What to know about headaches from smoking

The link between smoking and headache

Cigarettes contain many toxic substances, which may cause a person to experience headaches.

One theory suggests that cadmium, a toxic metabolite of cigarette smoking, may be a major cause of cluster headaches because it has a toxifying effect on the brain.

Nicotine, a highly addictive substance that is present in tobacco smoke, may also trigger migraines, but this remains controversial. However, nicotine can increase a person’s sense of pain and prevent pain medications from working as usual.

According to the American Cancer Society, children and teens who smoke regularly are at risk of experiencing more frequent headaches. They may also experience other health complications, including impaired lung growth and function, which can increase the risk of chronic obstructive pulmonary disease in later life.

Types of headaches smoking may cause

Smoking has links to many types of headaches:

Cluster headaches

Cluster headaches are severe headaches on one side of the head. They occur in cycles lasting 15 minutes to 3 hours each.

Cluster headaches can cause symptoms such as:

• tearing in one eye
• nasal drainage
• facial swelling
• eyelid droopiness

According to research from 2018, people who do not smoke begin to experience cluster headaches at a younger age and have a higher incidence of family history of migraines. This may suggest that a different underlying cause contributes to cluster headaches in people who smoke. Also, people who smoke tend to have more severe cluster headaches than those who do not.

Migraines

Migraines are more than just headaches, and the symptoms can vary from person to person. Typically, migraines occur in four phases. Possible symptoms include:

• head pain
• vision problems, such as seeing flashing lights
• high sensitivity to light, sounds, and smells
• fatigue
• nausea and vomiting

A 2022 review suggests that smoking can trigger migraine episodes.

Trigeminal neuralgia

A person experiencing trigeminal neuralgia can feel an intense, stabbing, electric shock-like pain that affects the nerves in the lower face, jaw, and nose and above the eye.

A small 2014 study suggests that smoking affects the way that the trigeminal nerve and the brain process pain.

Treating smoking-related headaches 

Quitting smoking can improve a person’s health and may help reduce headaches that a person experiences as a result of smoking. However, an older 2013 study suggests that smoking cessation may not always improve cluster headaches.

Also, headaches can be a side effect of quitting smoking.

People may try nicotine replacement therapy to gradually wean themselves off nicotine and avoid severe withdrawal symptoms. There are five forms of FDA-approved nicotine replacement therapy:

• patches
• gum
• nasal spray
• inhalers
• lozenges

According to the National Center for Complementary and Integrative Health, the following dietary supplements may also help reduce migraines:

• coenzyme Q10
• feverfew
• magnesium
• riboflavin

Although the evidence is inconclusive, some people may also find relief through therapies such as:

• acupuncture
• biofeedback
• massage
• relaxation techniques
• spinal manipulation
• tai chi

Can people get headaches from secondhand smoke?

Some people can get headaches from secondhand smoke. One theory suggests that secondhand smoke exposure in childhood can cause someone who has never smoked to experience cluster headaches later in life.

A headache after secondhand smoke exposure can have many possible causes, such as:

• the smell of cigarette, cigar, or pipe smoke
• an allergic reaction to the smoke
• various chemicals present in the smoke, such as:
  • ammonia
  • benzene
  • cyanide
  • formaldehyde
  • cadmium

Can people get headaches when they are trying to quit smoking? 

Yes, and quitting cold turkey can cause more severe withdrawal symptoms.

For some, smoking can lead to nicotine dependence, which makes it difficult to stop smoking.

A person who is trying to quit can use nicotine replacement therapy that gives them a low dose of nicotine without any of the other toxic chemicals typically present in cigarettes. This can help reduce the withdrawal symptoms a person may experience when quitting, such as bad moods and cravings.

However, headaches are one possible side effect of nicotine replacement therapy. For example, a medication called bupropion (Zyban) can help a person stop smoking but may cause headaches as a side effect.

Tips to relieve headaches that result from stopping smoking

When nicotine withdrawal causes headaches, a person can try a range of methods to manage the pain, including:

• staying hydrated by drinking enough fluids
• being physically active, which can also help heal the lungs after years of smoking
• doing breathing exercises
• trying relaxation techniques such as meditation
• avoiding situations or activities in which they previously used tobacco products
• using over-the-counter pain medications such as acetaminophen, ibuprofen, and naproxen

However, nicotine replacement therapy may reduce the effectiveness of any pain medication a person takes.

Someone with a condition such as cluster headaches or migraine can ask their doctor about available prescription medications to manage these specific types of smoking-related headaches.

E-cigarettes and headaches

E-cigarettes may also have a connection to headaches.

Most e-cigarettes contain nicotine. Different products may contain varying amounts, and product labels do not always clearly outline the nicotine content.

E-cigarettes may also contain volatile compounds that can cause headaches and other potentially dangerous health effects, such as:

• irritation of the eye, nose, and throat
• nausea
• damage to various body systems, such as the liver, kidneys, and nervous system

When to see a doctor

People should consult a doctor if they use tobacco and have frequent headaches. This is especially important if the headaches significantly affect their lives and do not improve or worsen with at-home treatment.

Any headache that occurs after a head injury and is sudden and severe or accompanies symptoms of a serious medical condition — such as a stroke or meningitis — requires immediate medical attention.

Summary

Smoking has links to several types of headaches, including cluster headaches, migraines, and trigeminal neuralgia.

Quitting smoking can be beneficial in treating headaches. However, going cold turkey may make withdrawal headaches worse. Nicotine replacement therapy may help alleviate the symptoms.

A person can support their effort to quit by using relaxation techniques, staying well hydrated, and staying physically active.