Table 3.

Industry arguments to prevent earmarking

Industry arguments	Assessing industry arguments against available evidence
(1) The earmarked funds will be used in ways which the public do not support and/or which differ from those described in the original proposal(s). [22,24,25,29–31,36–39,41,42,44–46,51,53,56]	This argument was supported by the experience of some case studies. In some cases, the tobacco industry was found to have worked collaboratively with healthcare and health insurance organizations in order to achieve these diversions.[22,24,53]
(2) Framing the use of ‘earmarked’ funds to pay for healthcare costs as a tax on smokers to pay for services for others, which the industry argued was unfair.[37,39,42,52,54]	This is a value-based claim which would only be valid if it reflected public opinion in the specific context in which tax increases were being proposed (i.e. it is not generalisable). It also fails to acknowledge most smokers want to quit.[64,65]
(3) Claiming constitutional barriers prevent the introduction of earmarked tobacco taxes.[29,30,38,44,52]	This claim is context-specific but it is worth noting that many of the studies which noted industry efforts to legally (or otherwise officially) challenge tax proposals found such challenges were unsuccessful.[36,37,38,41,56]
(4) Claiming tobacco tax revenues are not a reliable source of revenue and that it is therefore fiscally irresponsible to fund social programmes via earmarked tobacco taxes.[39,44,50]	IARC concludes tobacco tax increases usually lead to increased government revenue,[8] suggesting such claims are misleading.
(5) Claiming earmarked taxes are examples of excessive state interference in people’s personal lives/freedoms and/or are examples of the state exercising unwarranted power.[42,52].	This is a value-based claim which would only be valid if it reflected public opinion in the specific context in which tax increases were being proposed (i.e. it is not generalisable).
(6) Claiming earmarked taxes will lead to unnecessary, or unwieldy, state bureaucracies. [52,56]	We could find no evidence to support this claim.
(7) Claiming a dependency on earmarked taxes will result in spending cuts for specific programmes or gaps in funding for popular programmes.[37,51]	This claim is context specific but we could find no evidence to support it where it was used and, as IARC concludes tobacco tax increases usually lead to increased government revenue,[8] such claims appear to be misleading.