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Supporters of a measure that would sharply raise the state’s tobacco tax say, if approved, public health costs would be reduced and fewer young people would be drawn into taking up the habit.

Opponents counter that the measure places an unfair tax burden on a portion of the state’s population with lower income, adding that the measure lacks a specific spending plan for the tens of millions it would produce in new revenue.

If approved, Measure 4 would increase the tobacco tax for cigarettes in North Dakota from 44 cents per pack to $2.20 and would be the first increase in the state since 1993. Only Georgia, Missouri and Virginia have lower tobacco taxes than North Dakota.

Taxes on other nicotine products would be increased from 28 percent of the wholesale purchase price to 56 percent. The national average tax on a pack of cigarettes is $1.61.

Eric Johnson, a Grand Forks physician and head of Raise It for Health North Dakota, says Measure 4 would have save more than $250 million annually in health care costs related to smoking. According to the Campaign for Tobacco-Free Kids, the tax increase could result in a 20 percent drop in youth smoking, preventing about 5,800 youths from becoming adult smokers.

“It makes medical sense that we do this,” Johnson said.