Abstract
BACKGROUND: Alkyl nitrites, commonly known as "poppers," have been widely used as recreational inhalants since the 1970s, particularly among men who have sex with men (MSM). Despite regulatory restrictions in the United States, poppers remain available under misleading product labels (eg, nail polish removers). Limited epidemiologic research has focused on trends in prevalence and correlates of poppers use, particularly among populations that include non-MSM individuals. METHODS: We analyzed data from a repeated cross-sectional survey of adults entering electronic dance music events at nightclubs in New York City (NYC) between 2017 and 2024 (N = 3332). We estimated trends in past-year poppers use overall and stratified by demographic and drug use-related factors in the NYC nightclub-attending population, and we also delineated correlates of use. RESULTS: We estimated that past-year poppers use increased from 7.2% in 2017 to 18.1% in 2024 (a 151.4% increase; P < .001). Increases were estimated among both males and females (by 115.7% [P = .0013] and 199.4% [P = .003], respectively). While prevalence remained highest among gay males (46.3% in 2024), notable increases were estimated for heterosexual males (with an increase to 6.3% in 2024) and sexual minority females (increasing to 27.5% in 2024). Compared to heterosexual males, sexual minority males and females had higher prevalence of use, and those who used cocaine, ecstasy/MDMA, and/or ketamine also had higher prevalence of use (Ps < .05). CONCLUSION: While sexual minority males remain at highest risk for poppers use, prevalence is also increasing among traditional lower-risk groups, underscoring the need for expanded public health messaging and harm reduction strategies.