Discussion:

The evidence suggests: · Strong opposition within government, particularly from Treasury, and from the tobacco industry. · Tobacco tax rises are more acceptable if the revenue is used for tobacco control. · A clear advocacy strategy involving a wide variety of groups is needed.

Our review suggests that the following messages are needed to inform the public and policymakers: · The present funding system for tobacco control in New Zealand is inadequate. · Tobacco tax revenue comes disproportionately from Mâori (as a group) and from low-income households, without using that revenue to help ensure equal health outcomes for Mâori and non-Mâori, and for households of all incomes. · This inequity is directly contrary to government policy on health inequalities. · Population-level tobacco control activities are a very effective use of funds, with a high return on investment (in health and societal terms).

Advocates need to ensure that the revenue from the tied tax cannot be diverted or eroded, and that the revenue is effectively used. The use of the revenue needs to be part of an overall tobacco tax strategy.

Conclusion: Dedicated tobacco tax revenue is potentially achievable in New Zealand if adequate consideration is given to strategy and key messages.