In 1995, tobacco use contributed to the deaths of 6274 persons in Oregon (1995 population: 3,132,000) as reported by physicians on death certificates; annual costs in Oregon for the direct and indirect consequences of tobacco use were approximately $1 billion (State Health Division, Oregon Department of Human Resources, unpublished data, 1997). In response to the health burden associated with tobacco use in Oregon, in late 1995 a statewide coalition of health-care and tobacco-use prevention interests began a petition-driven citizen initiative, "Measure 44", to increase the tax on each pack of cigarettes from .38 to .68 and the tax on noncigarette tobacco products from 35% to 65% of wholesale price beginning February 1, 1997. This report presents findings of surveys conducted before and after the measure was approved by voters; in both surveys, respondents indicated that support for such an initiative was increased by dedicating a portion of the new revenue to tobacco-use prevention and education and to expanded insurance coverage under the Oregon Health Plan (OHP) for medically underserved persons.