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Non-medical use of nitrous oxide (N2O) is becoming increasingly popular globally, yet little data exists regarding N2O in Aotearoa New Zealand. We aimed to explore patterns of use and harm in those who consume N2O in Aotearoa, and related knowledge, perceptions and attitudes of those with and without N2O experience. A convenience sample of people with N2O experience (n = 466) and without (n = 510) completed an online survey about N2O. Most with N2O experience reported infrequent and low-dose consumption. Harm reduction behaviors were utilized by most consumers, and reports of adverse effects were relatively low. Self-reported acute or chronic harm (primarily psychological) was reported by only 5.8% of the N2O sample, whilst 9.2% reported ever experiencing persistent numbness (5.2% in the past 12 months). Self-reported knowledge about N2O varied and was greater in those with N2O experience. N2O knowledge was generally poor, although more accurate in those with N2O experience. Attitudes generally differed between those with and without N2O experience, and perceived harmfulness and experience significantly contributed to attitudes regarding N2O legality. Findings underscore the relative safety of N2O when used recreationally, but also highlight the need for greater drug education around potential risks of N2O use and harm reduction. [ABSTRACT FROM AUTHOR]