Headache and smoking – Symptoms, Causes, and Management

Smoking tobacco can increase carbon monoxide levels in your blood, which triggers a headache, most commonly a cluster headache. Smoking and headache are very commonly linked as smoke is a very important precipitating factor. The headache occurs at the back of the head, lasting 30 mins to an hour, and goes away as soon as the trigger (nicotine) is removed. People who quit smoking may experience headaches in the first 3 days, known as withdrawal headaches.

Symptoms of nicotine headache

  • Headache at the back of head
  • Dizziness
  • Increased pulse
  • Nausea and vomiting in case of odor sensitivity.

Causes of nicotine headache

  • Nicotine in cigarette smoke is a vasoactive substance affecting blood vessels. Nicotine, once entered the blood, causes the blood vessels to constrict resulting in a reduction of blood flow toward the brain and its coverings known as meninges. Decreased blood flow causes depressed brain activity and severe headaches.
  • Another cause is the presence of increased carbon monoxide which is a tobacco product. Smokers have high levels of carbon monoxide in the blood and brain which triggers headaches.
  • People who do not smoke can be allergic to smoke produced by a person smoking a cigarette nearby. Sensitivity to certain smells can trigger headaches.

Smoking and migraine

Cigarette smoke is the most common triggering factor for a migraine attack. People who smoke more than 5 cigarettes a day, experience more frequent migraine attacks.

Smoking and cluster headaches

A large number of patients who experience cluster headaches are active or passive smokers which may indicate an important role of smoking in the development of cluster headaches. Smokers have also shown a transition from episodic cluster headaches to chronic conditions.

Quitting smoking and headache

Some people quit smoking but the headaches do not stop. In such cases, this can be related to the type of headache they are experiencing. For example, people who experience migraines would not get rid of the headache but the frequency does drop. On the other hand, people who cut back on smoking might experience withdrawal headaches. 

Headache from passive smoking

According to studies, there is no correlation between passive smoking and headaches. However, some people can get triggered by the odor caused by smoke and may develop a headache. Passive smoking has several health risks such as stroke, lung cancer, and heart disease in adults. While in children, it may lead to the development of asthma, ear infections, lower respiratory tract infections, and sudden infant death syndrome (SIDS).

E-cigarettes and headaches

Although E-cigarettes or vapes do not contain tobacco, they do contain nicotine. People who use vapes tend to experience dry mouth, dizziness, loss/change in taste, shortness of breath, and cough.

Role of nicotine patches in a headaches

Nicotine patches are used by individuals who plan on quitting smoking. These patches are placed on the skin and they release small amounts of nicotine into your bloodstream time by time. This fulfills the nicotine requirement of the smoker. Headache while using nicotine patches may indicate that the patch is giving you too much or too little nicotine.

Management of nicotine headache


  • Those who have a family history of migraines and cluster headaches should avoid smoking.
  • Other Nicotine containing products should also be abstained from.


  • Over-the-counter analgesics can provide relief.
  • In case of a withdrawal headache, a small amount of nicotine can be taken to provide relief.

When to consult a doctor?

Most of the time, a headache due to smoking is relieved on its own but if the headache fails to settle within a couple of hours or is accompanied by other alarming symptoms such as vomiting, tremors, fits, or fever, you should consult the doctor and inform about smoking habits/abrupt cessation of smoking.


If I quit smoking would my smoking headache be relieved?

Some people quit smoking but the headache does not stop. In such cases, the frequency does drop. On the other hand, people who cut back on smoking might experience withdrawal headaches.

How long does a headache due to smoking last?

The headache usually lasts 30 mins to an hour and goes away as soon as the trigger (nicotine) is removed.

How are smoking and headache related to each other?

Nicotine in smoke produced by a cigarette is a vasoactive substance that affects blood vessels and causes pain in the head when the vessels constrict and decrease blood flow to the brain and meninges.

Are cluster headaches in any way related to smoking-induced headaches?

People who smoke are more likely to experience cluster headaches in their life; some smokers with cluster headaches also develop a chronic condition if they do not quit smoking.

Last medically reviewed on September 15, 2022.