People are being warned about the dangers of laughing gas and the potentially fatal impact it can have on the body.
The concern comes from the Royal College of Nurses who believe many people remain ignorant about the risks.
Figures from the Global Drug Survey reveal that the gas - nitrous oxide - is now the fourth most used drug in the UK.
While nitrous oxide can provide a euphoric effect to users it can cause chemical asphyxiation, which the RCN warns, could be fatal.
Other potential problems associated with the gas include breathing difficulties, dangerously-increased heart rate and burns.
Research also suggests that there have been 17 fatalities related to the use of nitrous oxide in the UK between 2006 and 2012.
Legislation introduced in 2016 made it illegal to sell the gas for psychoactive purposes.
But the RCN says enforcing the legislation has proved difficult something they partly attribute to a lack of understanding of the risks.
“The lack of understanding of the effects of nitrous oxide extends to contemporary health services and to governments leading to a lack of legislation precluding sale and increasing numbers of deaths,” the RCN said in a statement.
What is laughing gas?
"Nitrous oxide, or more commonly known as laughing gas, is a colourless gas that people inhale for recreational use,” explains Dr Faiza Khalid, GP at Medicspot.
“Laughing gas slows down responses from your brain and body and the effects can vary depending on how much you take.
“This can involve feelings of euphoria, calmness and relaxation. Some people may also experience hallucinations where they see or hear things that aren't really there.”
Dr Khalid explains that taking nitrous oxide can result in fits of laughter, hence the name 'laughing gas'.
“Unfortunately, inhaling this substance isn't all laughs and users can sometimes experience severe headaches, dizziness, confusion and intense short bursts of paranoia.”
According to an information leaflet produced by NHS Central and North West London, more serious side effects can include headaches, paranoia, nerve damage and sudden unconsciousness.
“Unconsciousness can occur when the available oxygen for breathing is effectively pushed out by the nitrous oxide,” the leaflet states. “The risk is greater if the gas is consumed in an enclosed space or if a plastic bag is used that covers both nose and mouth.”
Heavy regular use of nitrous oxide can also lead to deficiency of vitamin B12 and to a form of anaemia.
“The severe B12 deficiency can lead to serious nerve damage in some cases, which causes tingling and numbness in the fingers and toes and other extremities, and even difficulties with walking and pains in affected areas,” the leaflet warns.
There is also some concern about the impact of mixing nitrous oxide with alcohol as this can increase the risks associated with both substances leading to an increase risk of accidents and even death.
Risk of addiction
Dr Khalid also warns that laughing gas doesn't just have an impact on the body, but also on the mind.
“Like all substance abuse, laughing gas can also have psychological impacts which can lead to addiction,” he explains.
"The full extent of how much damage laughing gas causes to the body and mind is not yet understood and more research needs to be done. More work is needed to inform the public, especially festival goers and young people who are increasingly using laughing gas about the dangers of taking it."
That’s something Stuart McKenzie, a clinical nurse manager at NHS Ayrshire and Arran, agrees with.
"Parents of teenagers might also know about cannabis and legal highs, but if you asked them about the dangers of nitrous oxide, how many of them could confidently say what they were," he told BBC.
The issue is set to be debated at a conference on Tuesday with experts calling for more public warnings, particularly in the club and festival scene.