Compared to people without the condition, people with diabetes are at increased risk from vascular diseases – including heart attack and stroke. This risk is further increased in people with diabetes who smoke; smokers with the condition should be advised by their health carers to stop smoking as a matter of urgency. But giving up the habit is not easy. Successful cessation requires people to surmount a number of difficulties, including strong physical, psychological and behavioural dependencies, and the possibility of post-cessation weight gain. Jocelyne Bertoglio looks at a number of factors that complicate people’s attempts to stop smoking, and outlines some of the nutritional recommendations for smoking cessation, especially in people with diabetes.