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

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.