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Charcoal-burning suicide in Hong Kong
Charcoal-burning suicide is a way to end one’s life by carbon monoxide poisoning when burning charcoal in a small and closed space.

Background
Committing suicide by burning charcoal was not popular and known to be a way to end one’s life in Hong Kong until late 1997. Less than 2% of people commit suicide by carbon monoxide poisoning among all suicide cases in Hong Kong. People used domestic gas in private motor vehicle so as to be poisoned and commit suicide. The first media reported case in Hong Kong happened in November 1998. A middle-aged woman committed suicide by burning charcoal on a barbecue grill inside her confined and sealed bedroom. With the widely reported news, charcoal-burning had become the third most common way of suicide in Hong Kong within two months, which attributed to 24.2% of all the suicide deaths from 2002 to 2004.

Charcoal-burning is seen as a “novel method of suicide” as it is painless, odourless, peaceful, and not posing any risk of explosion to the scene or neighbourhood. Charcoal is portable and can be found easily at local shops or convenience stores as barbecuing is a popular leisure activity in Hong Kong. As people do not need any knowledge to set up the charcoals and the suicide can be taken place at any indoor location, charcoal-burning suicide had become a trend in Hong Kong.

Research
In a case study, there were 1750 cases of suicide from January 1998 to December 1999 in Hong Kong. Among those cases, there were 56 cases of charcoal-burning suicide and 22 of them, which is 39%, happened in 9 weeks after the first reported incident. 90% of the suicide occurred in the victim’s homes and all of the victims used barbecue charcoal to produce carbon monoxide. The numbers of this suicide method increased rapidly from 1998, reached a peak in 2003, and decline slowly after 2003.

In 1998-2009, never married young or middle age (30-59) males were more likely to commit suicide by burning charcoal. They are most likely being employed but having financial difficulties.

Media Influence
Visual image is known as an influential tool. Scholars believed that the dramatic reporting of suicide and the supporting images in newspaper are able to induce and encourage people to imitate and attempt such acts. The suicide occurred in November 1998 was the first charcoal-burning case being significantly reported by the media. The victim in this case learned about such suicide method from a Japanese film. She then copied what she watched and killed herself. Journalists put it on the front page with photographs of the scene, graphic reconstruction of the processes, and provide details of the incident, which provided a detailed guide of charcoal-burning suicide for the public and made it a sensational incident in Hong Kong. As the Hong Kong media had never covered any suicide case about carbon monoxide poisoning by burning charcoal, the copycat effect drove people to attempt suicide by burning charcoal. Since then, similar suicide cases rose within a few months. Scholars referred the dramatic media coverage as inappropriate and excessive as the media popularized this novel suicide method. They also criticized the majority of journalists of not following the guidelines suggested by the World Health Organization when covering suicide cases.

Cultural Influence
The traditional Chinese belief emphasized the importance of preserving the complete corpse for burial. To achieve Filial Piety in Confucianism, every individual should not damage their body or get injured as it is given by their parents. By having an intact corpse is also able to have a great start for the next incarnation. Therefore, Chinese obey the belief even when they commit suicide.

Carbon monoxide poisoning is able to comply with the traditional belief. As suicide by burning charcoal happens inside a quiet room and is not able to cause any damage physically to the body and the appearance of the people who commit suicide. Other suicide methods, such as jumping from a tall building, fails to follow the belief as it will cause broken arms and legs, damage to internal organs, and fractures to bones.

Unemployment
A study showed that the increase in unemployment rates correspond with the rise of suicide by burning charcoal. During the increase of charcoal-burning suicide cases from 1997 to 2003, Hong Kong was experiencing an economic recession. The unemployment rate increased from 2.2% to 7.9% as well as the growth of an overall suicide rate by 51.7%. The increase of males committing suicide was accounted for the use of charcoal. Males are often seen as breadwinners and responsible for the income of the family. With the high percentage of middle-aged males committing suicide by burning charcoal, the study proved that most of the victims are unable to bear the pressure, that is why they decided to kill themselves.

Preventions in Hong Kong
The Hong Kong government had worked on to make charcoal less accessible so as to reduce the numbers of suicide by burning charcoal. In 2004, the Suicide Prevention Service, the University of Hong Kong, the Chinese University of Hong Kong, and the Hong Kong Jockey Club Centre for Suicide Research and Prevention, tried to persuade supermarkets or charcoal producers to place a large warning label on the bags of charcoal, by having a quote of “Cherish your life, we are here to listen” and telephone hotlines. They hope such method is able to convince people to ponder their decision and prevent them to commit suicide just because of the media influence. Telephone hotlines, such as The SamaritansThe Samaritans, provided 24-hour telephone hotline to help and listen to people’s problems and tried to stop them from killing themselves. A coroner’s case record study showed that 45% of the victims who committed suicide by burning charcoal consumed alcohol and 9% of them had a drug overdose. As most of the residential buildings in Hong Kong have security guards, scholars believed that security companies could provide training to security guards, teach them what to do if they suspect individual of wanting to commit suicide. If a resident is carrying bags of charcoal and alcohol without any other food, security guards are able to take further actions to stop the individual from committing suicide.