Once again, we have a ballot initiative to raise cigarette taxes in California. It’s the third try in a decade, after voters narrowly defeated efforts in 2006 and 2012.

Proposition 56 on the Nov. 8 ballot proposes a whopping $2-per-pack increase to the state excise tax on all tobacco products, including e-cigarettes. It would be a 230 percent increase to the current excise tax of 87 cents.

The proposition is a battle between two special interest groups, and we voters get to decide who wins.

Supporters are primarily health groups, led by the California Hospital Association. While it may seem logical for it to back such a proposition, the true reason is a bit murkier.

Five years ago, the Legislature reduced reimbursement rates for Medi-Cal by 10 percent. That meant less money for hospitals, clinics and doctors who treat the rapidly growing population of Californians whose medical care is paid primarily by this government-funded program. The current estimate is 14.1 million will be served by Medi-Cal.

Health care lobbyists have been trying ever since to get Gov. Jerry Brown and lawmakers interested in upping reimbursement rates but have had little success. So they went to the ballot box with an initiative intended to help them out.

Prop. 56 would raise $1.3 billion to $1.6 billion a year. But only $160 million of that is specifically targeted for direct tobacco-related health care costs. About $230 million would replace an expected loss in funding for programs now receiving tobacco dollars, such as Proposition 10 early childhood education, as a higher tax is expected to reduce smoking and thus lower revenue from other tobacco taxes.

The bulk of the funds, about $710 million a year, would go to pay for Medi-Cal services. Although there is no specific tie to reimbursement rates in the proposition, the supposition is that more Medi-Cal money in the system means more dollars for hospitals, clinics and doctors.

On the other side, as expected, is the tobacco industry, which has raised $56 million to fight the proposition (supporters have a $19 million war chest).

One of tobacco's tactics is a series of TV ads saying the proposition would take money away from education. That is false. The proposition is written so that the $1 billion-plus a year it generates would not be considered part of the Proposition 99 formula on which state revenue for education is based. So it would not grow education dollars, but it would not decrease them, either.

Currently, about 12 percent of California adults smoke cigarettes. That’s one of the lowest percentages in the United States.

A pack of cigarettes costs about $6. There's a federal excise tax of $1.01 a pack, plus the state excise tax and sales taxes. The current state excise tax ranks 37th in the nation and has not been raised since 1999.

Empirical evidence shows that if the price of tobacco is raised dramatically, it results in a decline in teen-age smoking, because cost is one of the primary forces controlling teens who start experimenting with smoking.

For that reason alone, and because we believe others would also find the habit too expensive, we endorse Prop. 56. We are not a fan of the backroom maneuvering that led to this proposition on the ballot. But we support the intent of how the money would be spent — providing more funds to make our state healthier.

Vote yes on Proposition 56.

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