A campaign has been launched to raise awareness of the dangers of non-fatal strangulation.
Non-fatal strangulation is the application of pressure to the neck that restricts airflow or blood flow. It can occur in a range of contexts, including assault or during consensual sexual activity. Health organisations, local authorities, police and specialist support services across Gloucestershire are joining forces to raise awareness of the serious health risks associated with non-fatal strangulation, following a rise in incidents and disclosures across the county.
While strangulation can cause significant physical and psychological harm, its impacts are often hidden, making early recognition and support crucial.
Over the past year, Gloucestershire Constabulary recorded a 12% increase in offences, while NHS services and partner organisations have also reported more people coming forward to disclose their experiences.
Understanding the risks
While there may be no visible injury, the medical consequences can be significant. Reduced oxygen to the brain, damage to blood vessels or injury to the airway can all happen. Sometimes the effects may not appear straight away and can develop later.
Why this is a medical concern
Healthcare professionals are increasingly recognising that people may not always seek immediate care following pressure to the neck. Symptoms can be subtle, delayed or not immediately linked to the event itself.
Common symptoms can include:
- Headache
- Dizziness or confusion
- Voice changes
- Difficulty swallowing
- Memory changes
- Loss of consciousness (including delayed collapse)
These symptoms may develop hours after the event.
Some of the psychological/mental health impacts include:
- Intense fear
- Depression
- Thoughts of suicide
- Mood swings
- Paranoia
- Altered sense of self
- Feelings of powerlessness
- Feelings of loneliness and isolation
- Memory issues due to trauma (compounded by the physical impacts of oxygen deprivation)
There are also behavioural after-effects that may cause distress, such as increased aggression, people pleasing behaviour, or trying to stay constantly busy.
There is no safe way to strangle
Strangulation can cause serious and potentially life-threatening injury, including:
- Stroke
- Brain injury
- Loss of consciousness
- Longer-term cognitive and neurological effects
These injuries can occur even when there are no visible signs of harm.
- Evidence indicates that women under 40 who have experienced strangulation are at significantly increased risk of stroke.
- Research using brain scans suggests that repeated strangulation may affect how the brain works and how different parts of the brain communicate with each other. This can include areas that control movement, awareness, memory and emotions.
- Importantly, around half of people who have been strangled do not show any external injury.
Experts emphasise that someone may appear well immediately afterwards but still develop serious or life-threatening complications hours or even days later. For this reason, any episode of strangulation should always be taken seriously. Medical assessment is strongly advised, even if symptoms are not immediately present.
Research
In 2019, a poll conducted by BBC 5 Live found that 38% of respondents aged 18 to 39 said they had been “choked” during consensual sexual activity (BBC 5 Live, 2019).
More recent research from the Strangulation During Sex in the UK survey (Institute for Addressing Strangulation, 2025) suggests this is even more widespread, particularly among younger people:
- Over half (55%) of people aged 16 to 34 had either experienced strangulation during sex or done it to a partner
- Around one in three (35%) said they had been strangled at least once
- Around one in four (27%) said they had strangled a partner
- Many said this started in their late teens, with some reporting it even earlier
Information: Strangulation is the second-highest cause of stroke in women under 40.
Cultural context and awareness
There’s increasing awareness that strangulation is being referenced more frequently in some cultural and online contexts, including sexualised media.
However, normalisation does not reduce risk. A key driver of increasing rates of sexual strangulation is its depiction in pornography, which has become a default sexuality educator for many young people. Young people report feeling pressured to mimic the ‘porn script’ and to behave as if they enjoy acts that are painful or scary.
From a clinical perspective, there is no safe way to apply pressure to the neck outside of medically controlled settings.
Consent and safety
Consent is a fundamental principle in all aspects of care and relationships. However, consent does not make a harmful act safe.
Any pressure to the neck carries inherent risk, including reduced oxygen supply to the brain and potential for serious injury or death.
Information:
The amount of force required to occlude a vein (blocking blood supply/ oxygen to the brain) is less force than that used to crack an egg.
When to seek help
If you or someone else has experienced pressure to the neck, seek medical advice even if there are no immediate symptoms.
You should seek urgent care if any of the following occur:
- Difficulty breathing or swallowing
- Voice changes
- Neurological symptoms such as confusion or fainting
- Persistent headache or dizziness
- Any loss of consciousness
Where to get support
Support is available through:
- NHS 111
- Sexual health services
- Safeguarding or specialist support services
- In an emergency, dial 999
If you are unsure, it is always appropriate to seek medical advice.
The legal perspective
It’s important to note that non‑fatal strangulation became a stand‑alone criminal offence in 2022 because of the severity and prevalence of the harm. There were 23,817 police reports in England and Wales in the first year of the offence.
- Read about the non-fatal strangulation offence on GOV.UK
Information and support
- Hope House Sexual Assault Referral Centre (SARC) is a service in Gloucestershire offering emotional and practical support as well as medical care to anyone who has experienced sexual violence or sexual abuse.
- Gloucestershire Domestic Abuse Support Service (GDASS) is a county-wide service designed to reduce the level of domestic abuse and improve the safety of victims and their families
- The Survivor Pathway has links to a range of further local support
- More information at https://ifas.org.uk/
Adapted from an original campaign by the Avon & Somerset Office of the Police and Crime Commissioner (OPCC).
