While not specific to Cluster, there is some insight into an old question which we often discuss. [BJ}
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Headache. 2010 Jun 10.

A History of Cigarette Smoking Is Associated With the Development of Cranial Autonomic Symptoms With Migraine Headaches.
Rozen TD.

From the Geisinger Wyoming Valley, Department of Neurology, Wilkes-Barre, PA, USA.

Abstract
(Headache 2010;**:**-**) Objective.- To look at the smoking history of migraine patients and to determine if a history of cigarette smoking is associated with the development of cranial autonomic symptoms with migraine headaches. Background.- It has recently been noted that a significant number of migraine patients may develop autonomic symptoms during their attacks of headache. Why some headache patients activate the trigeminal autonomic reflex and develop cranial autonomic symptoms while others do not is unknown. CLUSTER HEADACHE OCCURS MORE OFTEN IN PATIENTS WITH A HISTORY OF CIGARETTE SMOKING, SUGGESTING A LINK BETWEEN TOBACCO EXPOSURE AND CLUSTER HEADACHE PATHOGENESIS. COULD CIGARETTE SMOKING IN SOME MANNER LEAD TO ACTIVATION OF THE TRIGEMINAL-AUTONOMIC REFLEX IN HEADACHE PATIENTS? If cigarette smoking does lower the threshold for activation of the trigeminal autonomic reflex then do migraine patients who have a history of cigarette smoking more often develop cranial autonomic symptoms than migraineurs who have never smoked? Methods.- Consecutive patients diagnosed with migraine (episodic or chronic) who were seen over a 7-month time period at a newly established headache center were asked about the presence of cranial autonomic symptoms during an attack of head pain. Patients were deemed to have positive autonomic symptoms along with headache if they experienced at least one of the following symptoms: eyelid ptosis or droop, eyelid or orbital swelling, conjunctival injection, lacrimation, or nasal congestion/rhinorrhea. A smoking history was determined for each patient including was the patient a current smoker, past smoker, or had never smoked. Patients were deemed to have a positive history of cigarette smoking if they had smoked continuously during their lifetime for at least at 1 year. Results.- A total of 117 migraine patients were included in the analysis (96 female, 21 male). Forty-six patients had a positive smoking history, while 71 patients had no smoking history. Some 70% (32/46) of migraineurs with a positive history of cigarette smoking had cranial autonomic symptoms along with their headaches, while only 42% (30/71) of the nonsmoking patients experienced at least 1 autonomic symptom along with headaches and this was a statistically significant difference (P < .005). In total, 74% of current smokers had autonomic symptoms with their headaches compared with 61% of past smokers and this was not a statistically significant difference. There was a statistically significant difference between the number of current smokers who had autonomic symptoms with their headaches compared with the number of patients who never smoked and had autonomic symptoms (P < .05). Overall, 52% of the studied migraineurs had autonomic symptoms. THERE WAS A STATISTICALLY SIGNIFICANT DIFFERENCE BETWEEN AUTONOMIC SYMPTOM OCCURRENCE IN MALE AND FEMALE SMOKERS VS MALE AND FEMALE NONSMOKERS. EACH SUBTYPE OF CRANIAL AUTONOMIC SYMPTOMS WAS ALL MORE FREQUENT IN SMOKERS. CONCLUSION.- A HISTORY OF CIGARETTE SMOKING APPEARS TO BE ASSOCIATED WITH THE DEVELOPMENT OF CRANIAL AUTONOMIC SYMPTOMS WITH MIGRAINE HEADACHES.

PMID: 20553330 [PubMed]

interesting study on a subject that definitely needs more evaluation.
One point I find particularly interesting is that there was no statistical difference in occurrence of autonomic sx between current and past smokers - to imply that quitting smoking did not change the autonomic responses of these patients. 

Question - then is it as Brew suggests - there is an inherent issue with those with CH that predisposes to behaviors such as smoking? 
Or, did the smoking (however distant in the past) change the structure and composition of neurotransmitters/arteries/veins/whatever in such a permanent way as to continue to have effects long after the exposure?

I also noticed (as it is only an abstract) that while the definition of smokers is outlined, there is no similar definition of an ex-smoker.  How long much one have quit to be considered an ex-smoker - 1day, 1 month, 1 year?  The time of last exposure may make a difference.

Also brings up the question, is it nicotine - i.e. chewers, pipe smokers - or is it cigarettes?

Cause and effect........vs simple coincidence! CH will drive you batty trying to figure out that one! What seems like a guaranteed trigger one cycle will have absolutely no effect in the next cycle. Like we need anything else about this condition to give us more frustration. Hoping you catch a break soon.

Joe

Quote:

No it doesn't. That's pure conjecture.

Brew wrote on Jun 23^rd, 2010 at 1:15pm:


If by conjecture, you mean "A proposition that is unproven but appears correct and has not been disproven" then I would agree it is conjecture. As I said in my original statement, no one has done the type of experiment that would conclusively prove or disprove the idea, and no one is likely to do so.

Given incomplete information, scientists and doctors can only rely on concepts like 'likely', 'convergence of evidence' and 'precautionary principle'. Given all that we know about how smoking affects neurotransmitters (not to mention health in general), old fashioned ideas of 'prudence' dictates that the habit should be avoided, not embraced.

Jimi wrote on Jun 23^rd, 2010 at 2:23pm:


Sure - to get started, go to PubMed, and look up the research that shows that nicotine up-regulates the serotonin-2 receptors.  This is the opposite of things like the clusterbusters, olanzapine and kudzu, which abort or prevent by reducing the activity of serotonin-2 receptors.

Correlation is not causation, and shouldn't be assumed to be such.

Hello,

I write this with full knowledge that it is anecdotal and therefore the equivalent of an opinion....and everyone has got one of those...and you know what is said about those.

I grew up in a home where my Father smoked. Never bothered me....and no ch.

At age 22 I started smoking myself...no ch for the next 4 yrs.

At age 26, ch hit me like a 2 x 4 to the head. Over the years I have "quit".... for sometimes months at a time. Whether smoking or not....no effect on the ch.
Couldn't smoke DURING a hit...made it MUCH worse...but AFTER a hit....a desperate need that helped the "come down".

Recently had to quit (3-30-10) for the "long term" due to other concerns. Have been in a low cycle since...but now ramping back up....I KNOW what's coming.

SO...was it a history of exposure? Dunno.

My personal belief is that a "cracked" hypothalamus is contributory to an addictive personality. What smoking has to do with cause or effect re ch...I have no idea.

Best,

Jon

It's why you like us all so much....you're as defective as we are!

Joe

Headache Boy uk wrote on Jun 23^rd, 2010 at 10:02pm:

No. Not that. Anything but that.

Not the dreaded P.E.N.I.S. suckers....

Hay just leave us P.E.N.I.S. user out of this.

We are not bothering anyone .
There is no smell, no second hand smoke - NO tobacco and most important NO SIN TAX!!!!!

Brew wrote on Jun 23^rd, 2010 at 10:35pm:


and proud of it 

monty wrote on Jun 23^rd, 2010 at 7:17pm:

And some CH medications are agonists and some are antagonists.  Go figure.