Abstract
ObjectiveTo evaluate the potential signaling effect of the Mexican tax on sugar-sweetened beverages (SSBs) by analyzing the association between awareness of and opinions about its effectiveness with current consumption of taxed SSBs and with a self-reported change in consumption of SSBs since the implementation of the tax. We also examined the association between psychosocial and environmental determinants of SSB consumption with current consumption of taxed SSBs and with a reported change in consumption of SSBs.MethodsCross-sectional analyses of survey and food-frequency questionnaire data from the Mexican National Health and Nutrition Survey 2016. Participants were Mexican adults (20–59 years, N = 6,650). Logistic regression was used to evaluate the probability of a person reporting a decrease in SSB consumption, given their awareness of the tax, opinion about its effectiveness, psychosocial (SSB health-related beliefs, self-efficacy, and liking of SSBs) and environmental (availability of potable water) determinants. Multiple linear regression analysis was utilized to examine the association between the aforementioned factors and current consumption of taxed SSBs.ResultsCompared with adults not aware, adults who were aware of the SSB tax were more likely (OR = 1.30) to report a decrease in SSB consumption (p = .012). In urban areas, adults aware of the tax drank a significantly lower amount of taxed SSBs (-15.7%; p = .023) than those not aware. Self-efficacy and liking of SSBs were significantly associated with a reported decrease in consumption and with current consumption (p < .001), while health beliefs and availability of potable water were not significantly associated with either reported change in SSB consumption or current consumption of taxed SSBs.ConclusionsImplementation of an SSB tax accompanied by highly visible campaigns may further influence the impact of taxes on SSBs consumption. Future public health and nutrition education campaigns designed to increase knowledge and enhance motivation should be complemented by programs to assist individuals develop self-efficacy and self-regulation skills.
Highlights
In Mexico, 73% of adults and 36% of children and adolescents have overweight or obesity [1]
Compared with adults not aware, adults who were aware of the sugar-sweetened beverages (SSBs) tax were more likely (OR = 1.30) to report a decrease in SSB consumption (p = .012)
Multiple linear regression analysis was utilized to examine the association between six variables: (1) awareness of the tax, (2) opinion about the effectiveness of the SSB tax, (3) health beliefs scale, (4) liking of SSBs, (5) self-efficacy and (6) availability of potable water for free or at a low cost; with current consumption of taxed SSBs, after controlling for seven covariates
Summary
In Mexico, 73% of adults and 36% of children and adolescents (aged 2–19 years) have overweight or obesity [1]. 15% of adults are estimated to have type 2 diabetes—being the principal cause of mortality [2]. Frequent consumption of SSBs has been linked to an increased risk of a number of adverse health outcomes, including obesity [3,4,5], type 2 diabetes [6,7,8,9], coronary heart disease [10], dental caries [11], and tooth loss [12]. Consumption of SSBs, soda in particular, in Mexico is widespread [13] and has a strong cultural component [14]. SSBs contribute about 69% of added sugars, 45% of total sugar intake, and 10% of total energy intake to the Mexican diet [13], more than three times the level recommended by the American Heart Association and approximately 3% of total energy intake [15, 16]
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