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January 16, 2026BMJ Public Health0 citationsOpen Access

Social determinants of health in recreational nitrous oxide use: a narrative review

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ISIsabelle SymesPJPiranavi JeyarubanSZSafiya A Zaloum

Key Result

Recreational nitrous oxide use is influenced by various social determinants of health, emphasizing the need for targeted prevention and treatment strategies.

Key Points

  • This review investigates how social determinants of health influence recreational nitrous oxide use and its consequences.
  • Conducted a narrative review of existing literature on nitrous oxide use.
  • Applied the WHO Commission on Social Determinants of Health framework for analysis.
  • Examined the intersections of socioeconomic status, mental health, and social environments.
  • Identified significant links between socioeconomic position and nitrous oxide misuse.
  • Highlighted the influence of mental health on recreational use patterns.
  • Found that social settings and health systems impact health outcomes related to nitrous oxide.

PICO

P
Population
Recreational nitrous oxide use (n=85)
I
Intervention / Comparator
Recreational nitrous oxide use
O
Primary Outcome
Prevalence of recreational nitrous oxide use and associated health outcomes across social determinants

Limitations

  • Narrative review may introduce subjective bias in study selection
  • Potential underreporting of N2O use due to stigma and illegality
  • Most data derived from high-income countries may not represent experiences in lower-income contexts.

Abstract

Nitrous oxide (N 2 O), also known as laughing gas, is a colourless, odourless gas. In recent years, recreational use of N 2 O has become increasingly common. Heavy or regular use can induce health and social harms. Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work and age. SDOH influence drug misuse and health outcomes but remains underexplored in N 2 O. This narrative review examines evidence on the impacts of SDOH on health and social outcomes within the context of N 2 O use. We applied the WHO Commission on Social Determinants of Health conceptual framework to map and synthesise extracted literature. Evidence supports an intersection between socioeconomic position, mental health, social setting, health system and political factors within the context of N 2 O. Identifying and addressing these intersections between SDOH and N 2 O misuse could aid prevention efforts and improve care for those affected. Future research into the impacts of ethnicity, culture and legislative changes is now warranted.

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Cite This Study

Symes et al. (2026) conducted a review in Recreational nitrous oxide use (n=85). Recreational nitrous oxide use was evaluated on Prevalence of recreational nitrous oxide use and associated health outcomes across social determinants. Recreational nitrous oxide use is influenced by various social determinants of health, emphasizing the need for targeted prevention and treatment strategies.

synapsesocial.com/papers/6969d4a2940543b97770987ehttps://doi.org/10.1136/bmjph-2025-003386
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