763 - Sniffing for Strength: An Analysis of Inhalant-Related Content on TikTok

Publication Number: 763.6599

Julian Franco, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, West Babylon, NY, United States; Grace Liberatore, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Pelham, NY, United States; Alyssa Kim, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States; Audrey Ng, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, United States; Ruth Milanaik, Cohen Children's Medical Center, Great Neck, NY, United States

Background: Inhalants, such as aerosols, gases and volatile solvents, are commonly used by athletes for perceived cognitive and strength benefits. Ammonia, the substance inhaled from smelling salts, induces cerebral vasodilation and increased heart rate, creating a “head rush” effect that appeals to younger athletes. The use of these substances, which can be dangerous, adds an alarming element to their appeal. Professional athletes could influence young viewers negatively if seen using inhalants on the sidelines or online.

Objective: This study examines inhalant-related content on TikTok, primarily used by young people, to assess the potential dangers of exposure to this demographic.

Design/Methods: Top TikTok videos under the hashtags #smellingsalts, #inhalants, and #ammonia were collected using an online web scraper. Data collected included creator age range and gender, inhalant presence, usage demonstration, mention of ammonia or health risks, and video characteristics. Age was self-reported by coders. Descriptive analysis was conducted in R.

Results: A total of 92 videos (155,281,807 views) were analyzed. Age distribution was: 38% (n=35) adults >27, 30% (n=28) young adults 23-27, 8% (n=7) college-aged 18-22, 4% (n=4) children < 18 and 20% (n=18) unspecified. Gender distribution: 39% (n=36) men, 28% (n=26) women, 16% (n=15) multiple individuals, 16% (n=15) anonymous or undetermined. 96% (n=88) of videos displayed inhalants, and 78% (n=72) demonstrating their use. Table 1 shows characteristics of videos such as method of demonstration and discussion of ammonia and health risks. Examples of common uses (Figure 1) were recreational (55%, n=51) and weightlifting (27%, n=25). Ammonia was mentioned in 37% (n=34) of videos, of which only 9% (n=3) discussed health risks. 97% (n=89) of videos did not discuss health risks.

Conclusion(s): Most videos showcased inhalant usage, but only 37% (n=34) explicitly mentioned ammonia. Improper use of ammonia inhalants can cause severe damage, including bronchitis, pulmonary edema and even permanent injury or death. For weightlifters, ammonia use can increase the risk of syncope and affect cerebral perfusion. The prevalence of sports-related inhalant videos may attract young users, especially those new to athletics who admire these figures. While smelling salts are believed by many to transiently increase athletic performance, they offer limited advantages. Beyond athletics, recreational inhalant can pose health risks when misused. The engagement of young users and lack of discussed health risks necessitates the need for medical professionals to address inhalant use with patients.

Table 1. Characteristics of Inhalant-Related TikTok Videos with Examples


Figure 1. Stills of Inhalant Display and Demonstrations


Table 1. Characteristics of Inhalant-Related TikTok Videos with Examples


Figure 1. Stills of Inhalant Display and Demonstrations