Association of volatile substance, nitrous oxide and alkyl nitrate use with mental health 1 in UK adolescents

Hawkins, Jemma ORCID: https://orcid.org/0000-0002-1998-9547, Hines, Lindsey A., Bonell, Chris, Hickman, Matthew, Adara, Linda ORCID: https://orcid.org/0000-0002-0015-3942, Townson, Julia ORCID: https://orcid.org/0000-0001-8679-3619, Cannings-John, Rebecca ORCID: https://orcid.org/0000-0001-5235-6517, Moore, Lawrence and White, James ORCID: https://orcid.org/0000-0001-8371-8453 2025. Association of volatile substance, nitrous oxide and alkyl nitrate use with mental health 1 in UK adolescents. The British Journal of Psychiatry 226 (1) , pp. 10-15. 10.1192/bjp.2024.128

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Abstract

Background: ‘Inhalants’ have been associated with poorer mental health in adolescence, but little is known of associations with specific types of inhalants. Aims: We aimed to investigate associations of using volatile substances, nitrous oxide and alkyl nitrates with mental health problems in adolescence. Method: We conducted a cross-sectional analysis using data from 13- to 14-year-old adolescents across England and Wales collected between September 2019 and March 2020. Multilevel logistic regression examined associations between lifetime use of volatile substances, nitrous oxide and alkyl nitrates with self-reported symptoms of probable depression, anxiety, conduct disorder and auditory hallucinations. Results: Of the 6672 adolescents in the study, 5.1% reported use of nitrous oxide, 4.9% volatile solvents and 0.1% alkyl nitrates. After accounting for multiple testing, adolescents who had used volatile solvents were significantly more likely to report probable depressive (odds ratio = 4.59, 95% CI 3.58, 5.88), anxiety (odds ratio = 3.47, 95% CI 2.72, 4.43) or conduct disorder (odds ratio = 7.52, 95% CI 5.80, 9.76) and auditory hallucinations (odds ratio = 5.35, 95% CI 4.00, 7.17) than those who had not. Nitrous oxide use was significantly associated with probable depression and conduct disorder but not anxiety disorder or auditory hallucinations. Alkyl nitrate use was rare and not associated with mental health outcomes. Adjustment for use of other inhalants, tobacco and alcohol resulted in marked attenuation but socioeconomic disadvantage had little effect. Conclusion: To our knowledge, this study provides the first general population evidence that volatile solvents and nitrous oxide are associated with probable mental health disorders in adolescence. These findings require replication, ideally with prospective designs.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Social Sciences (Includes Criminology and Education) Schools > Medicine Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Publisher:	Cambridge University Press
ISSN:	0007-1250
Funders:	MRC, ESRC, Wellcome Trust, BHF, CRUK
Date of First Compliant Deposit:	23 July 2024
Date of Acceptance:	21 July 2024
Last Modified:	12 Mar 2025 12:52
URI:	https://orca.cardiff.ac.uk/id/eprint/170845

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