Resources for Campuses

Sexual strangulation, commonly referred as “choking,” is growing in popularity and considered a normal sexual practice among young adult populations¹. Sexual strangulation is defined as applied pressure to the neck by any means to restrict oxygen and blood flow. The practice has been showcased in hit shows like Euphoria and seen on popular social media sites. 

A recent representative survey of U.S. undergraduate students at a single campus found 45% of women, 25% of men, and 61% of gender diverse students have ever been choked during sex².  

The Campus Sexual Health Survey³ (CSHS) (2021), a probability survey of U.S. undergraduate students at a single campus, found 

  • 53% of college students report they never or only sometimes consented to sexual choking before being choked. Few rarely discussed the practice prior to the choking encounter.

  • 19% of undergraduate college students who engaged in multiple choking events were choked more than 25 times.

  • 16% of women and one-third of LGBTQ+ of undergraduate and graduate students reported feeling scared while being choked.

  • 25% of undergraduate students experienced their first strangulation encounter between the ages of 10 and 17.

Yet sexual choking is not without risk. Most of the physical harm from sexual strangulation is not visible. Research indicates postsecondary students believe choking during sex is a relatively safe sexual practice and are unaware of the long-term health effects which can include persistent headaches, working memory deficits, depression or anxiety, traumatic brain injury, stroke, heart attack, and death⁴ ⁵.

Campaign Resources

Breathe: A Campus Awareness Campaign on Sexual Choking Risks and Resources offers ready-made, materials customizable to your campus or institution, including: 

  • Executive Summary developed for administrators

  • A reference list of peer-reviewed articles

  • Sexual Choking Frequently Asked Questions for Students

  • Sexual Choking Scenarios Discussion Guide

  • Choking Signs & Symptoms for Students

  • Choking Signs and Symptoms for Campus Health Care Providers

  • Breathe Campaign Customizable Social Media Graphics and Posters

All materials were based on college students’ impressions and feedback of the materials, aged 19 – 48.

  1. Herbenick D, Fu TC, Eastman-Mueller H et. al. (2022) Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students. Archives of Sexual Behavior Jul 28;51(6):3121–3139. doi: 10.1007/s10508-022-02347-y

  2. Herbenick, D., Fu, T., Carver, D., Brandenburg, D., Balle, M., & Eastman-Mueller, H. (2025). Prevalence and correlates of sexual choking and consensual non-consent (CNC) among college students: Findings from a campus-representative survey.  Journal of Sex & Marital Therapy. Vol. 51 (2) 224- 242. DOI: https://doi.org/10.1080/0092623X.2025.2458173

  3. Herbenick D, Fu TC, Eastman-Mueller H et. al. (2022) Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students. Archives of Sexual Behavior Jul 28;51(6):3121–3139. doi: 10.1007/s10508-022-02347-y

  4. Bichard, H., Byrne, C., Saville, C. W. N., & Coetzer, R. (2021). The neuropsychological outcomes of non-fatal strangulation in domestic and sexual violence: A systematic review. Neuropsychological Rehabilitation, 32, 1164–1192.

  5. Hou, J. et. al (2023). Structural brain morphology in young adult women who have been choked/strangled during sex: A whole-brain surface morphometry study. Brain and Behavior. Wiley Open Access.  DOI: 10.1002/brb3.3160

Thank you for your interest in the Breathe Campaign. Please fill out the following brief form to access all the campaign assets for Professionals and Campuses. The purpose of this is to track distribution and interest in the campaign only.