Nicotine Headache

What is a nicotine headache?

Some people who use nicotine notice that they develop headaches during or after its use. Nicotine withdrawal may also cause headaches. Nicotine is the addictive ingredient in cigarettes, e-cigarettes, chewing tobacco, cigars and other tobacco products.

There’s a link between nicotine and headaches. But tobacco products contain many other chemicals as well, which may also contribute to headaches. In addition, headaches have countless causes. It may be difficult to figure out if nicotine is causing your headache or something else.

Researchers are still learning how nicotine and other tobacco chemicals contribute to headaches. So far, there isn’t a clear cause.

What does a nicotine headache feel like?

The main symptom of a nicotine headache is pain. Headache and pain types can vary. Some types of headaches are more common with nicotine use, including:

• Cluster headaches: This severe, focused pain can last for 30 to 45 minutes at a time. You may get cluster headaches up to eight times a day for weeks or months.
• Migraines: These headaches cause severe, throbbing pain. Studies have found conflicting results about the link between tobacco and migraines. Getting a migraine after you smoke may be linked to factors unrelated to nicotine, but research is still ongoing.
• Tension headaches: These headaches cause a pressure or tight band feeling around your head. Cigarette smoke can be a trigger for this type of headache.

What causes nicotine headaches?

In general, headache pain results from signals interacting among your brain, blood vessels and surrounding nerves. During a headache, multiple mechanisms activate specific nerves that affect muscles and blood vessels. These nerves send pain signals to your brain, causing a headache.

Researchers are still learning how exactly nicotine causes headaches. So far, some theories include:

• Long-term (chronic) nicotine use makes your nerves more sensitive to pain signals. This could increase your vulnerability to headaches and pain in general.
• Nicotine narrows your blood vessels, which could decrease blood flow to your brain and cause headaches.
• Nicotine withdrawal may cause headaches due to changes in neurotransmitters that your brain was previously used to.

Researchers think the other chemicals involved in smoking cigarettes could contribute to headaches, including toxicity from carbon monoxide.

Strong odors are also known to trigger headaches and migraines. Smoke odors from cigarettes or cigars may be triggers.

Can nicotine patches cause headaches?

Yes, one of the possible side effects of nicotine patches is headaches. Nicotine patches are a type of nicotine replacement therapy (NRT). NRT can help you quit using nicotine. Other NRT products, like nicotine gum, can also cause headaches.

If you have severe headaches while using NRT, speak with a healthcare provider. Headaches may be a sign that the therapy is giving you too much or too little nicotine.

How are nicotine headaches diagnosed?

To diagnose a nicotine headache, a healthcare provider may ask you questions about headache symptoms. It’s important to be honest about your nicotine use, even if your healthcare provider doesn’t directly ask.

Your provider may want to know:

• When headache symptoms start.
• How long your symptoms last.
• What factors decrease headache symptoms.
• What tobacco products you use.
• How often you use tobacco products.

What is the treatment for nicotine headache?

If you use nicotine regularly, your healthcare provider will likely encourage you to quit. Quitting nicotine use is the best way to get rid of nicotine headaches permanently. Giving up nicotine has many other health benefits, too.

Keep in mind that nicotine withdrawal can also lead to headaches in the first two to three weeks after quitting nicotine. To help you find nicotine withdrawal headache relief, your provider may recommend:

• Over-the-counter pain medications: Acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®) and naproxen (Aleve®) can provide pain relief. Be aware that using nicotine can make these medicines less effective.
• Prescription medications: Medicines such as triptans (Ergomar®, Imitrex®, Maxalt®) or calcitonin gene-related peptide (CGRP) inhibitors (Nurtec®, Ubrelvy®), among other medications, may relieve migraine symptoms.

How can I prevent nicotine headaches?

The best way to prevent nicotine headaches is to avoid using all tobacco products. Besides getting headaches, using tobacco significantly increases your risk of lung cancer, stroke and cardiovascular disease. It also makes it harder for your body to recover from surgery and health problems.

When you quit smoking cigarettes, your health risks decline sharply. Within five years of quitting, your stroke risk may be about as low as someone who has never smoked. Your risks for mouth, throat, esophagus and bladder cancer are cut in half. And within 10 years, your risk of dying from lung cancer decreases by 50%.

When do nicotine headaches stop?

Usually, nicotine headaches start going away about two to three weeks after quitting tobacco. You may still have mental symptoms, such as depression, irritability or anxiety, after physical symptoms go away.

When you quit using tobacco, the first week is the hardest. Physical symptoms like headaches, insomnia and tobacco cravings are usually the most intense in the first five days.

When should I see my healthcare provider about nicotine headaches?

If you want help quitting nicotine use, reach out to a healthcare provider. Their job is to help you, not to judge you. They can offer various resources and strategies for quitting.

If you have headaches or migraines that interfere with your life — whether you think they’re from nicotine or something else — it’s important to see a provider. They can do a headache evaluation and offer treatment options.