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Updated August 11, 2015.
Smoking is a trigger for some headache sufferers – although the precise relationship still leaves doctors and scientists scratching their heads. Let's explore this questionable link between smoking and headaches and what you can do to stop smoking– difficult but doable!
Headaches and Smoking
Cluster Headaches: In the headache world, smoking is most notably associated with cluster headaches. In fact, one study in Cephalagia revealed that nearly 80% of people with episodic cluster headaches smoked compared to nearly 90% of people with chronic cluster headaches.
That being said, there does not appear to be a casual relationship between smoking and cluster headaches – meaning smoking does not appear to directly trigger cluster headaches. So, cluster headache sufferers who stop smoking rarely have headache improvement. But, please do not let this deter you from quitting smoking – there are many other health benefits from smoking cessation – and your headaches may or may not be one of them.
Migraines: There may be a link between smoking and migraines – but again, research is limited and questionable. For one, smoking has been shown to be more prevalent in people who suffer from chronic migraine. Additionally, one small study in The Journal of Headache and Pain found that people with migraines who smoked had more frequent migraine attacks than non-smokers with migraines. Why? Scientists are not sure, but potentially migraineurs' attacks are triggered by the smell of smoke – known as osmophobia.
Alternatively, since both headaches and smoking are associated with psychiatric disorders – especially depression – it could be that a person's psychiatric illness is the root of both their smoking and migraines.
Medication Overuse Headache: A high rate of smoking has been found among people who suffer from medication overuse headache – a headache disorder characterized by over-utilization of pain-alleviating medications. Like cluster headaches and migraines, there may be many factors that mediate this connection between smoking and medication overuse headaches.
On the Flip Side
It's important to note that there are a number of studies that do not support the association between migraines or other headaches and smoking. These conflicting results tell us that the relationship between smoking and headaches is still not understood.
Regardless, smoking does increase a person's risk of heart disease, stroke, and lung cancer. It is also linked to a number of other cancers like bladder, cervical, esophageal, pancreatic, and colon cancer. Cessation is critical for prevention of these health-related conditions.
 Smoking Cessation Medications
If you are a smoker and are itching to quit, good for you! Here are some medications and strategies that your doctor may recommend. Please note this is just a brief summary. Be sure to discuss therapies with your doctor to ensure they are appropriate for you.
Nicotine Replacement Therapy
Nicotine replacement therapy helps a person avoid nicotine withdrawal symptoms which include:
- low mood
- insomnia
- irritability
- restlessness
- increased appetite
- decreased heart rate
- weight gain
Nicotine replacement therapy also alleviates smoker's nicotine cravings. There are a variety of nicotine replacements forms – like a skin patch, gum, lozenge, inhaler, lozenge, and nasal spray. Some are available over-the-counter – like the patch, gum, and lozenge – whereas others are available by prescription – like the inhaler and nasal spray.
Each has its pluses and minuses so be sure to talk carefully with your doctor regarding what the best option is for you.
Varenicline (Chantix): Varenicline works by both reducing nicotine withdrawal symptoms and blocking the rewarding sensation a person feels from smoking. Nausea is a potential side effect. More serious side effects include a possible increased risk of heart disease and neuropsychiatric symptoms – like mood changes or suicidal thoughts.
Bupropion (Zyban): Buproprion is an anti-depressant and is believed to work by treating the low mood that accompanies smoking cessation. One of the biggest side effects is insomnia. Bupropion should be avoided in people with an underlying seizure disorder or those at risk for seizures – like people with eating disorders.
Other Smoking Cessation Strategies
Behavioral therapy – especially when given in addition to taking a medication – can also help a person stop smoking. Examples include:
- Acupuncture
- Exercise
- Hypnotherapy
- Telephone, internet, or group-based counseling
Final Message
If you do smoke, stopping is a top priority. With support from your doctor and loved ones and a proper individualized treatment plan, cessation is absolutely possible. Quitting smoking has a vast number of health benefits – and may help your headaches too.
Sources
Centers for Disease Control and Prevention. (2014). Smoking and Tobacco Use. Retrieved August 10th 2015, from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/#children.
Chandler MA & Rennard SI. Working Group for the Stidy of Transdermal Nicotine in Patients with Coronary Artery Disease. Chest. 2010;137(2):428-35.
Kristoffersen ES & Lundqvist C. Medication-overuse headache: epidemiology, diagnosis and treatment. Ther Adv Drug Saf. 2014 Apr; 5(2): 87–99.
Ferrari A. Impact of continuing or quitting smoking on episodic cluster headache: a pilot survey. J Headache Pain. 2013; 14(1): 48.
Larzelere MM. Promoting Smoking Cessation. Am Fam Physician. 2012 Mar 15;85(6):591-598.
López-Mesnero L et al. Smoking as a precipitating factor for migraine: a survey in medical students. J Headache Pain. 2009 Apr;10(2):101-3.
Manzoni GC. Cluster headache and lifestyle: remarks on a population of 374 male patients. Cephalalgia. 1999 Mar;19(2):88-94.
Payne TJ et al. The impact of cigarette smoking on headache activity in headache patients. Headache. 1991 May;31(5):329-32.
Straube A. et al. Prevalence of chronic migraine and medication overuse headache in Germany – the German DMKG Headache Study. Cephalalgia. 2010. Feb;30(2):207-13.
Taylor FR. Tobacco, Nicotine, and Headache. Headache. 2015 Jul;55(7):1028-44.
Zanchin G et al. Osmophobia in migraine and tension-type
headache and its clinical features in patients with migraine. Cephalalgia. 2007 Sept;27(9):1061–68.
DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition