Abstract

BackgroundOn October 1, 2014, the Chilean government modified its previous sugar-sweetened beverage (SSB) tax, increasing the tax rate from 13% to 18% on industrialized beverages with high levels of sugar (H-SSBs) (greater than 6.25 grams [g] sugar/100 milliliters [mL]) and decreasing the tax rate from 13% to 10% on industrialized beverages with low or no sugar (L-SSBs) (less than 6.25 g sugar/100 mL). This study examines changes in beverage prices and household beverage purchases following the implementation of the tax reform.Methods and findingsWe used longitudinal data collected between January 1, 2013, and December 31, 2015, from 2,000 households. We defined the pretax period as January 1, 2013, to September 30, 2014, and the posttax period as October 1, 2014, to December 31, 2015. We conducted a pre–post analysis for changes in prices and purchases, with the latter examined by volume and calories. We compared posttax changes in prices and purchases to a counterfactual, defined as what would have been expected in the posttax period based on pretax trends. All results are stated as comparisons to this counterfactual. We linked beverages at the bar code level to nutrition facts panel data collected by a team of Chilean nutritionists who categorized them by taxation level and beverage subcategory, which included carbonated and noncarbonated H-SSBs and concentrated, ready-to-drink L-SSBs and untaxed beverages. We reconstituted concentrated beverages and analyzed all beverages using as-consumed volumes and calories. Posttax monthly prices of H-SSBs increased, but these changes were small. Prices of carbonated H-SSBs increased by 2.0% (95% confidence interval [CI] 1.0%–3.0%), while those of noncarbonated H-SSBs increased by 3.9% (95% CI 1.6%–6.2%). Prices of L-SSB concentrates decreased after the tax by 6.7% (95% CI −8.2%–−4.6%), and prices of ready-to-drink L-SSBs increased by 1.5% (95% CI 0.3%–2.7%). Households decreased monthly per capita purchases of H-SSBs by 3.4% by volume (95% CI −5.9%–−0.9%) and 4.0% by calories (95% CI −6.3%–−1.9%), and this change was greater among high socioeconomic status (SES) households. The volume of household purchases of L-SSBs increased 10.7% (95% CI 7.5%–13.9%), while that of untaxed beverage purchases decreased by 3.1% (95% CI −5.1%–−1.1%). The main limitation of this study was that there was no control group, so we were unable to assess the causal impact of the tax.ConclusionsThe modifications of Chile’s SSB tax were small, and observed changes in prices and purchases of beverages after the tax were also small. Our results are consistent with previous evidence indicating that small increases in SSB taxes are unlikely to promote large enough changes in SSB purchases to reduce obesity and noncommunicable diseases (NCDs).

Highlights

  • In response to the increasing global burden of obesity and related chronic diseases in the last decade, taxes on industrially produced sugar-sweetened beverages (SSBs) have emerged as a regulatory strategy to prevent the continued rise of obesity [1,2]

  • We linked beverages at the bar code level to nutrition facts panel data collected by a team of Chilean nutritionists who categorized them by taxation level and beverage subcategory, which included carbonated and noncarbonated industrialized beverage with high levels of sugar (H-SSB) and concentrated, ready-to-drink industrialized beverage with low or no sugar (L-SSB) and untaxed beverages

  • Prices of carbonated H-SSBs increased by 2.0% (95% confidence interval [CI] 1.0%–3.0%), while those of noncarbonated H-SSBs increased by 3.9%

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Summary

Introduction

In response to the increasing global burden of obesity and related chronic diseases in the last decade, taxes on industrially produced sugar-sweetened beverages (SSBs) have emerged as a regulatory strategy to prevent the continued rise of obesity [1,2]. Limited evidence exists on the impact of tax rate changes to existing SSB taxes. In high-income countries and low- and middle-income countries with rapid income growth, households might be unaware of small changes in tax rates due to higher median incomes, and commercial beverage companies might choose not to switch prices proportionally to the tax change [12]. Access to safe tap water could affect choices available to consumers. In Mexico, which leads in bottled water consumption worldwide [13] and has relatively limited access to safe tap water in many areas, the main substitution for SSBs in the first year after the tax implementation was water purchases [9]. This study examines changes in beverage prices and household beverage purchases following the implementation of the tax reform

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