J Clin Neurol.  2021 Apr;17(2):229-235. 10.3988/jcn.2021.17.2.229.

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

Affiliations
  • 1Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
  • 3Department of Neurology, Uijeongbu St. Mary’s Hospital, Uijeongbu, Korea
  • 4Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
  • 5Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 6Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
  • 7Department of Neurology, Severance Hospital, Seoul, Korea
  • 8Department of Neurology, Seoul Medical Center, Seoul, Korea
  • 9Department of Neurology, Dr. Choi’s Neurology Clinic, Jeonju, Korea
  • 10Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
  • 11Department of Neurology, College of Medicine, The Catholic University of Korea, Suwon, Korea
  • 12Department of Neurology, Chungnam National University College of Medicine, Daejeon, Korea
  • 13Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Korea
  • 14Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea
  • 15Department of Neurology, Inje University College of Medicine, Seoul, Korea
  • 16Department of Neurology, Korea University College of Medicine, Seoul, Korea
  • 17Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea

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.

Keyword

cluster headache; smoking; sex differences
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