原发性头痛中的吸烟——一项系统评价与荟萃分析。

Smoking in primary headaches - a systematic review and meta-analysis.

作者信息

Błaszczyk Bartłomiej, Martynowicz Helena, Przegrałek Jakub, Niemiec Piotr, Straburzyński Marcin, Budrewicz Sławomir, Waliszewska-Prosół Marta

机构信息

Department of Neurology, Wroclaw Medical University, Wroclaw, Poland.

Department of Diabetology, Hypertension and Internal Diseases, Wroclaw Medical University, Wroclaw, Poland.

出版信息

J Headache Pain. 2025 Jun 4;26(1):133. doi: 10.1186/s10194-025-02076-2.

DOI:10.1186/s10194-025-02076-2

PMID:40468190

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12139338/

Abstract

BACKGROUND

Primary headaches mainly consist of headaches such as migraine, tension-type headache (TTH), and cluster headache (CH). There is contradictory data concerning the association between smoking cigarettes and headaches. The objective of this study was to evaluate the prevalence of an association between smoking and primary headaches.

METHODS

A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed and Scopus were screened up until February 2025. Next, those studies with eligible criteria related to this topic were included in a meta-analysis. To assess risk of bias, the Joanna Briggs Institute tool (JBI) was used. The random effects model was used to estimate odds ratios (OR) and smoking prevalence.

RESULTS

There were 2,713 records out of which 37 studies were included in the meta-analysis. 22 out of the 37 included studies had a low risk of bias. The prevalence of smoking in migraine was 20% (95% CI: 16–24) and in migraine with aura (MwA) 27% (95% CI%: 17–27). For TTH, the prevalence was 19% (95% CI: 7–34) and in CH, it was 65% (95% CI: 55–76). The overall smoking prevalence in primary headaches was 32% (95% CI: 8–62). Current smoking was associated with an increased risk of migraine (OR = 1.29, 95% CI: 1.02–1.62, = 0.034) compared to the group without any headache. Meta-regression revealed that neither age, sex, nor year of publication influenced this result. Current smoking was associated with a decreased risk of TTH (OR = 0.78, 95% CI: 0.68–0.89, < 0.001). No association was observed between current smoking and CH and MwA; additionally, no association was found between former smoking and migraine. Meta-regression could not be conducted for TTH and CH.

CONCLUSIONS

Current smoking was associated with an increased risk of migraine and a decreased risk of TTH. There was no association between current smoking and CH despite the fact that over half of CH patients smoked. The influence of electronic cigarettes commonly used these days is not yet explored in primary headaches, despite the wide-spread use of such cigarettes among the young population who are vulnerable to primary headache onset.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s10194-025-02076-2.

摘要

背景

原发性头痛主要包括偏头痛、紧张型头痛（TTH）和丛集性头痛（CH）等。关于吸烟与头痛之间的关联，存在相互矛盾的数据。本研究的目的是评估吸烟与原发性头痛之间关联的患病率。

方法

按照系统评价和Meta分析的首选报告项目（PRISMA）2020指南进行系统评价。截至2025年2月对PubMed和Scopus进行筛选。接下来，将符合该主题相关纳入标准的研究纳入Meta分析。为评估偏倚风险，使用了乔安娜·布里格斯研究所工具（JBI）。采用随机效应模型估计比值比（OR）和吸烟患病率。

结果

共检索到2713条记录，其中37项研究纳入Meta分析。37项纳入研究中有22项偏倚风险较低。偏头痛患者的吸烟患病率为20%（95%CI：16 - 24），有先兆偏头痛（MwA）患者的吸烟患病率为27%（95%CI：17 - 27）。TTH患者的吸烟患病率为19%（95%CI：7 - 34），CH患者的吸烟患病率为65%（95%CI：55 - 76）。原发性头痛患者的总体吸烟患病率为32%（95%CI：8 - 62）。与无任何头痛的组相比，当前吸烟与偏头痛风险增加相关（OR = 1.29，95%CI：1.02 - 1.62，P = 0.034）。Meta回归显示，年龄、性别和发表年份均未影响这一结果。当前吸烟与TTH风险降低相关（OR = 0.78，95%CI：0.68 - 0.89，P < 0.001）。未观察到当前吸烟与CH和MwA之间存在关联；此外，既往吸烟与偏头痛之间也未发现关联。无法对TTH和CH进行Meta回归。