Cigarette Smoke Smell Triggers Migraines

I received this excellent question from a reader today... and wanted to post my response in the hope that my "survival tips" might be of help to you.

Hi Kelli,

My question for you is about cigarette smoke as a trigger for a headache.  When someone comes inside from smoking cigarette and I can smell it, it instantly gives me a headache that will last for hours, even after the person is gone.  I have always been avoiding smokers, but sometimes I can’t.  I go to college, and it happens on the bus, in classrooms, and in the tutoring center.  It happens countless other places, like in line at a store, movie theaters, etc.

What should I do?  Is there anything I can do to prevent the headache from the smell.  The same thing happens from perfume.

I see a neurologist who tells me I have migraines, but sometimes from the smell of a smoker I feel like it’s just in my sinuses.  I tried topamax and verapimil for a preventative medication, topamax made me sick and verapimil didn’t work.  Any pill for migraine relief makes me very nauseous.  I feel desperate, so I wrote you for advice.

Thank you,
Stefanie

Dear Stefanie,

First, let me tell you that you are not alone.  So many migraineurs cite cigarette smoke as a major trigger for their headaches. Unfortunately, as you stated in your email, there are many times where we just don't have control over whether we will be around the smell of it (it makes me so mad sometimes).  I don't have a definite answer to eliminate this in every situation, but I can at least tell you what I do personally.

I find peppermint to be a great smell for me when I'm confronted with a smell trigger... or even when I already have a migraine (most mint scents are great for me - and there's a cucumber/melon combo I love too)... and I carry a little vial of peppermint oil in my purse (mine came from a Bath & Body Works Headache Relief kit they came out with several years ago, but I can't find them anymore - http://www.migrainedaily.com/2004/10/peppermint_head.html - but they do still have some cool aromatherapy stuff).  I also found a similar vial to the one I carry, but with both peppermint and lavender oil, at this website:  http://www.lilslavender.com/product/1431

Sometimes, if I'm sitting next to someone who has been smoking... or I am in a smoky environment, I will take the peppermint oil and put it on my pulse points (wrists, neck, temples)... and then at least I can have the nice fresh scent of peppermint close to me.  I have some peppermint lip balm too that I keep handy and wear all the time... I just love the fresh, clean smell.  Sometimes it can help mask the smoke smell... or any unfamiliar smell that I know might be a trigger for me.  (Perfume can be a tough one though if the wearer has really overapplied it... but hopefully that isn't too often.)

There are scents other than peppermint that are known to help migraineurs including: lavender, bay, melissa, jasmine, eucalyptus, and rosemary.  I personally do well with some citrus smells too... but they have to be pretty subtle.  If you don't do well with any smells though, this isn't going to be a good solution for you.

If you are being forced to walk through clouds of smoke to enter "non-smoking" buildings (smokers always seem to stand right by the door), consider talking to the building administrator and asking them to post signage that requires smokers to move away from the entrances. It's the least they can do to help us non-smokers not have to smell like smoke for the rest of the day just for entering a building.

In terms of how you feel the pain/pressure in your sinuses... I am not sure as to how the smell would affect your sinuses... I haven't had that same experience.  I do know several people who have allergies and sinusitus who use a "neti pot"?  I wonder if you may be having some sinus congestion... and if so, a neti pot might help you clear your sinuses.  There are some good articles explaining it below: 

http://www.netipot.org/about_nasal.htm (video here: http://www.netipot.org/demo_video.htm - and make sure to read the reviews on Amazon.com as some people have found these types of neti pots to be too big for their nostrils)
http://www.healingdaily.com/exercise/neti-pot.htm
http://www.healthandyoga.com/html/product/neti.html

You're on the right tracking by checking in with your doctor and continuing to look for solutions.  We are all different in the way we experience migraine and headache.  It can sometimes take quite a bit of trial and error to find the right personalized solution.  You will find yours... just keep your spirits up and don't give up.

No more migraines,
Kelli  :)

Comments

[Diana]

These are excellent suggestions. I wanted to share another product that helps me, Origins Peace of Mind On-the-Spot Relief. This stuff has been a lifesaver for me on many occasions.

http://www.origins.com/templates/products/sp_nonshaded.tmpl?CATEGORY_ID=CATEGORY5981&PRODUCT_ID=PROD54

[zette]

I'm a long-term migraine sufferer and am really interested in learning more about the connection between smells and migraines. But I'm not sure where to begin, so I'll just try to begin.

I'm now 49, but have had migraines since I was a teenager. I've known for years that MSG and BHA and BHT trigger migraines for me, so I've avoided those for most of my life. As I got older, my headaches seemed to cluster right around my period. I used to do the high dose of caffeine and tylenol routine, but when new medications started coming out for migraines, my doctor made them available to me. I take Imitrex, and most of the time, it seems to work pretty well, but lately I've been going through these periods of heightened sense of smell or hyperosmia in which any smell becomes more intense and more and more kinds of smells are triggering migraines. I've also been getting migraines that wake me up at night -- something I've never had before. I go for a few months with only those migraines connected to my period, and those I can manage, but then I get these months in which I have a series of the other kind of migraine and the "smell thing."

And I'm not finding much in the literature about smells as migraine triggers -- only about how smells and noise exacerbate migraines once they've started. Are the doctors just not getting it? When I asked my neurologist about it he literally just said, "Well that sucks because you can't control what smells you encounter." End of story.

But I'm finding that I need to change my daily habits in order to avoid smell triggers as much as possible. I've also started coughing and having trouble getting my breath when I encounter some smells -- particularly perfume. And trying to replace one smell with another doesn't seem to work for me because once I've encountered the trigger, I'm done for. All smells are then so intense. It has become excruciating for me to take the elevator in our building (small space intensifies smells, especially perfumes), or even to sit at dinner with friends, and most of the time, no one else is really even aware of the smells -- except my husband who has learned to watch out for me. He'll tell me -- don't sit by my mom tonight, she's doused herself in perfume again (even though I've told her several times that it's really painful to be around her when she's wearing perfume). My son and I were walking down the street yesterday and a woman half a block away was wearing a coat that reeked of moth balls; that set off a coughing fit, followed by a migraine. Last week, I scared my son when I couldn't stop coughing because a man a few paces ahead of us lit his cigarette using an old fashioned butane lighter. I spent the rest of the day fighting just to get through the day with a headache hanging out around my temples. I don't know what to do anymore to manage these, and I'm tired to being looked at as though I'm exaggerating or as though I'm a freak. I know what I smell, and I know what pain it causes.

I can't be the only person out these who has these clusters of migraines, can I? What do other people do to function on a daily basis and get through the day when everywhere you encounter triggers?

Thanks for listening.

[Johnny Shmoe]

Cigarettes trigger cluster headaches for me.
http://www.electroniccigarettesinc.com helped