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Letters to the Editor |

Burning Charcoal: A Novel and Contagious Method of Suicide in Asia

Dominic T. S. Lee, MD, MRCPsych; Kathy P. M. Chan, MRCPsych; Sing Lee, MD, FRCPsych; Paul S. F. Yip, PhD
Arch Gen Psychiatry. 2002;59(3):293-294. doi:.
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Until recently, suicide by carbon monoxide poisoning was uncommon in most Asian cities. One reason may be safety, as the use of coal gas can claim innocent casualties in the typically crowded living environments. Another factor may be accessibility, because the limited ownership of private vehicles precludes automobile exhaust poisoning.

In November 1998, a 35-year-old Hong Kong woman left a suicide note and burnt charcoal in a barbeque grill within her sealed and cramped apartment. This swiftly generated a lethal level of carbon monoxide that brought about her death. The incident was pictorially portrayed in the local news headlines, and resulted in charcoal burning being romanticized as an easy, effective, and comfortable way of suicide. In the ensuing month, 9 more charcoal burning suicides followed, and by the end of 1998, charcoal burning had become the third most common method of suicide in Hong Kong. Compared with jumping from heights, which remains the most common method of suicide, charcoal burning is seen to confer privacy, especially in the familiar Asian situation of subjects killing their family members before committing suicide. Unsurprisingly, charcoal burning continued to rise in 1999 and 2000, accounting for 18% of all suicide deaths. What's more, charcoal burning is spreading to Hong Kong's neighboring cities. In Macau, a formerly Portuguese colony 60 km away from Hong Kong, 12 charcoal burning suicides were reported in 2000.1 Charcoal burning suicide also spread to Taiwan, and the first victim allegedly learned the method by reading Hong Kong newspapers on the Internet.2

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