{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T18:39:31Z","timestamp":1785609571307,"version":"3.56.0"},"reference-count":61,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite consistent epidemiological evidence identifying smoking as a risk factor for medication-overuse headache (MOH), the mechanisms underlying this association remain incompletely elucidated. The aim of this work was to explore the relationship between the severity of analgesic dependence, headache-related disability, nicotine dependence, psychological distress, and addiction-related personality traits in patients with MOH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter cross-sectional study was conducted on 442 patients with primary headache disorders. Participants underwent structured face-to-face interviews and were asked to fill out the following questionnaires: Headache Impact Test\u20136 (HIT-6), Severity of Dependence Scale (SDS), Depression Anxiety Stress Scales-12 (DASS-12), and Substance Use Risk Profile Scale (SURPS). Smoking status was documented for all participants. Current smokers were asked to complete Fagerstr\u00f6m Test for Nicotine Dependence questionnaire (FTND).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 442 patients with primary headache disorders, of whom 150 had MOH and 292 did not. Patients with MOH (n\u2009=\u2009150) reported significantly higher monthly headache days (MHD), acute medication days (AMD), HIT-6, DASS-12, and SURPS scores than those without MOH (n\u2009=\u2009292) (all P-values\u2009&lt;\u20090.001). Smoking prevalence and FTND scores were significantly higher among MOH patients than those without MOH (all P-values\u2009&lt;\u20090.001). Smokers demonstrated higher MHD, AMD, prevalence of MOH, DASS-12, and SURPS scores than non-smokers (all P-values\u2009&lt;\u20090.05). Among smokers, FTND correlated positively with MHD, AMD, HIT-6, DASS-12, and SURPS (all P-values\u2009&lt;\u20090.001). In patients with MOH, SDS scores showed positive correlations with AMD, HIT-6, DASS-12, and SURPS (all P-values\u2009&lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severity of dependence on analgesics in patients with MOH is strongly associated with headache burden, nicotine dependence, psychological distress, and addiction-related personality traits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261453544","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:41:20Z","timestamp":1780393280000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Smoking and medication-overuse headache: Exploring the potential link between nicotine dependence and analgesic overuse"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7478-7008","authenticated-orcid":false,"given":"Mona","family":"Hussein","sequence":"first","affiliation":[{"name":"Beni-Suef University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7374-7074","authenticated-orcid":false,"given":"Amr","family":"Hassan","sequence":"additional","affiliation":[{"name":"Cairo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4916-276X","authenticated-orcid":false,"given":"Rehab","family":"Magdy","sequence":"additional","affiliation":[{"name":"Cairo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0478-8486","authenticated-orcid":false,"given":"Ahmed","family":"Dahshan","sequence":"additional","affiliation":[{"name":"Cairo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Yacoub","sequence":"additional","affiliation":[{"name":"Cairo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abdelghaffar","sequence":"additional","affiliation":[{"name":"Fayoum University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3759-7264","authenticated-orcid":false,"given":"Nourhan Abdelmohsen","family":"Taha","sequence":"additional","affiliation":[{"name":"Ain Shams University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Essmat","sequence":"additional","affiliation":[{"name":"Al Azhar University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May M.","family":"Fayez","sequence":"additional","affiliation":[{"name":"El Mounira Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahla","family":"Merghany","sequence":"additional","affiliation":[{"name":"Cairo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Elgenidi","sequence":"additional","affiliation":[{"name":"Cairo University"},{"name":"Department of Neurology, Mayo Clinic, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6187-1588","authenticated-orcid":false,"given":"Ramez Reda","family":"Moustafa","sequence":"additional","affiliation":[{"name":"Ain Shams University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6311-6359","authenticated-orcid":false,"given":"Anter Mothenna Abdullah","family":"Nasser","sequence":"additional","affiliation":[{"name":"Thamar University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Elmazny","sequence":"additional","affiliation":[{"name":"Cairo University"},{"name":"Arabian Gulf University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2023.1194134"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60692-4"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1129-2377-14-S1-P13"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2017.01.003"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1118929"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2010.01755.x"},{"key":"e_1_3_3_8_2","first-page":"592","article-title":"Psychological characteristics associated with tobacco smoking behavior","volume":"33","author":"Rondina Rde C","year":"2007","unstructured":"Rondina Rde C, Gorayeb R, Botelho C. 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