Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 65 5 2026 07 06 309 316 Atessa Pakfetrat Department of Oral and Maxillofacial Diseases, Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran Mahdi Talebi Department of Family Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Taghi Shakeri Department of Epidemiology and Biostatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Reza Shakiba Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Mahdi Rivandi Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran Ala Ghazi Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2025 01 25 2025 11 10 This study was conducted with the aim of investigating the pattern of smoking and its relationship with chronic pain in patients with atypical facial pain (AFP). This descriptive cross-sectional study was conducted on patients with AFP referred to the Oral and Maxillofacial Medicine department of Mashhad Dental faculty. Patients whose disease was confirmed through clinical and psychiatric examinations, and standard diagnostic criteria were included in the study. The information based on the designed checklist includes demographic characteristics, pain characteristics, and information related to tobacco use was extracted and recorded. Out of 77 patients included in the study, 23 were smokers and 54 were non-smokers. The most common site of pain in the smoking group was the face and, in the non-smoking group was the mandible. The most reported pain type was sharp pain in both groups. In non-smokers, a history of mental stress at the same time as the onset of pain was reported in 56% of people, and in the population of smokers, it was reported in 73% of people. In both groups, most people reported that pain does not affect sleep patterns. No significant difference was observed between the smoking and non-smoking groups in terms of pain intensity. According to the findings of present study, Smoking does not play a role in the pain intensity and sleep pattern of people with AFP, and other factors such as economic status, stress, anxiety, and smoking compounds may be effective, which should be investigated in future studies. https://acta.tums.ac.ir/index.php/acta/article/view/11500 https://acta.tums.ac.ir/index.php/acta/article/download/11500/6058