Nicotine use and withdrawal from nicotine may contribute to headache pain, particularly cluster headaches. Various therapies and management techniques can help reduce symptoms.

Nicotine is the active ingredient in cigarettes, cigars, chewing tobacco, and other tobacco products. It’s a stimulant, which means it increases your central nervous system’s activity.

When nicotine enters your bloodstream, it helps release two neurotransmitters: dopamine and epinephrine. Releasing these brain chemicals can lead to a pleasurable “rush” or “kick.” Because nicotine also stimulates your brain’s reward centers, it’s highly habit-forming.

Nicotine may lead to many side effects. One of these involves getting headaches.

This article explores the link between nicotine and headaches, how to find relief, and more.

Nicotine may increase your risk of headaches. Getting headaches can be a potential side effect of nicotine replacement therapy (NRT), which people use to treat nicotine dependence. NRT works by supplementing a person with progressively lower levels of nicotine.

However, experts have performed most of the research into nicotine and headaches in the context of tobacco smoking. Indeed, a 2023 research review linked tobacco smoking with increased headache frequency.

This point is important because nicotine isn’t the only chemical that’s in tobacco smoke. Tobacco smoke actually contains a mixture of more than 7,000 chemicals, according to the American Lung Association.

This information means that, in addition to nicotine, many other chemicals present in tobacco products could also contribute to headaches.

How can nicotine contribute to headaches?

Nicotine may increase your risk of developing headaches in several ways:

  • Nicotine’s stimulant effects can narrow blood vessels. This narrowing can reduce blood flow to your brain, leading to headache pain.
  • Continued exposure to nicotine and other chemicals found in tobacco products may increase pain receptor sensitivity in your brain.
  • Nicotine can reduce the effects of some pain medications people take to ease headaches. Because of this, if you already have a headache when you use nicotine, it may be harder to relieve your headache pain.

Research closely links some headache types with the use of nicotine or tobacco products. These include:

  • Cluster headache: Cluster headaches are severe headache attacks that happen in clusters and can last for weeks to months. Many people with cluster headaches smoke, and smoking may lead to an attack.
  • Trigeminal neuralgia: Several types of trigeminal neuralgia exist with potential causes. In many cases, the cause isn’t known. A 2024 study suggested that smoking may worsen this condition or cause it to occur at a younger age.
  • Migraine: Migraine is a type of recurrent headache that causes throbbing or pulsating pain. Many causes may lead to migraine, including tobacco. However, according to a 2023 review, it’s unclear whether smoking is a cause of migraine.

E-cigarettes are small, battery-powered devices that heat a liquid into an aerosol that you then inhale. People also refer to e-cigarettes as e-cigs, vapes, or vape pens.

Mostly, e-cigarettes contain nicotine. A 2021 review showed that even some e-cigarette refills labeled as nicotine-free still contained detectable nicotine levels.

While e-cigarettes don’t contain many of the harmful chemicals in regular cigarettes, potentially harmful substances — along with nicotine — can still be in e-cigarette aerosols. Some examples include heavy metals and known carcinogens.

E-cigarette users participating in a 2019 survey reported many side effects, including:

Experts don’t yet know whether nicotine or other chemicals in e-cigarette aerosols cause these side effects. Since e-cigarettes are relatively new, research is ongoing into their potential short- and long-term health effects.

One of the best ways to relieve headaches due to nicotine is to try to stop using nicotine. You can do this in many ways. However, keep in mind that nicotine withdrawal can also cause headaches.

If you have a headache due to nicotine use or nicotine withdrawal, you can try the following:

If you use nicotine frequently, your body and brain become used to it. When you stop using nicotine or lower your nicotine intake, you may experience nicotine withdrawal as your body adjusts to not having nicotine.

Headaches can be a nicotine withdrawal symptom. The exact mechanism of why nicotine withdrawal causes headaches still isn’t known, but it may have to do with nicotine’s effect on pain processing in your brain.

In addition to headaches, nicotine withdrawal can include other physical or psychological symptoms such as:

Nicotine withdrawal symptoms can be unpleasant. However, you can take steps to help ease these symptoms and to stay on track with your quit plan:

  • Know what to expect: Talk with a doctor before starting your quit plan. They may suggest some specific coping strategies you can use for managing cravings or withdrawal symptoms.
  • Get support: Let your loved ones know that you’re quitting nicotine and ask them to help support you on your journey. Joining a support group may also be beneficial.
  • Prioritize sleep: Nicotine withdrawal can disrupt your sleep, contributing to feelings of irritability and fatigue. That’s why it’s important to prioritize your sleep each night.
  • Be active: Regular exercise benefits your overall health, can improve your mood, and helps you sleep better at night.
  • Eat healthy snacks: Some people experience an increased appetite when they quit tobacco. Try to keep nutritious snacks on hand to reduce the temptation of sugary or fatty foods.
  • Drink water: Staying well hydrated may help ease your headache and reduce cravings.
  • Lower stress: Examples of some relaxation techniques include yoga, exercise, breathing exercises, or engaging in a hobby you enjoy.
  • Avoid triggers: Avoid situations that may urge you to use nicotine, like being around people who use tobacco or e-cigarettes.
  • Talk with a doctor about medications: Some types of medications can help you manage withdrawal symptoms. Examples include:
    • NRT lozenges, gum, or patches
    • varenicline (Chantix)
    • bupropion (Zyban)

Make an appointment with a doctor if you use tobacco and experience headaches that:

  • happen frequently
  • significantly affect your daily activities
  • don’t get better or get worse with at-home care

When to get immediate care

Get immediate medical attention if you experience a headache that:

The nicotine in tobacco and e-cigarette products can increase your risk of headaches. There are several biological mechanisms through which this may occur.

Other chemicals found in these products may also contribute to headaches. Headaches may also happen due to nicotine withdrawal.

Medication, cool compresses, and rest may help ease a headache due to nicotine. However, one of the best ways to reduce nicotine-related headaches is to stop using nicotine. If you’re interested in quitting, your doctor or healthcare professional can help you develop a quit plan that’s right for you.