Nitrous Oxide (N2O) is a gaseous substance with a sweet odour and taste. N2O was originally used as an anaesthetic within health organisations to relieve patients of pain during complicated medical procedures (e.g. surgery). Alternatively referred to as the street name ‘hippy crack’, the recreational use for the substance’s euphoric properties has notably risen in the United Kingdom (UK). In 2019, the Crime Survey for England and Wales reported 2.3% of 16-59-year olds had used N2O recreationally, with no decrease in consumption from 2018 (GOV.UK, 2019). Additionally, young adults aged 16-24 were reportedly the most common users of N2O in 2019 (GOV.UK, 2019). Previous studies have demonstrated that there is limited knowledge and risk awareness of N2O among both users and non-users. Using a mixed-method approach, this study aimed to identify the areas of limited knowledge and to gain a comprehensive insight into common misconceptions of N2O through interviews and a questionnaire. A total of 119 quantitative responses were analysed for trends and patterns regarding knowledge and risk awareness, with qualitative data from 5 interviews analysed via a thematic analysis for common themes about N2O. Both data sets confirmed that not only are 16-24-year olds the most common N2O users in the UK, but that students account for the majority of young adults abusing N2O. There were also similarities between both sets of data regarding misconceptions about N2O. There was also a general consensus from all participants in this study that N2O is very easy to purchase, highly accessible on the internet and very common in the UK. Most importantly, there was a concerning lack of awareness about the serious side-effects of N2O as 32% of participants from the questionnaire did not think N2O can cause long-term effects, which is supported by similar comments within the interviews. Overall, this study about the use and knowledge of N2O in the UK revealed there could be a strong association between the prevalence of N2O use and the lack of knowledge and risk awareness the public has. This study highlights an increasing need for better public awareness and education about N2O to reduce the substances recreational consumption. Further research should look towards recruiting larger populations in order to identify additional areas where education is needed and to assemble a strategy strong enough to reduce the prevalence and increase the knowledge of risks associated with N2O abuse.
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