for instance the australian state of victoria established a health promotion agency funded by tobacco taxes and several us states california massachusetts arizona and oregon have hypothecated part of tobacco excise revenues for tobaccorelated education and tobaccocontrol activities alcohol revenue are used for alcoholrelated education and prevention programs in new jersey ohio texas sassi et al local taxes can be an important source of revenues especially in decentralised health care systems eg denmark finland italy sweden local taxes have the advantage of creating a strong link between payers and health care service beneficiaries thus potentially increasing accountability in addition the level of local taxation may be set in line with local preferences about the level and quality of medical services however in the absence of a centrally managed riskadjusted transfer mechanism decentralisation lowers risk pooling and might result in larger interregional health disparities