To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan, 707-565-4774; Amelyn Olson, 707-565-2696
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Adoption of an Ordinance Adding Article VII to Chapter 14 of the Sonoma County Code, entitled Restrictions on the Retail Sales and Distribution of Nitrous Oxide - Second Reading
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Recommended Action:
Recommended action
Adopt an Ordinance titled “An Ordinance of the Board of Supervisors of the County of Sonoma, State of California, adding Article VII to Chapter 14 of the Sonoma County Code to restrict the retail sales and distribution of Nitrous Oxide, subject to limited exceptions” - Second Reading
end
Executive Summary:
On August 25, 2026, at a regular meeting, the Board of Supervisors introduced an ordinance to add Article VII to Chapter 14 of the Sonoma County Code to restrict the retail sales and distribution of Nitrous Oxide (N₂O), subject to limited exceptions. This Board item recommends adoption of the ordinance that would:
1. Restrict the retail sales and distribution of N₂O and N₂O dispensing devices, except as expressly exempted;
2. Allow wholesale transactions to qualifying businesses for lawful exempt uses;
3. Establish multiple enforcement tools, including criminal, civil, administrative, nuisance-abatement, and Tobacco Retail License consequences, to support compliance;
4. Declare violations a public nuisance, while expressly limiting enforcement against property owners unless they caused, permitted, or participated in the violation; and
5. Provide that violations by Tobacco Retail License (TRL) holders may also constitute violations of Chapter 32A and may result in suspension or revocation of the retailer’s TRL.
The ordinance is intended to protect public health and safety by reducing retail access to N₂O products intended for or susceptible to non-medical inhalation, while preserving legitimate uses.
Discussion:
Background
Nitrous Oxide (N₂O) is a colorless gas with legitimate medical, commercial, industrial, scientific, automotive, and food-related applications. In medically supervised clinical settings, N₂O is used as an anesthetic and analgesic to reduce pain and anxiety during certain medical and dental procedures. However, when inhaled outside clinical settings for non-medical purposes, N₂O can produce psychoactive and intoxicating effects and has been associated with serious substance use disorders and health consequences, including neurological injury, oxygen deprivation, impaired judgment, loss of consciousness, and impaired driving. These acute effects may occur suddenly and can significantly impair driving ability, increase the likelihood of traffic collisions and other accidental injuries, and place both users and members of the public at risk.
Local inspections, community reports, and observations from the County’s Public and Behavioral Health staff, public safety and environmental partners indicate increasing concerns regarding the misuse of N₂O products sold through retail outlets such as smoke shops and convenience stores. In addition to health and safety impacts, discarded N₂O cartridges and cylinders contribute to litter and hazardous waste disposal challenges.
In response to these concerns, DHS has been working with local jurisdictions and community partners to explore potential policy approaches. Adoption of a local ordinance restricting retail sales of N₂O products has been the direction 19 jurisdictions in CA have taken. Another six, including San Francisco, are actively considering this type of policy. Cloverdale adopted retail restrictions on N₂O in 2018. All other Sonoma County cities and the Town of Windsor have expressed support for a coordinated regional approach.
Need for a Local Ordinance
California law currently prohibits the sale of N₂O products to persons under 18 years of age and prohibits certain sales associated with unlawful inhalation. Despite these restrictions, County staff have documented the continued retail availability of N₂O products marketed and sold for non-medical inhalation, including flavored products, large-capacity containers, and products that facilitate use sold alongside inhalation accessories.
Prior to developing the proposed ordinance, Sonoma County conducted retailer outreach regarding existing California laws governing the sale and distribution of N₂O. On March 11, 2026, the County issued a notice to retailers describing applicable state law, identifying product characteristics and sales practices associated with unlawful inhalation, and encouraging compliance with existing requirements. On June 17, 2026, the County issued a follow-up notice providing additional clarification regarding the County's interpretation of state law, identifying factors that may indicate unlawful sales, and encouraging retailers to voluntarily discontinue the sale of N₂O products commonly associated with non-medical inhalation. Despite these outreach and education efforts, County staff continued to document through periodic retail inspections the sale of N₂O products marketed and sold in forms commonly associated with non-medical inhalation. Staff therefore concluded that education and voluntary compliance efforts alone are insufficient to adequately address the resulting public health, safety, and environmental concerns.
