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

Introduction: 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. Methods: 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. Results: 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. Discussion and Conclusions: 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.