Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Mar 7, 2024
Date Accepted: Jun 24, 2024
Effect of Smoking on the Development of Migraine in Women: A Nationwide Cohort Study in South Korea
ABSTRACT
Background:
No longitudinal study has investigated the effect of smoking on the risk of migraine.
Objective:
We, therefore, aimed to investigate the impact of smoking on the incidence of migraine in women and the effect of menopausal modification.
Methods:
Using nationally representative National Health Insurance Service data, women aged ≥40 years who participated in national breast cancer screening in 2009 were followed-up until the end of 2019. Data on smoking status (non-, ex-, and current) and duration and amount of cigarette smoking were collected at baseline. A Cox proportional hazards regression model was utilized to examine the independent effect of smoking on the risk of incident migraine after adjusting for demographics, comorbidities, and female reproductive factors. The results were stratified by menopausal status and an interaction analysis (smoking × menopause) was performed.
Results:
In total, 1,827,129 women were included in the analysis. A higher risk of migraine was observed in women with past cigarette use (adjusted HR, 1.044 [95% confidence interval (CI), 1.000–1.089]) and women with current cigarette use (adjusted HR, 1.050 [95% CI, 1.023–1.079]) than in nonsmokers. The effect was greater in premenopausal women (adjusted HR, 1.140 [95% CI, 1.108–1.172]) than in postmenopausal women (adjusted HR, 1.045 [95% CI, 1.018–1.073]) (P < 0.0001). The risk increased with an increased amount of smoking, with a greater association in premenopausal women (p < 0.0001).
Conclusions:
Smoking increases the risk of migraine attacks in women and its effect is greater in premenopausal women.
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