Addressing strangulation harms — what we learnt from talking to IFAS

The updated RSHE statutory guidance for secondary schools requires that students should be taught:

“That strangulation and suffocation are criminal offences, and that strangulation (applying pressure to the neck) is an offence, regardless of whether it causes injury. That any activity that involves applying force or pressure to someone’s neck or covering someone’s mouth and nose is dangerous and can lead to serious injury or death”.

Back in November, we sat down with Harriet Smailes — the Research Manager at the Institute for Addressing Strangulation (IFAS) — to explore what the latest research can tell us about the prevalence of strangulation, the risks involved, and how we can go about teaching this challenging topic through PSHE lessons.

The full video recording of this interview is available exclusively to School Plus members, via our on-demand training library. But here are some of our top takeaways:

Prevalence

IFAS were researching experiences of strangulation during sex amongst 16–34-year-olds and spoke to over 4,000 participants. They found that over half of all respondents (55%) had either been strangled or had strangled someone else during sex.

• 18-20 years old is the most common age for people to have first experienced strangulation during sex.
• Of 16–17-year-olds in the survey who reported having prior sexual experience, 43% reported having been strangled during sex, whilst 32% reported having strangled others during sex.
• Whilst both sexes reported experiencing strangulation, males were significantly more likely to have strangled someone else during sex compared to females (63% vs 37%.)

Risks and harms

Despite what some respondents believed, IFAS’s position is that there is no safe way to strangle someone.

Common physical symptoms reported during strangulation included feeling pain in the neck, dizziness or a cough.

A minority of people reported having lost consciousness during or after the strangulation, or having been incontinent of urine or faeces, during or after the strangulation.

Just over a third of respondents who had experienced negative symptoms described feeling scared or anxious during or after the strangulation. In almost three quarters of cases, people experiencing negative symptoms following strangulation did not seek medical advice or treatment.

Teaching about strangulation in PSHE education

It’s unlikely that an entire lesson about strangulation would be an appropriate approach in most schools.

In most cases, schools will be embedding learning about the harms of strangulation into existing lessons on topics such as:

• Pornography — how pornography can promote negative sexual norms and encourage harmful behaviours such as choking during sex.

• Consent — how young people might ask, give or not give when communicating about possible sexual behaviours.

• Unhealthy relationship behaviours — for example when exploring behaviours in a relationship that may be coercive, harmful or creating unhealthy power dynamics.

• Social media, pressure and dares — for example how social media trends such as the blackout game can put pressure on young people to carry out harmful behaviours.

In our 2026 Programme of Study, strangulation is embedded within a subsection on online harms (13):

[Students should have the opportunity to learn...] how pornography can normalise harmful sexual behaviours (that many people do not and will never engage in), including the representation of strangulation; the legal, physical and emotional consequences associated with strangulation and suffocation; that applying force or pressure to someone’s neck or covering the mouth and nose is dangerous and can lead to serious injury or death.