title: Associations between frequent headaches, persistent smoking, and attempts to quit.
abstract: BACKGROUND
  Recent studies have found a strong relationship between tobacco smoking and headache pain. It remains unclear whether smoking behavior leads to headache or visa versa, mainly due to the cross-sectional nature of the majority of this research.
  
  
  OBJECTIVE
  To help clarify the direction of the relation between smoking and frequent headaches in a representative cohort study.
  
  
  METHODS
  Members of the Dunedin Multidisciplinary Health and Development Study (N=980) were asked about their cigarette smoking and headache history at ages 11 and 13 (childhood), age 15 (mid-adolescence), and age 26 (adulthood). Both cross-sectional and longitudinal associations between smoking and headache status were examined using logistic regression.
  
  
  RESULTS
  During mid-adolescence, the likelihood of frequent headaches doubled for smokers relative to nonsmokers (OR: 2.16, 95% CI: 1.39-3.35). Smoking did not increase the risk of developing headaches in adulthood, however. In contrast, individuals who suffered from frequent headaches during mid-adolescence were 2 times more likely to smoke in adulthood than those without headache (OR: 2.20, 95% CI: 1.3-3.7), after controlling for sex and family socioeconomic status. Attempts to quit smoking were significantly more difficult for migraine sufferers with a history of headache than for those with tension-type headache.
  
  
  CONCLUSIONS
  Frequent headaches during mid-adolescence appear to increase the risk of daily smoking in adolescence and adulthood. These individuals also have a more difficult time quitting than their headache-free peers.
authors.affiliation: Department of Psychology, University of Auckland, Auckland, New Zealand.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Waldie
authors.forename: Rob
authors.initials: R
authors.lastname: McGee
authors.forename: Anthony I
authors.initials: AI
authors.lastname: Reeder
authors.forename: Richie
authors.initials: R
authors.lastname: Poulton
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000453:epidemiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation; D011795:Surveys and Questionnaires