The recreational inhalation of N₂O "whippits" among college students at a Saudi University: prevalence, patterns, and perceived harm

Background Recreational nitrous oxide (N2O) inhalation is a growing trend among young adults, but few studies have explored its prevalence. We aimed to measure the prevalence of recreational N2O inhalation among Saudi university students, its perceived harm, as well its association with gender, college type and use of tobacco and alcohol.Methods A cross-sectional study was conducted among undergraduate students at King Saud University, Riyadh, in September, 2022. Self-administered questionnaires asked about knowing someone who inhaled N2O, awareness of whippits (cream charger bulbs), its recreational use, and perceived side effects.Results A total of 720 students participated (response rate = 82%). About 13.3% of the students heard about N2O, 15.7% knew someone who inhaled N2O recreationally, 7.9% ever inhaled it (8.3% women, and 7.5% men), and 36.8% thought it had no negative health effects. Whippits were the most common mode inhaled. Being a health-college student increased the odds for lifetime recreational inhalation by 97% (AOR = 1.97; 95% CI = 1.10, 3.55), while hookah use increased the odds around three-fold (AOR = 3.27; 95% CI = 1.01, 10.63).Conclusion Saudi university students have a low perception of harm toward recreational N2O inhalation and are experimenting with it, with greater odds for use among healthy college students. Raising community awareness about this behavior is needed.