众所周知，吸烟是多种疾病的重要危险因素。偏头痛是一种需要仔细生活方式管理的疾病，目前缺乏提倡戒烟作为预防措施的具体指南。尽管横断面研究表明吸烟与偏头痛风险增加之间存在潜在联系，但研究结果不一致且相互矛盾。迄今为止，还没有前瞻性研究调查吸烟对偏头痛风险的影响。这项纵向研究旨在调查吸烟对女性偏头痛发病率的影响，并检查更年期状态的改变作用使用具有全国代表性的国民健康保险服务 (NHIS) 数据，对 2009 年参加全国乳腺癌筛查的 40 岁以上女性进行随访直至 2019 年底。关于吸烟状况的基线数据（非吸烟、戒烟和吸烟状况）当前吸烟者）以及吸烟的持续时间和数量被收集。在调整人口统计、合并症和女性生殖因素后，使用 Cox 比例风险回归模型检查吸烟对偏头痛发生风险的独立影响。结果按更年期状态进行分层，并进行交互分析（吸烟 × 更年期）。分析总共包括 1,827,129 名女性。与不吸烟者相比，有吸烟史的女性患偏头痛的风险更高。具体而言，过去（调整后的风险比 [HR] 1.044，95% CI 1.000-1.089）和当前使用香烟（调整后的 HR 1.050，95% CI，1.023-1.079）的女性患偏头痛的风险高于不吸烟者。绝经前女性（调整后 HR 1.140，95% CI，1.108-1.172）的效果大于绝经后女性（调整后 HR 1.045，95% CI 1.018-1.073；P<.001）。该风险随着吸烟量的增加而增加，与绝经前女性的相关性更大 (P<.001)。吸烟会增加女性偏头痛的风险，且呈剂量依赖性关系。更年期会改变这种效果。我们的研究结果表明，吸烟是偏头痛的一个重要的可改变危险因素，对绝经前女性的影响更大。吸烟和雌激素之间的相互作用可能会增加偏头痛大脑的脆弱性。© Seung Ae Kim、Kyungdo Han、Soyoun Choi、Michelle Sojung Youn、Hyemin Jang、Mi Ji Lee。最初发表于 JMIR 公共卫生和监测 (https://publichealth.jmir.org)。

Smoking is known to be a significant risk factor for various diseases. Migraine, a condition requiring careful lifestyle management, currently lacks specific guidelines advocating for smoking cessation as a preventive measure. Although cross-sectional studies have suggested a potential link between smoking and an increased risk of migraine, the findings have been inconsistent and conflicting. To date, there has been no longitudinal study which investigated the effect of smoking on the risk of migraine in a prospective setting.This longitudinal study aimed to investigate the impact of smoking on the incidence of migraine in women and examine the modifying effect of menopausal status.Using nationally representative National Health Insurance Service (NHIS) data, women aged ≥40 years who participated in national breast cancer screening in 2009 were followed-up until the end of 2019. Baseline data on smoking status (non-, ex-, and current smoker) as well as the duration and amount of cigarette smoking were collected. A Cox proportional hazards regression model was used 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.In total, 1,827,129 women were included in the analysis. Women with a history of smoking exhibited a higher risk of developing migraine, compared with nonsmokers. Specifically, a higher risk of migraine was observed in women with past (adjusted hazard ratio [HR] 1.044, 95% CI 1.000-1.089) and 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<.001). The risk increased with an increased amount of smoking, with a greater association in premenopausal women (P<.001).Smoking increases the risk of migraine in women, with a dose-dependent relationship. Menopause modifies this effect. Our findings suggest that smoking is an important modifiable risk factor of migraine, with a higher impact in premenopausal women. The interaction between smoking and estrogen may increase the vulnerability of the migraine brain.© Seung Ae Kim, Kyungdo Han, Soyoun Choi, Michelle Sojung Youn, Hyemin Jang, Mi Ji Lee. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org).