UM Pediatricians Enlist Colleagues, Teachers and Parents in Ending the “Cinnamon Challenge”

Hoping to halt the Internet-fueled fad that dares kids to swallow a tablespoon of powdered cinnamon, two of the Miller School’s top pediatric experts are urging fellow physicians, parents and teachers to discuss the potential harm of the “Cinnamon Challenge” with adolescents and teens.

Published online April 22 as a “News Highlight” by the journal Pediatrics, the “Pediatrics Perspectives” article by Steven E. Lipshultz, M.D., the George Batchelor Professor of Pediatrics and Director of the Batchelor Children’s Research Institute, and Judy Schaechter, M.D., M.B.A., Interim Chair of Pediatrics, has garnered extensive national media attention and is slated to appear in the May print issue of the official journal of the American Academy of Pediatrics.

“Given the allure of social media, peer pressure and a trendy new fad, pediatricians and parents have a ‘challenge’ of their own in counseling tweens and teens regarding the sensibilities of the choices they make and the potential health risks of this dare,” Lipshultz, Schaechter and first author Amelia Grant-Alfieri, an undergraduate student, wrote in the article, “Ingesting and Aspirating Dry Cinnamon by Children and Adolescents: The ‘Cinnamon Challenge.’”

“Parents should be reminded,” the co-authors continued, “that their advice matters in countering peer pressure. Further, schools and pediatricians should be encouraged to discuss with children the ‘Cinnamon Challenge’ and its possible harmful effects.”

Andrew Colin, M.D., Batchelor Family Chair for Cystic Fibrosis and Pediatric Pulmonology, and Director of the Division of Pediatric Pulmonology, and Richard Weisman, Pharm.D., professor of pediatrics and Associate Dean for Admissions, as well as Vivian Franco, M.P.H., senior research associate at the Miller School, were also part of the study group that Lipshultz established to address this timely issue.

A YouTube sensation, the “Cinnamon Challenge” is apparently widely familiar to adolescents, but not to their parents, teachers and physicians. Schaechter, an associate professor of pediatrics in the Division of Adolescent Medicine, recalls attending a recent dinner with a dozen pediatricians where she was the only one who had heard of the dare, which entails swallowing a tablespoon of ground cinnamon in 60 seconds without drinking fluids, a nearly impossible challenge. Even the website dedicated to the challenge warns, “It’s going to burn, you are going to cough, and regret you tried.”

Although most young people who do it anyway endure only temporary effects, the authors said the stunt has led to dozens of calls to poison centers, emergency department visits, and even hospitalizations for adolescents who required ventilator support for collapsed lungs.

Lipshultz and his team also warn that swallowing so much cinnamon, a caustic powder composed of cellulose fibers which neither dissolve nor biodegrade in the lungs, has been shown in animal studies to cause lesions, scarring and inflammation of the airways and lungs, and other lasting effects such as progressive pulmonary fibrosis. This may be a concern especially among those with asthma, pulmonary cystic fibrosis, chronic lung disease or a hypersensitivity to the spice.

“Although we cannot make a strong statement on documented pulmonary sequelae in humans, it is prudent to warn that the ‘Cinnamon Challenge’ has a high likelihood to be damaging to the lungs,” the authors said. “These discussions can also help children learn to weigh the risks and rewards of yielding to peer pressure when considering senseless and risky behaviors.”

As of August 2012, the authors noted, more than 50,000 YouTube videos of young people choking, gagging and coughing as they accept the dare had appeared on the Internet, attracting millions of viewers predominantly in the 13-to-24-year-old age group, which is “associated with the greatest need for conformity.”

No doubt, the authors said, the growing Internet presence of the “Cinnamon Challenge” led to the surge in calls to the American Association of Poison Control Centers related to the fad. In the first six months of 2012, the center received 178 challenge-related calls, more than triple the 51 calls the center received the entire previous year. Of those 178 calls, 122, or 69 percent, were classified as intentional misuse or abuse (consistent with the “Cinnamon Challenge”) and about 30 of them, or 17 percent, required medical attention.

As the authors noted, even though the known health risks of the “Cinnamon Challenge” are relatively low, “they are unnecessary and avoidable.”

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