M

arijuana advocates racked up big wins across the country Tuesday, as voters in California, Nevada, and Massachusetts approved recreational pot use and voters in Arkansas, Florida, and North Dakota gave the green light to medical cannabis.

A recreational marijuana measure was also leading in Maine, and a medical marijuana initiative was ahead in Montana.

The only state where marijuana decisively lost: Arizona, where voters rejected recreational legalization. Medical marijuana remains legal in the state.

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In other ballot results, California voters approved a whopping $2-a-pack increase on the cigarette tax, which had been one of the lowest in the nation. Tobacco companies had fought hard against it, spending more than $56 million, but more than 62 percent of voters supported the tax. Some of the revenue will fund state smoking cessation programs.

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Dom Smith/STAT

Anti-smoking campaigns didn’t fare as well in other states: Voters in Colorado and North Dakota both rejected hefty cigarette tax hikes, and a small proposed tax hike was trailing in Missouri.

Voters in Boulder, Colo., and in three California Bay Area communities — San Francisco, Oakland, and Albany — all OK’d new soda taxes, rejecting strenuous (and expensive) campaigns by the American Beverage Association to beat back the measures. The California cities will all tack an extra penny per ounce on the cost of sugary drinks. In Boulder, soda taxes will rise 2 cents per ounce.

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Alex Hogan/STAT

Faced with a dizzying array of 17 ballot measures, Californians were less inclined to rock the boat on other health and science measures.

A measure to strengthen the law requiring porn actors to wear condoms was losing by a significant margin early Wednesday morning.

Defying the state’s liberal label, Californians also appeared to reject a repeal of the death penalty and narrowly approve a measure to speed up executions.

And thanks to more than $109 million in spending, much of it on TV and web ads, drug companies appear to have beaten back a ballot measure that would have capped the prices state agencies could pay for some prescription drugs. The likely defeat of Proposition 61 was a blow to Senator Bernie Sanders, who had campaigned heavily for the measure, calling it a vital tool to rein in “greedy” drug companies and to crack down on “price gouging.”

Sanders also failed to move another of his cherished agenda items across the finish line Tuesday, when voters in Colorado soundly defeated a proposal to institute a single-payer health care system. Nearly 80 percent of voters rejected the measure; it was even going down in liberal Denver.

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Alex Hogan/STAT

Colorado voters did approve an assisted suicide measure that lets doctors prescribe a lethal dose of medication to mentally competent, terminally ill adults under certain circumstances. Proposition 106 won strong support, with nearly two-thirds of voters backing it.

In other news, voters in two Florida communities split on whether to allow the release of mosquitoes genetically modified to die before they reproduce. The divided outcome will likely make it more difficult for the local government to begin releasing the mosquitoes in a bid to control the spread of diseases such as Zika.

And in Montana, voters rejected a proposal to issue $20 million a year in bonds over a decade to fund neurological research. The measure was trailing by a 60-40 margin.

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Alex Hogan/STAT

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