Smoking History and Clinical Features of Cluster Headache: Results from the Korean Cluster Headache Registry

Abstract

Background and Purpose Epidemiologic data suggest that cluster headache (CH) is significantly associated with cigarette smoking. The aim of this study was to determine differences in features between patients with a smoking history and those who are never-smokers, using data from a prospective multicenter registry. Methods Data used in this study were obtained from the Korean Cluster Headache Registry that collected data from consecutive patients diagnosed with CH. We compared clinical and demographic features between ever-smokers (current or former smokers) and never-smokers. Results This study enrolled 250 patients who were diagnosed with CH, of which 152 (60.8%) were ever-smokers and 98 (39.2%) were never-smokers. The age at CH onset was significantly lower in the never-smoker group than in the ever-smoker group [27.1±12.9 years vs. 30.6±10.9 years (mean±standard deviation), p =0.024]. Seasonal rhythmicity (58.1% vs. 44.7%, p =0.038) and triptan responsiveness (100% vs. 85.1%, p =0.001) were higher in never-smokers, while other clinical features such as pain severity, duration, attack frequency, and associated autonomic symptoms did not differ significantly between the groups. The male-to-female ratio was markedly higher in ever-smokers (29.4:1) than in never-smokers (1.7:1). Conclusions Most of the clinical features did not differ significantly between patients with a smoking history and never-smokers. However, the age at CH onset, sex ratio, and seasonal rhythmicity were significantly associated with smoking history.

Cluster Headache and Associated Risk Factors: A Systemic Review and Meta-Analysis

“…Tobacco consumption has been reported as one of the leading risk factors; it is not only linked with CH but this habit is also associated with the transition of disease severity from episodic CH to chronic CH [33]. [24]. However, the history of tobacco consumption is strongly associated with the age of the disease onset.…”

“…Eight studies among the selected studies reported the prevalence of gender discrimination in CH patients [2,8,19,[24][25][26][27][28]. The selected studies from 2004 to 2021 demonstrate the predominance of males among CH patients.…”

“…Studies by Steinberg et al, Al-Hashel et al, and Ferrari et al evidently support disease severity with tobacco consumption [ 22 , 25 , 28 ]. Chung et al reported another aspect that clinical presentation of the disease did not differ between smokers and nonsmokers [ 24 ]. However, the history of tobacco consumption is strongly associated with the age of the disease onset.…”

“…FIGURE 3: Impact of smoking on cluster headache (CH)[2,[22][23][24][25][26][27][28][29][30][31][32][33][34] …”

“…FIGURE 5: Impact of alcohol drinking/alcohol consumption on cluster headache (CH)[23][24][25][26][27] …”