagement in challenges or increased awareness of the phenomenon. Additional research is needed to expand the understanding of the problem, including further exploration of who participates in challenges, their motivations for participation, and interventions to mitigate the harmful effects of risky SMC.
Supplementary Information
Abbreviations
- SM
Social media
- SMC
Social media challenge
Author contributions
LKM contributed to the conception and design of the study, conducted data analyses, interpreted data, drafted the article, and reviewed and revised the article critically for important intellectual content. AEM conducted data analyses, contributed to interpretation of data, drafted the article, and reviewed and revised the article critically for important intellectual content. SM contributed to the conception and design of the study, interpreted data, drafted the article, and reviewed and revised the article critically for important intellectual content. SH conducted data analyses, contributed to interpretation of data, drafted the article, and reviewed and revised the article critically for important intellectual content. LBM contributed to the conception and design of the study, conducted data analyses, interpreted data, and reviewed and revised the article critically for important intellectual content. All authors approved the final version to be published and agree to be accountable for all aspects of the work.
Funding
The presented study has no funding to declare.
Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Declarations
Ethics approval and consent to participate
Not applicable.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Social media Merriam-Webster.com Dictionary: Merriam-Webster; https://www.merriam-webster.com/dictionary/social%20media.
- 2.Shah S. The history of social networking: digital trends; 2022 https://www.digitaltrends.com/computing/the-history-of-social-networking/.
- 3.Maryville University. The evolution of social media: how did it begin, and where could it go next? 2020 [updated May 28, 2020. https://online.maryville.edu/blog/evolution-social-media/.
- 4.Pew Research Center. Americans' social media use 2024. https://www.pewresearch.org/internet/wp-content/uploads/sites/9/2024/01/PI_2024.01.31_Social-Media-use_report.pdf.
- 5.Batra N, Colson CD, Alberto EC, Burd RS. Using social media for the prevention of pediatric burn injuries: pilot design and usability study. JMIR Form Res. 2021;5(7):e23242. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Drake SA, Zhang N, Applewhite C, Fowler K, Holcomb JB. A social media program to increase adolescent seat belt use. Public Health Nurs. 2017;34(5):500–4. [DOI] [PubMed] [Google Scholar]
- 7.McMillan-Cottom T. Mitigating concerns and maximizing returns: social media strategies for injury prevention non-profits. West J Emerg Med. 2014;15(5):582–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Lin LY, Sidani JE, Shensa A, Radovic A, Miller E, Colditz JB, et al. Association between social media use and depression among U.S. young adults. Depress Anxiety. 2016;33(4):323–31. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Surgeon general issues new advisory about effects social media use has on youth mental health HHS.gov: U.S. Department of Health and Human Services; 2023 https://www.hhs.gov/about/news/2023/05/23/surgeon-general-issues-new-advisory-about-effects-social-media-use-has-youth-mental-health.html.
- 10.Dewey C. A comprehensive guide to YouTube’s dumbest and most dangerous teen trends: The Intersect; 2014 https://web.archive.org/web/20150629190122/http://www.washingtonpost.com/news/the-intersect/wp/2014/07/30/a-comprehensive-guide-to-youtubes-dumbest-and-most-dangerous-teen-trends/.
- 11.Healy M. Teens' 'cinnamon challenge': dangerous, not innocent: Los Angeles Times; 2012. https://web.archive.org/web/20150703083543/http://articles.latimes.com/2012/mar/28/news/la-heb-teen-cinnamon-challenge-20120328.
- 12.Linkletter M, Gordon K, Dooley J. The choking game and YouTube: a dangerous combination. Clin Pediatr (Phila). 2010;49(3):274–9. [DOI] [PubMed] [Google Scholar]
- 13.Wilkinson PS, Isa. Neknominate: 'Lethal' drinking game sweeps social media CNN.com. 2014. https://web.archive.org/web/20150427145828/http://www.cnn.com/2014/02/18/world/europe/neknominate-drinking-game.
- 14.Bruner R. YouTube has banned dangerous pranks and challenges TIME.com: TIME Magazine; 2019. https://time.com/5504295/youtube-bans-challenges/.
- 15.Carville O. TikTok’s viral challenges keep luring young kids to their deaths: Bloomberg News; 2022 [updated November 30, 2022. https://www.bloomberg.com/news/features/2022-11-30/is-tiktok-responsible-if-kids-die-ng-dangerous-viral-challenges.
- 16.Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. [Google Scholar]
- 17.Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):143. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.About Covidence and systematic reviews Covidence support website 2025. https://support.covidence.org/doc/how-can-i-cite-covidence.
- 19.Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Ortega-Barón J, Machimbarrena JM, Montiel I, González-Cabrera J. Viral internet challenges scale in preadolescents: an exploratory study. Current psychology (New Brunswick, NJ). 2022:1–11. [DOI] [PMC free article] [PubMed]
- 22.Moran K. Jumping to (fatal) conclusions? An analysis of video film on a social networking web site of recreational jumping from height into water. Int J Inj Contr Saf Promot. 2014;21(1):47–53. [DOI] [PubMed] [Google Scholar]
- 23.Purushothaman V, McMann T, Nali M, Li Z, Cuomo R, Mackey TK. Content analysis of nicotine poisoning (Nic sick) videos on TikTok: retrospective observational infodemiology study. J Med Internet Res. 2022;24(3):e34050. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Ward S, Dumas TM, Srivastava A, Davis JP, Ellis W. Uploading risk: examining the social profile of young adults most susceptible to engagement in risky social media challenges. Cyberpsychol Behav Soc Netw. 2021;24(12):846–50. [DOI] [PubMed] [Google Scholar]
- 25.Lenhart A. Teens, social media & technology overview 2015: Pew Research Center; 2015 [updated April 9, 2015]. file:///C:/Users/lxm105/Downloads/PI_TeensandTech_Update2015_0409151.pdf.
