The Coalition for a Healthy California is sponsoring a comprehensive statewide ballot initiative to raise the tobacco excise tax by $2.60 per pack of cigarettes in order to provide funding to qualified hospitals for emergency services, nursing education, and health insurance to eligible children. This paper uses the best possible science to estimate the effect of a new tax on cigarette comsuption, adult and youth smoking rates, tax revenues, and long term health outcomes. The additional tax would raise the average price of cigarettes to $6.55 per pack.