In 2001-2002 the UK began taxing vehicles according to CO2 emission rates. Since then, there has been a significant increase in consumer choice of small cars and diesel engines. We estimate CO2 reductions and air quality impacts resulting from UK consumers switching from petrol to diesel cars from 2001 to 2020. Annual reductions of 0.4 megatons (Mt) of CO2 and 1 million barrels of oil are estimated from switching to diesels. However, diesels emit higher levels of particulate matter estimated to result in 90 deaths annually (range 20-300). We estimate 570, 460, and 0 additional deaths per Mt of CO2 abated, for Euro III, Euro IV, and post-Euro IV emission class vehicles, respectively. CO2 policies are suspected to have contributed substantially to diesel growth, but the magnitude of impact has yet to be quantified rigorously. To the extent that CO2 policies contribute to diesel growth, coordinating CO2 controls with tightening of emission standards would save lives. This research shows that climate policy, while reducing fuel use and CO2, does not always ensure ancillary health benefits. Lessons from the UK can help inform policies designed elsewhere which strive to balance near-term ambient air quality and health with long-term climate mitigation.