A Spicy Dare Not Worth Taking

Cinnamon Challenge dare among teens may damage the lungs

(RxWiki News) Truth or dare is an age-old game that will never wear out in childhood and adolescence. Often, the game involves harmless fun. But some dares should never be taken.

A recent medical paper reviewed a disturbing and dangerous new dare among teens called the Cinnamon Challenge.

It has become popular in the past few years in YouTube videos and other social media outlets. However, trying to swallow large amounts of cinnamon quickly can harm the lungs.

Parents should be sure their children know the risks of the Cinnamon Challenge so they will avoid taking this dare.

"Talk to your children about Cinnamon Challenge dangers."

The paper, by lead author Amelia Grant-Alfieri, of the Division of Pediatric Clinical Research at the University of Miami Leonard M. Miller School of Medicine, discusses the dangers of the "Cinnamon Challenge."

The Cinnamon Challenge is apparently a new and dangerous trend among adolescents in which a person attempts to swallow a tablespoon of ground cinnamon in 60 seconds without drinking fluids.

Poison control centers received 51 calls related to the Cinnamon Challenge in 2011 and 178 calls in the first six months of 2012. Among the 2012 calls, 30 of them (17 percent) required medical attention.

The authors said that cinnamon-containing household food or personal hygiene products do not pose risks, and reactions to them are very rare.

"However, attempts to swallow a large quantity of dry cinnamon carry a real risk of aspiration," the authors wrote. Aspiration means to inhale the cinnamon instead of just swallowing it.

Inhaling cinnamon can cause inflammation in human lungs, leading to lesions and scarring. It can also damage the upper airways and even cause aspiration pneumonia in serious cases.

Although none of his patients have told him they have tried it, Thomas Seman, MD, has had patients ask him about the challenge and he tells them similar information to what this paper explains.

"Inhalation can cause long-termm thickening and fibrosis," said Dr. Seman, a pediatrician at North Shore Pediatrics in Danvers, Mass. and a dailyRx expert.

He explained that fibrosis refers to fiber or scar tissue in the walls of the lung that make them stiffer and thicker, decreasing their ability to exchange oxygen and carbon dioxide.

"These are long-term and even life long effects from a few seconds of abuse," Dr. Seman said.  

He noted that this challenge's appeal works on teens' desire to make their own decisions and try new things without realizing that they are not indestructible.

"Thus, challenges like these are more dangerous than they appear on first glance," he said. "The Cinnamon Challenge is highly dangerous and should be discussed by parents."

The study authors noted that more than 51,100 YouTube videos showed a person attempting the Cinnamon Challenge up through August 10, 2012. The increase in poison control calls involving cinnamon occurred alongside the increase in views of these videos.

One of these videos has been viewed more than 19 million times, mostly by teens and young adults between the ages of 13 and 24.

"These videos have raised concerns of choking, aspiration, and pulmonary damage," the authors wrote. "In most cases, the effects are temporary, yet the Cinnamon Challenge has led to dozens of calls to poison centers, emergency department visits, and even hospitalizations for adolescents requiring ventilator support for collapsed lungs."

Two individuals who called in to the Florida Poison Information Center-Miami had "potentially toxic" exposures to cinnamon.

"Common symptoms included coughing and burning of the mouth, nose, and throat. More serious symptoms included extensive coughing, vomiting, nosebleed, and chest tightness," the authors wrote.

"Schools and pediatricians should be encouraged to discuss with children the Cinnamon Challenge and its possible harmful effects, especially with children having cinnamon hypersensitivity, asthma, pulmonary cystic fibrosis, or chronic lung disease," the authors wrote.

The researchers looked for clinical research studies related to inhaling or ingesting cinnamon in humans and did not find any. They did find two studies involving rats that inhaled cellulose, the substance that makes up cinnamon.

In one study, the two groups of rats that inhaled powder from cellulose had mild inflammation in their lungs two to 30 days later. Three to six months later, several rats developed more serious conditions, including lesions.

The other study also showed damage in the rats' lungs a week after the inhalation and then other changes in the lungs a month later.

While these studies do not mean exactly the same effects will happen in humans, they do show that the cellulose substance that makes up cinnamon can be dangerous in a mammal's lungs when inhaled in large amounts.

"Although we cannot make a strong statement on documented pulmonary [symptoms] in humans, it is prudent to warn that the Cinnamon Challenge has a high likelihood to be damaging to the lungs," the authors concluded.

The article was published April 22 in the journal Pediatrics.

The research was funded by the US Department of Health and Human Services Health Resources and Services Administration, the National Center for Toxicological Research, the L. Coulter Foundation, the Batchelor Foundation at the Batchelor Children's Research Institute and the National Institutes of Health. The authors declared no conflicts of interest.

Review Date: 
April 19, 2013