Violence

Open Access: No.

Abstract

Introduction
Sexual choking has become prevalent among young adults, including college students, and poses significant health risks; yet, no evidence-based interventions address it. Using data from a campus-representative survey of college students, we examined participants’ age at first learning about choking and their views about teaching youth about choking and its risks. We also randomized students to one of three groups and tested the feasibility, acceptability, and preliminary efficacy of educational messages related to choking.

Method
This study uses data from a campus-representative confidential online survey of 973 undergraduate students in Fall 2021.

Results
On average, students had first learned about sexual choking at 15.3 years old. Also, 61.1% felt that youth should first be taught about choking and its health risks during high school, with an additional 22.1% indicating middle school. Our educational messages had high feasibility and acceptability ratings and showed strong evidence of preliminary efficacy among students who had previously choked or been choked during sexual activities.

Conclusions
Most students had first learned about choking as adolescents, highlighting the need for fact-based sexuality education. We found broad student support for learning about choking and its risks from college health professionals, including faculty who teach sexuality- and health-related courses. Our educational messages can be expanded to support student health and safety.

Policy Implications
Findings have implications for the development of educational programming to address sexual choking. Public health agencies also have an important role in education.

Relevance

The average age when participants first learned that some people choke others during sex was 15 years old. Yet 54% of the sample were between 8 and 15 years old.

Pornography is a key source of information on choking.

Nearly two-thirds felt that education about choking and its health risks should be taught in high school – with an additional 22% indicating middle school.

“In conclusion, the college students we surveyed were highly supportive of choking-related education for adolescents and college students. They were open to a range of delivery platforms, but especially rated college-affiliated platforms highly and placed high levels of trust in college faculty and college health professionals. Overall, the educational messages we examined were acceptable to students and felt important to them; the messages also showed some preliminary evidence of efficacy for students with prior histories of choking and/or being choked. College health professionals have an opportunity to counter misinformation about sexual choking and to help college students establish positive sexual health behaviors that will support college students’ short-term and long-term health.”

Citation

Herbenick, D., Tsung‑chieh, F., Simić Stanojević, I., Rosenberg, M., Eastman‑Mueller, H., Patterson Perry, C., Kawata, K., Strack, G., Gwinn, C., &. Wright, P. J. (2025). Exploring Educational Messages About Sexual Choking: Results of a Feasibility, Acceptability, and Efficacy Study Among College Students. Sexuality Research and Social Policy. https://doi.org/10.1007/s13178-025-01189-2