- 26.Anderson M, Jiang J. Teens, Social media & technology 2018: Pew Research Center; 2018 [updated May 31, 2018]. file:///C:/Users/lxm105/Downloads/PI_2018.05.31_TeensTech_FINAL.pdf.
- 27.Vogels EAG-W, Risa; Massarat, Navid. Teens, social media and technology 2022: Pew Research Center; 2022 [cited 2022 August 10]. https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/.
- 28.Faverio MS, Olivia. Teens, social media, and technology 2024: Pew Research Center; 2024. https://www.pewresearch.org/wp-content/uploads/sites/20/2024/12/PI_2024.12.12_Teens-Social-Media-Tech_REPORT.pdf.
- 29.Johnson SB, Jones VC. Adolescent development and risk of injury: using developmental science to improve interventions. Inj Prev. 2011;17(1):50–4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.O’Keeffe GS, Clarke-Pearson K. The impact of social media on children, adolescents, and families. Pediatrics. 2011;127(4):800–4. [DOI] [PubMed] [Google Scholar]
- 31.Romer D. Adolescent risk taking, impulsivity, and brain development: implications for prevention. Dev Psychobiol. 2010;52(3):263–76. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Khasawneh A, Chalil Madathil K, Zinzow H, Rosopa P, Natarajan G, Achuthan K, et al. Factors contributing to adolescents’ and young adults’ participation in web-based challenges: survey study. JMIR Pediatr Parent. 2021;4(1):e24988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Burgess A, Miller V, Moore S. Prestige, performance and social pressure in viral challenge memes: neknomination, the Ice-Bucket Challenge and SmearForSmear as imitative encounters. Sociology. 2018;52(5):1035–51. [Google Scholar]
- 34.Guilheri J, Andronikof A, Yazigi L. The “choking game”: a new craze among Brazilian children and young people. Psychophysiological, behavioral and epidemiological characteristics of ‘asphyxial games.’ Cienc Saude Coletiva. 2017;22(3):867–78. [DOI] [PubMed] [Google Scholar]
- 35.Fulcher JA, Dunbar S, Orlando E, Woodruff SJ, Santarossa S. #selfharn on Instagram: understanding online communities surrounding non-suicidal self-injury through conversations and common properties among authors. Digit Health. 2020;6:2055207620922389. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 36.Lookingbill V, Le K. “There’s always a way to get around the guidelines”: nonsuicidal self-injury and content moderation on TikTok. Soc Media Soc. 2024;10(2):20563051241254371. [Google Scholar]
- 37.O'Connor A. Consequences of the ‘cinnamon challenge’. New York Times. 2013
- 38.Grant-Alfieri A, Schaechter J, Lipshultz SE. Ingesting and aspirating dry cinnamon by children and adolescents: the “cinnamon challenge.” Pediatrics. 2013;131(5):833–5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 39.Isaacs D. The cinnamon challenge. J Paediatr Child Health. 2013;49(11):984. [DOI] [PubMed] [Google Scholar]
- 40.Bosmia AN, Leon KJ. Lung injury and the cinnamon challenge: college students should beware this Internet dare. J Inj Violence Res. 2015;7(1):41–2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 41.Lyons K. Kiki challenge: police warn against dangerous viral dance. The Guardian [Internet]. 2018 July 9, 2025. https://www.theguardian.com/music/2018/jul/30/kiki-keke-challenge-drake-police-warn-dangerous-viral-dance.
- 42.Elkhazeen A, Poulos C, Zhang X, Cavanaugh J, Cain M. A TikTok™ “Benadryl Challenge” death-a case report and review of the literature. J Forensic Sci. 2023;68(1):339–42. [DOI] [PubMed] [Google Scholar]
- 43.Avery AH, Rae L, Summitt JB, Kahn SA. The fire challenge: a case report and analysis of self-inflicted flame injury posted on social media. J Burn Care Res. 2016;37(2):e161-5. [DOI] [PubMed] [Google Scholar]
- 44.Roussel LO, Toscano NC, Bell DE. The fire challenge: dare to be burned. J Burn Care Res. 2016;37(4):e395-6. [DOI] [PubMed] [Google Scholar]
- 45.Veljanovski L. What is the tiktok 'fire challenge'? Teen hospitalized in new online Craze. Newsweek [Internet]. 2021 May 22, 2022. https://www.newsweek.com/fire-challenge-tiktok-trend-13-year-old-injured-1596392.
- 46.Poston A. Guidance on the application of human factors to consumer products: U.S. Consumer Product Safety Commission; 2020. https://www.cpsc.gov/s3fs-public/Human-Factors-Standard-Practice-Document-Final-ENGLISH-Feb03-2020_0.pdf.
- 47.Asher EM, Morris NP, McNiel DE, Binder RL. The forensic mental health implications of social media challenges. J Am Acad Psychiatry Law. 2024;52(1):80–9. [DOI] [PubMed] [Google Scholar]
- 48.House of Representatives C. 47 U.S.C. 230—Protection for private blocking and screening of offensive material.: U.S. Government Publishing Office; 2011.
- 49.Utah's new social media law means children will need approval from parents NPR.org: The Associated Press; 2023. https://www.npr.org/2023/03/24/1165764450/utahs-new-social-media-law-means-children-will-need-approval-from-parents.
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.