Question

Headache

How does smoking affect headaches?

A Answers (3)

  • AKathleen Mullin, MD, Neurology, answered on behalf of The Mount Sinai Health System

    It goes without saying that smoking should be avoided by all people for a myriad of reasons, regardless of its effect on your headaches. Having said that, both active smoking, as well as second-hand smoke from cigarettes, cigars, and pipes can not only worsen existing headaches but can also trigger new onset headaches in many people.

     This relationship exists for a few reasons. First, smoke inhalation increases inflammatory markers in the body, which in turn trigger pain sensitive structures leading to headache. In addition, nicotine, one of the components of tobacco, stimulates the blood vessels in the brain to narrow, when it is out of your system the blood vessels over-dilate which leads to rebound and withdrawal headaches. Finally, patients that suffer from migraines in particular, are often very sensitive to smell both during and between attacks, and being around the smell of smoke alone can often lead to a migraine attack. For many patients, by avoiding situations or places where smoking occurs, headaches may be avoided.

     It should be mentioned that patients that suffer from migraines with aura are at a baseline increased risk of having a stroke in their lifetime. Smoking further increases that risk. Subsequently, while smoking is strongly advised against for all patients, patients with aura should be particularly mindful of their heightened stroke risk. One more reason to put down that cigarette!

    Helpful? 2 people found this helpful.
  • AMark Green, MD, Neurology, answered on behalf of The Mount Sinai Health System

    Smoking can contribute to headaches for both the smoker and the nonsmoker. Nicotine, one of the compounds found in tobacco, has vascular properties which may contribute to headache.

    • Frequently associated with cluster headaches.
    • During a cluster cycle, reducing use to less than one-half pack of cigarettes per day may be beneficial in controlling the headaches.
    • The odor produced by burning tobacco products, and other scents, can trigger migraine in some susceptible individuals.
    • Migraine is associated with an increased risk of stroke and this risk is amplified in smokers.


  • ADawn Marcus, Neurology, answered
    Nicotine-containing products change brain levels of a variety of chemicals that influence headache, including endorphins, serotonin, norepinephrine, and dopamine. The ability of nicotine to alter these chemicals explains changes in feelings of anxiety with lighting up and why quitting can be so tough. These chemical changes can also aggravate your headaches. For example, people who smoke are over one-third more likely to develop migraines, compared to non-smokers. Once smokers are having headaches, the use of nicotine products will further lower their headache threshold, making it easier for headaches to occur. Patients sometimes report a reduction in headaches after quitting smoking, although no research studies have confirmed this link.
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