An initiative filed with the Attorney General’s Office on May 4 may give California voters the final say on a proposal that would raise the state’s tobacco tax by $2 per pack.

The Save Lives California Coalition filed two ballot initiatives with the Attorney General. Both would direct revenue from a new tobacco tax into smoking prevention, cures for tobacco-related diseases and reinforcing the state’s health care system. The only difference between them is that one includes a tax hike on e-cigarettes in addition to combustible cigarettes.

The filing is the first step to qualify for a 2016 ballot measure. The coalition will decide at a later time which of the two initiatives it will place on the ballot, according to the Los Angeles Times.

“California doctors know that prevention is the best medicine when it comes to tobacco-related diseases,” said Luther F. Cobb, M.D., president of the California Medical Association (CMA). “With the California Healthcare, Research and Prevention Tobacco Tax Act of 2016, California voters can restore our state’s leadership in research, cures and access to health care.”

CMA has joined the American Heart Association, American Lung Association in California, American Cancer Society Cancer Action Network, SEIU California, the California Dental Association, Tobacco Free Kids and Health Access California to comprise the Save Lives California Coalition in an effort to fight youth smoking and protect public health.

Studies show that smoking costs $23 billion in California in direct health care costs and indirect costs from lost productivity. Furthermore, more than 34,000 people died from smoking-related causes in the state in 2009 — five times the number of fatalities from diabetes, influenza and pneumonia.

“The working men and women of SEIU are proud to lead the way to a healthier California by mobilizing voters to stop tobacco-related diseases that devastate families and ring up costly bills for taxpayers,” said Laphonza Butler, president of SEIU California and SEIU United Long Term Care Workers. “We know our state is stronger when everyone has access to quality care.”

Legislators are currently considering two bills — Senate Bill 591 and Assembly Bill 1396 — that would accomplish the same goals that are laid out in the initiatives, but coalition members said that filing them anyway keeps “all options open for 2016 and helps build public awareness of the need for urgent action to save lives,” according to Monday’s announcement. So far, the tobacco tax bills have been well-supported in the state legislature.

If passed, revenue generated from either the initiatives or the bills would be used to support existing health programs, broaden health care access for Medi-Cal patients with tobacco-related illnesses, prevent illegal tobacco sales to minors and increase funding for medical research into finding cures for tobacco-related diseases.

Research shows that more than 100,000 lives would be saved each year if a $2 per pack tax increase was implemented, and that billions of dollars would be saved from tobacco-related health care costs. A tobacco tax increase would also prevent more than 150,000 people per year from starting to smoke.

For more information, go to www.savelivesca.com.