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The Impact of Smoking on People With Migraine and Headache Disorders

Both cigarette and cigar smoke contains many headache triggering chemicals. Nicotine, a component of tobacco products, has vascular activities that have been known to trigger headache. People living with Cluster headache are often greatly affected by smoking.

Second-hand smoke also proves to be an environmental factor that can precipitate headaches. According to a 2006 NHF survey, 52% of respondents reported that smoke triggers their headaches. Additionally, 73% of people living with headache disorders indicated that they limit their time in smoky environments. Tobacco products have been known to produce an odor that triggers migraine in some people.

Thankfully, since 2006, laws have implemented smoking bans in cities and states across the nation. But to completely minimize smoke’s influence on head pain, the NHF suggests that you kick the habit.

In order to stop smoking, the NHF tells you the benefits and drawbacks to the following cessation programs:

  • Gum can quickly satisfy cravings, has a lower incidence of weight gain, and patients can adjust their dose to manage withdrawal symptoms. On the other hand, gum-chewing may not be socially acceptable, can be difficult with dentures, and may cause jaw muscle ache.
  • A lozenge can satisfy oral cravings, is easy to use and conceal, and patients can adjust their dose, but stomach and intestinal side effects (nausea, hiccups, flatulence, and heartburn) are more common.
  • Patches provide consistent nicotine levels, are easy to use and conceal, and have decreased compliance issues, but patients cannot quickly adjust their dose, local skin reactions may occur, and people with dermatologic conditions (i.e., psoriasis, eczema, etc.) should not use the patch. In addition, the 16-hour patch can lead to morning cravings and the 24-hour patch can cause vivid dreams or insomnia.
  • The spray allows for easy dose changes to manage withdrawal symptoms, but nasal and throat irritation can occur and people with chronic nasal disorders or severe airway disease should not use the spray.
  • Lastly, the doses of inhalers are easily changed and the inhaler mimics the hand-to-mouth ritual of smoking. However, initial throat or mouth irritation can be a problem, inhaler cartridges may not be as effective in very cold or very warm temperatures, and patients with underlying bronchospastic disease must use the inhaler with caution.
  • The only oral tablet that is FDA-approved for smoking cessation is sustained-release bupropion (Zyban), which can be prescribed by itself or combined with NRT. Bupropion may be more expensive for some patients (depending on insurance coverage), must be taken daily (sometimes twice daily), and should be used with caution in patients with seizures or eating disorders.

–From NHF HeadLines 2006 July/August Issue

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