Recreational nitrous oxide use in France in 2022: Results from a nationwide representative sample of adults

The increasing heavy and sustained use of nitrous oxide (N₂O) for recreational purposes in several countries is a growing public health issue, as it can cause neuropathy and other harms. Documenting recreational N₂O use prevalence and characteristics of people who use the drug in the general population is essential.

Between 2 March and 9 July 2022, we conducted a nationwide survey of a random sample of adults in France to estimate the prevalence of N₂O awareness and reported use. Logistic regression analyses were performed to identify factors associated with reported lifetime recreational N₂O use.

Of the study's 3229 participants, we estimated that 75.2% (95% confidence interval [CI] 73.2-77.2) of the French adult population had heard of N₂O, that 4.3% (95% CI: 3.6-5.2) had used it, and that 0.8% (95% CI 0.5-1.3) used it in the past year. Reported lifetime use prevalence was highest in persons aged 18-29 years, at 13.9% (95% CI 10.9-17.5). Reported lifetime use was associated with younger age, being male, a tertiary education diploma (vs. no upper secondary school certificate) and tobacco use.

We estimated that in 2022 three-quarters of adults in France were aware of recreational N₂O use, and that 4.3% used it in their lifetime; prevalence was highest in 18-29-year-olds. To implement successful interventions to reduce N₂O-related risks, its use in specific contexts needs to be explored. Moreover, representative studies focusing exclusively on adolescents and young adults are needed to acquire an in-depth understanding of N₂O-related practices.