Voters in Missouri will decide on November 6 whether to increase their state tobacco tax, which is currently the lowest in the nation. The measure would raise the tax from 17 cents per pack to 90 cents.

This will be the third time in the past 10 years that Missouri voters will consider whether to raise the tobacco excise tax, the Associated Press reports. The national tobacco tax average is $1.46. If Missouri voters approve the measure, their state tobacco tax would become the 33rd highest in the nation.

Large tobacco companies are not opposing the increase, because the measure would remove a loophole that allows smaller cigarette makers to get back money they paid into a state fund designed to offset costs associated with smoking-related illnesses.

The measure is supported by a coalition of educators, whose schools would receive millions of dollars from the tax increase, the article notes. Tax revenues from the measure, known as Proposition B, would be used for public schools, higher education and tobacco prevention and cessation programs. A state auditor’s report estimated the measure would generate between $283 million and $423 million each year.

The American Cancer Society backs the tax increase. “Each year thousands of Missourians are diagnosed with tobacco-related cancer and some will lose their lives to this devastating disease,” Government Relations Director Misty Snodgrass said in a statement. “This ballot measure will mean increased longevity, improved quality of life, and fewer Missourians who will needlessly suffer and die from cancer.”

Opponents of the measure, including the Missouri Petroleum Marketers and Convenience Store Association, say the big tax increase would eliminate the state’s competitive edge in the tobacco market, resulting in the loss of tens of millions of dollars in sales tax revenue.