Accordingly, the proposed ordinance is intended to supplement, rather than replace, existing state law by establishing a local education and enforcement framework designed to reduce the availability of N₂O products intended for non-medical inhalation while preserving legitimate medical, commercial, industrial, scientific, automotive, and food-related uses.
Local and Emerging Data
Comprehensive surveillance data on non-medical N₂O use is limited at the local, state, and national levels. However, available information indicates that misuse of N₂O is an emerging public health concern.
Since 2018, Sonoma County has documented four deaths where N₂O was identified as a contributing factor. Two deaths were accidental and involved additional substances and two deaths were deemed suicides involving intentional inhalation. Additional deaths from 2026 remain under investigation. Local emergency medical services (EMS) data also confirm a growing problem with an average of 15 incidents a year (2022-2025). This year, 2026, EMS have already reported 19 incidents thus far. A similar trendline is seen for local treatment/recovery programs where data show increasing admission; in 2024 there were two admissions, in 2025 eight, and so far in 2026 there have been 10 admissions reporting N₂O as the primary or secondary substance being used.
Preliminary data indicate Sonoma County hospitals treated approximately five N₂O-related emergency department visits per month between October and December 2025. County staff are continuing to evaluate historical trends and demographic characteristics of these visits.
Similar concerns have been reported by public health agencies throughout California. Recent reports from other jurisdictions describe increasing availability of flavored products and large-capacity canisters that may facilitate N₂O inhalation. Nationally, poison center calls, emergency department visits, and emergency medical service responses associated with N₂O misuse have increased in recent years, prompting public health advisories from federal agencies.
Community Outreach Summary
Staff conducted outreach with local jurisdictions, public safety partners, environmental stakeholders, retailers, medical and commercial users, and youth-serving organizations. A virtual meeting invitation was sent to over 1,000 stakeholders with 24 people attending the presentation and Q & A session on July 8th. On July 9th, staff made a presentation to the Lower Russian River Municipal Advisory Committee. Feedback consistently emphasized concerns about the proliferation and sizes of products, ease of access, health and safety impacts associated with non-medical use, environmental impacts from discarded cartridges and cylinders, and the importance of regional alignment. Stakeholders also highlighted the need for retailer education, clear exemptions for legitimate uses, coordinated public information efforts, and practical enforcement strategies. Staff have also coordinated with the Sonoma County Sheriff’s Office regarding implementation and enforcement considerations.
Proposed Ordinance
Prohibitions:
Retail sale of, or for any person providing or offering, N₂O or any device capable of dispensing or administering N₂O.
Exceptions:
• Commercially packaged and factory-sealed food products in their original packaging containing N₂O as a propellant;
• Food-grade N₂O cartridges clearly labeled and packaged for culinary purposes.
• Wholesale transactions to licensed business entities for lawful exempt uses, subject to recordkeeping requirements;
• Automotive N₂O systems manufactured and labeled for vehicle performance.
• Medical and dental use under the supervision of licensed practitioners;
• Pharmacy and wholesaler distribution as authorized under state law;
• Research and development uses conducted by qualifying institutions or entities defined as universities, medical facilities, and other qualifying research institutions engaged in documented scientific or industrial research;
• Any other circumstances exempted under state or federal law.
Enforcement:
The ordinance affords the County access to a variety of enforcement tools, ranging from:
• Misdemeanor penalties of up to $1,000 and/or six months in County Jail;
• Civil penalties of up to $1,000 per day, with attorneys’ fees recoverable by County Counsel;
• License suspension or revocation for licensed tobacco retailers under Chapter 32A;
• Public nuisance designation with explicit protection for non-participating property owners;
• Cumulative remedies, including administrative enforcement.
