Increased Risk of Stroke for People with Migraines who Smoke

Migraines affect more than 10% of all Americans and are three times more common in women than in men.

A study has found that migraines appear to be associated with a higher risk of stroke among active smokers but not for non-smokers. Encouraging smokers who get migraines to stop smoking may be critical to lessening the headaches and/or preventing migraines. 

It's been known for decades that smoking cigarettes can significantly worsen health and lead to various forms of cancer. But now, research suggests that tobacco acts as a precipitating factor for headaches, specifically migraines. Smokers have more migraine attacks and smoking more than five cigarettes a day triggers this headache.

The study revealed that the hazard ratio of stroke for people with migraine who currently smoked was significantly higher than that of current non-smokers. The hazard ratio for migraine versus no migraine among current smokers was also higher than that of current non-smokers.

Consistent with previous reports, evidence also suggests that patients with migraine were more likely to have hypertension, be physically inactive, smoke, and have higher cholesterol levels. Quitting smoking and addressing other lifestyle issues—even at older ages—may improve vascular outcomes in those with migraine.

Non-smokers with migraine had a lower risk of combined vascular events in the study. One possible reason for this finding is that patients who did not smoke may be more health conscious than others. It’s possible that these people avoided other lifestyle behaviors that can trigger migraines, resulting in better overall health.

The cessation of smoking is critically important for people who suffer from migraines. While the study of migraine and vascular events in older people found that only smokers with migraine had an increased risk of stroke, earlier studies have shown that women younger than 45 who have migraine with aura are also at an increased risk of stroke, regardless of whether or not they smoke.

It’s important that clinicians focus efforts to manage chronic illnesses and emphasize the importance of primary prevention, especially for migraine sufferers. 

The Bottom Line

Since data suggests that smoking may be more common among migraineurs, smoking cessation counseling should be encouraged as a part of routine migraine care at all ages. 

Do you or does someone you know suffer from migraines? Do you want to learn more about migraines and how to prevent them? Try speaking with a licensed physician.