Background:
Tobacco taxation is an effective intervention to reduce tobacco consumption. Tobacco taxes also generate substantial government revenue, and this is often framed as an argument to support tobacco tax increases. Achieving the tobacco endgame would eliminate tobacco taxation revenue, and the implications of this for endgame progress are not currently understood. This study aimed to:
(1) Quantify changes to tobacco tax revenue in four endgame-committed countries (New Zealand, Finland, Scotland, Ireland).
(2) Review how revenue in an endgame context is addressed in tobacco tax policy guidance published by health and financial institutions.

Methods:

(1) Annual tobacco tax receipts (2008-2015, as available) were extracted from online government sources and tobacco revenue as a proportion of total government tax revenue calculated.
(2) Relevant published guidance was identified using dynamic Internet searches and reviewed with respect to our research question.

Results:
In three countries, tobacco revenue increased in absolute terms and as a proportion of total government revenue over the study period: New Zealand ($ 1001m to $ 1562m, 1.82% to 2.41%), Finland (€ 622m to € 874m, 0.78% to 0.95%) and Scotland (£ 917m to £1224m, 2.02% to 2.98%). In Ireland, revenue decreased in absolute and proportional terms (€ 1171m to € 1082m, 2.05% to 1.73%). Published guidance of the World Health Organisation, National Cancer Institute, International Monetary Fund and World Bank included no specific reference to tax revenue in an endgame context.

Conclusions:
Increasing government tobacco tax revenues threaten to impede political will for continued endgame progress. Despite this, current policy guidance includes no recommendation regarding how governments may transition towards having no tobacco taxation revenue. Our findings suggest that Ireland have exceeded the point of 'critical elasticity': where increases to the tobacco tax rate are associated with declining revenue. This is an informative example of one way in which governments may progressively diminish tax revenue in preparation for the endgame.