Legal Structure and Safeguards
The ordinance includes several protections to ensure fair and appropriate enforcement:
• Property owners are not liable unless they caused, permitted, or participated in the violation;
• Enforcement is directed toward retailers engaged in prohibited sales or distribution;
• A preemption clause clarifies that the ordinance applies only where not in conflict with state or federal law.
Implementation
Implementation will build on existing coordination, education, inspection, and outreach activities carried out by the DHS and partner agencies. Public Health will serve as the lead agency for routine surveillance and compliance monitoring through the existing Tobacco Retail License (TRL) inspection program, which will continue to conduct inspections at retail locations where N₂O sales have been documented. A public reporting mechanism will be established to allow residents to report suspected unlawful sales of N₂O products. Public Health will triage these complaints, conduct follow-up inspections, and initiate enforcement when violations are substantiated.
Cases involving repeat violations, unlicensed retailers, or more complex fact patterns will be coordinated with County Counsel for enforcement using nuisance abatement authority and available civil or administrative penalties. When circumstances indicate potential criminal activity or require field level investigation, Public Health will refer cases to the Sheriff’s Office for further investigation or criminal enforcement.
The ordinance also provides the Sheriff’s Office with additional enforcement tools relevant to impaired driving and public safety. It allows deputies to seize bulk N₂O cylinders or large quantities of cartridges found in situations suggesting illegal sales or distribution. These tools complement existing Vehicle Code enforcement and strengthen the County’s ability to address N₂O-related harms in the field.
Public Health will continue to promote responsible disposal of N₂O canisters and chargers in coordination with Zero Waste Sonoma and appropriate waste haulers. Behavioral Health programs will continue to provide educational materials and linkage to treatment and recovery services for individuals seeking support related to N₂O misuse and will offer consultation and resources to substance use treatment and recovery providers. Public Health, with support from the Health Officer, will also provide clinicians with awareness materials and clinical guidance on prevention, screening, and early intervention for N₂O related harms. This multiagency approach supports a coordinated response across prevention, enforcement, and treatment systems.
To support successful implementation, there will be an initial focus on education and outreach activities. Public Health staff will serve as the primary liaison to retailers, local jurisdictions, and community partners by providing education regarding ordinance requirements, responding to community inquiries, assisting with complaint intake and follow-up, and supporting public awareness activities. By producing a multifaceted education campaign and setting expectations for voluntary compliance, the County can establish consistent expectations across jurisdictions while allowing enforcement resources to focus on repeat or willful violations.
City Coordination
DHS staff convened local jurisdictions to discuss concerns related to N₂O misuse and potential policy responses. Cloverdale adopted a local N₂O sales restriction in 2018. The remaining Sonoma County cities and towns have expressed interest in a coordinated regional approach and are preparing to consider aligned ordinances following County adoption.
The proposed ordinance is consistent with actions already adopted or under consideration in multiple California jurisdictions and reflects a growing statewide movement toward restricting retail access to N₂O products and supplementing current state law with local education and enforcement tools to enhance compliance.
This Ordinance was introduced on August 25, 2026, and this item seeks the adoption of the Ordinance. The Ordinance will take effect thirty (30) days after adoption.
Correction to Introduced Ordinance
Due to a scrivener’s error, the heading on page nine (9) of the ordinance introduced on August 25, 2026, incorrectly identified the proposed section of the Sonoma County Code as Section 14-8-020. The correct section number is Section 14-7-070. The ordinance attached to this Board item for adoption contains the corrected section heading. No changes have been made to the operative text of the ordinance.
Strategic Plan:
None
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
Yes
Prior Board Actions:
On August 25, 2026, the Board adopted a Resolution introducing, reading the title of, and waiving further reading of an ordinance adding Article VII to Chapter 14 of the Sonoma County Code entitled Restrictions on the Retail Sales and Distribution of Nitrous Oxide.
Fiscal Summary
Narrative Explanation of Fiscal Impacts:
None
Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Ordinance
Attachment 2 - Post-Adoption Summary
Attachment 3 - Racial Equity Analysis
Related Items “On File” with the Clerk of the Board:
None