Rope, especially when made of polyester or other high-resistance materials, is the most effective tool for hanging due to practical and mechanical reasons: it has high tensile strength, does not stretch, ensures constant pressure on the neck, and allows for fixed knots such as the hangman's knot, which provide immediate and stable constriction. In contrast, using scarves, shawls, dupattas, or other household fabrics is often improvised and unreliable. While these can sometimes cause rapid loss of consciousness—particularly if the carotid arteries are compressed correctly—they carry a high risk of failure: they may loosen, slip, or tear, do not provide constant tension, and often lack a secure anchor point. These poorly executed attempts are precisely what lower the lethality statistics in domestic hanging cases. As my aunt, who works in a hospital trauma unit, often says, it's not uncommon for patients to arrive after a failed hanging with broken knees, fractures, or injuries from the fall—and many of them are transferred directly to psychiatry afterwards. It happens far more often than people think.
And I can assure you, it's not pleasant at all. She had a 24-year-old guy who spent almost two months going back and forth to the hospital for treatments, and he could barely move because of the injury he sustained—it affected both his pelvis and part of his spine. He only started walking again a few days ago.