Taxes are the country's largest source of income. Cigarettes are one of the goods that are subject to excise, and the results of cigarette excise are included in taxes for the region. The regulation on cigarettes has two opposite sides and traps in quite a dilemma. On the one hand, the cigarette tax provides a large income for a region, but on the other hand, the government must also be responsible for the negative impact of cigarettes on the health of its consumers, which results in an increase in the budget for health facilities. Law Number 28 of 2009 concerning Regional Taxes and Regional Levies Article 31 on cigarette taxes that enter local government revenues applies a minimum of 50% to enter into health service funding. The object of this research is the Regional Revenue Agency (BAPENDA) of Java Province. West Java Provincial Health Office. This research uses descriptive research methods and a qualitative approach. The use of cigarette taxes in West Java has been appropriate in terms of the inclusion of cigarette tax results in the health budget, but the absorption is still not optimal. The West Java Health Office focuses on the fulfillment of medical devices to deal with the negative effects of smoking on society. Meanwhile, local governments should be better at absorbing the budget from cigarette taxes in order to be effective and efficient in their use, then there needs to be socialization to the public regarding the special cigaretttax allocation for the health budget.