July 31, 2025 | Ethan Simmons
Misuse of nitrous oxide, or “laughing gas,” is on the rise nationally. Researchers warn that the U.S. may be at the “bottom of the hill” for this public health issue.
An anesthetic most often used at the dentist or doctor’s office, nitrous oxide or “laughing gas” has been misused recreationally for decades in the form of whipped cream chargers, often called “whippets.”
Research from a University of Illinois professor shows an alarming rise in fatalities associated with the drug in the last decade, potentially driven by efforts to mass-market products to a new generation.
In the study, “US nitrous oxide mortality” published in JAMA Network Open and co-authored by Health and Kinesiology Assistant Professor Rachel Hoopsick and University of Mississippi Assistant Professor of Public Health Andrew Yockey, the researchers tracked the number of deaths in the United States associated with nitrous oxide misuse from 2010 to 2023, using Centers for Disease Control and Prevention data.
In that timeframe, U.S. annual deaths from nitrous oxide poisoning are up by nearly 600%, the study found. Of the 1,240 reported deaths during that period, 74% occurred in the last 7 years.
“I think we are currently at the bottom of a hill,” said Hoopsick. “Without any type of regulatory intervention, deaths and poisonings from nitrous oxide will increase at an accelerating rate and become a tremendous public health issue.”
For reference, 23 users of nitrous oxide died from the drug in 2010, compared to 156 in the year 2023. two factors make the picture look even worse: the sale of nitrous oxide is largely unregulated, and unlike most “party drugs,” users can die after inhaling it just once.
“This product is killing kids, it’s killing young adults,” Yockey said. “There’s no clear intention for using this product recreationally. Our message at the end of the day is: no one should be dying from nitrous oxide poisoning, at all.”
Repackaged for a new generation
Hoopsick and Yockey are frequent collaborators on research into substance use and mortality, often studying highly addictive drugs like methamphetamine and heroin.
Until recently, Yockey wasn’t convinced nitrous oxide misuse had become a public health issue. During a class he taught on substance abuse, he initially dismissed whippets as a fad of the past.
“A student raised their hand and said, ‘I can buy this at a gas station,’” Yockey said. Sure enough, the student pulled up pictures of colorfully packaged canisters of nitrous oxide, with goofy brand names such as “Galaxy Gas” or “Exotic Whip.”
These emerging brands are exploiting a regulatory loophole, the researchers said. Nitrous oxide is the whipping agent for whipped cream, so companies use that purpose as a cover to sell the product for recreational use.
“Flavored and scented versions, there’s no legitimate culinary purpose for that,” Hoopsick said. “It’s a gas—it doesn’t flavor the whipped cream. But it gives a scent or flavor to that gas for people using it as an inhalant.”
In the U.S., misuse of the inhalant has steadily risen since 2010. From 2023 to 2024, the number of intentional nitrous oxide exposure reports increased by 58 percent, Yockey wrote in a letter to the Journal of Medicine, Surgery and Public Health. More than 13 million people in the U.S. report using the inhalant in their lifetime.
A separate analysis showed emergency medical visits for nitrous oxide misuse in Michigan jumped by four to five times from 2019 to 2023.
Rachel Hoopsick
Assistant Professor of Health and Kinesiology
As of now, due to the culinary purpose of these products, the sale of nitrous oxide is still largely unregulated. Four states—Alabama, California, Michigan and Louisiana—have banned its recreational use as of July 2025. Others, such as Arizona and Connecticut, have banned the sale of the substance to minors; New York banned the sale of whipped cream chargers to anyone under 21 years of age.
Earlier this year, the Food and Drug Administration advised consumers to avoid inhaling nitrous oxide “from any size canisters, tanks, or chargers,” naming more than a dozen brands.
Still, in most states, users can pick from collections of brightly colored whipped cream chargers or dispensers at local smoke shops, or have canisters of nitrous delivered to their door from online shopping platforms.
“Since last summer, it’s taken off,” Yockey said.
A familiar playbook
The marketing “playbook” for nitrous oxide bears eerily similarity to the tobacco industry, Hoopsick said, in both appeal and accessibility. Sellers minimize health risks while dressing up the products in flashier exteriors, targeted at young people.
Tobacco companies were pressured by federal regulators to end practices that targeted young buyers, such as flavored cigarettes and cartoon brand mascots.
“We know nitrous oxide has neurological effects,” Hoopsick said. “But sellers rarely, if ever, provide health warnings. The public largely views it as a harmless party drug.”
Unlike the usual “party drug,” however, nitrous oxide risks both instant brain damage and death. The brief “high” temporarily paralyzes users, and can lead to hypoxia, or deprivation of oxygen to the body. Nitrous oxide inactivates vitamin B12, which can lead to a host of other health problems, including nerve damage.
Many deaths arise from the drug’s paralytic effect: the researchers were recently contacted by a mother whose college-age child died from drowning in a hot tub after inhaling nitrous oxide.
In the researchers’ view, the best path to stem nitrous oxide misuse is by making it harder to get, by raising the age requirements for purchase or limiting where the substance can be purchased.
“From a public health perspective, now is a critical window of time to intervene,” Hoopsick said. “We don’t want to wait until we’re at the top of the mountain, which is what we did with opioids.”
Editor’s note:
To reach Rachel Hoopsick, email hoopsick@illinois.edu.
To reach Andrew Yockey, email rayocke1@olemiss.edu.
The paper “U.S. nitrous oxide mortality” is available online.
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