Swedish state regulation of tobacco use came much later than the regulation of alcohol and drugs. Only in 1993 did the first more comprehensive regulatory actthe Swedish Tobacco Actcome into force. By examining the political prehistory of the act in 1957-1993, this article analyses the increasingly complex problem description that made the new legislation possible. The article shows that different parts of the problem descriptionharms to others, a connection to the public health discourse, and an increasing medicalisationcame to reinforce each other, but also that all essential components were in place from the outset and that research confirmed established descriptions rather than drove the development.