A newspaper columnist in the UK recently grumbled that, ‘The anti-smoking groundswell seems to have come from nowhere. Why didn’t it occur in 2000 or 1996 or 1986?’ He admitted to being a smoker, and wondered why he was becoming a ‘social pariah’. The reality, of course, is that the health risks of smoking have been known for more than a generation; that the health community has long been demanding a public policy approach to effective tobacco control, and that political change – especially concerning sensitive and contested issues – takes time. In this article, Andrew Hayes looks at the experience of European anti-tobacco campaigners and focuses on the lessons arising from their work for those advocating more effective policies to prevent diabetes and provide adequate care for people with the condition.