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Patients with migraines smoke less, drink less, and use fewer illicit drugs than general population

Presented By
Dr Thomas van den Hoek, Leiden University Medical Center, the Netherlands
EHC 2022

A study performed in the Netherlands revealed that migraine patients are less likely to smoke, drink alcohol, or use illicit drugs compared with the general population. The reasons for this were not studied, but the authors speculated migraine patients avoid the substances studied because of their presumed potential to trigger a migraine attack.

The study reflects the growing attention to lifestyle factors as possible triggers of migraine. Patients are interested in such factors because they can influence these themselves. The use of tobacco, alcohol, and illicit substances may act as triggers of migraine attacks, although hard evidence for this assumption is lacking. Dr Thomas van den Hoek (Leiden University Medical Center, the Netherlands) and colleagues examined the prevalence of substance use by means of a survey in a large migraine cohort and compared it with the general population [1]. The study cohort comprised 5,176 patients from the Leiden Headache Center, and data on substance use in the Dutch general population (n=9,500) were derived from the annual health survey for substances (2016/2017). Of the migraine cohort, 83% were women. The mean age was 45 years; mean number of monthly migraine days was 6.6.

The use of all studied substances was lower in migraine patients than in controls. The odds ratio (OR) for illicit drug use was 0.53 (95% CI 0.45–0.63; P<0.01), for current smoking 0.52 (95% CI 0.47–0.57; P<0.01), for lifetime smoking 0.52 (95% CI 0.48­­­–0.55; P<0.01), and for current alcohol consumption it was 0.44 (95% CI 0.40–0.47; P<0.01). Subanalyses per substance stratified by age groups showed similar trends and differences. Subanalyses of chronic versus episodic migraine patients will be performed in the future.

    1. Van den Hoek T. Prevalence of substance use in a Dutch migraine population. Abstract A38, EHC 2022, 07–10 December, Vienna, Austria.

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