Abstract
Health taxes are policy tools used to reduce harmful consumption of products and raise tax revenue, and they may also be associated with signaling (ie, informational and educational) factors that enhance their impact. To examine changes in prices and volume sold of sweetened beverages following the implementation and repeal of the Cook County, Illinois, Sweetened Beverage Tax (SBT) compared with the comparison site of St Louis County and city, Missouri, which did not impose a tax. This study used interrupted time series analyses to assess changes in price and volume sold of taxed (based on beverage type and sweetener status) and untaxed beverages in Cook County compared with St Louis following the implementation of the SBT on August 2, 2017, and its repeal effective December 1, 2017. Statistical analysis was performed from January to June 2020. Implementation and repeal of the Cook County SBT. Changes in taxed and untaxed beverage prices and volume sold. Nielsen food store scanner data were obtained for weekly volume and dollar amount sold of nonalcoholic beverage universal product codes (UPCs) for each site in supermarkets and mass merchandise, grocery, drug, convenience, and dollar stores. The analytic samples included 16 510 UPCs for volume and 2141 UPCs (balanced sample) for prices for 122 pretax weeks, 16 tax weeks, and 35 postrepeal weeks. Compared with St Louis, posttax implementation in Cook County resulted in a level increase in taxed beverage prices of 1.13 cents per fluid ounce (95% CI, 1.01 to 1.25 cents per fluid ounce), representing a slight overshifting, followed by a posttax repeal level decrease of -1.19 cents per fluid ounce (95% CI, -1.33 to -1.04 cents per fluid ounce), with no resulting change pretax to posttax repeal. Volume sold of taxed beverages in Cook County compared with St Louis exhibited a posttax implementation level decrease of 25.7% (β = -0.297; 95% CI, -0.415 to -0.179) and a posttax repeal level increase of 30.5% (β = 0.266, 95% CI, 0.124 to 0.408), with no net change in volume sold from pretax to 8 months after repeal. This study using interrupted time series analysis found no net change in volume sold of taxed beverages following the implementation and repeal of the Cook County SBT, suggesting the tax had no signaling association. Repeals of such taxes may fully reverse their associations with reduced demand and harms associated with sweetened beverage intake.
Highlights
Goals of health taxes are often 2-fold: (1) reduce consumption of the taxed products deemed to pose health risks and (2) raise tax revenue.[1]
Compared with St Louis, posttax implementation in Cook County resulted in a level increase in taxed beverage prices of 1.13 cents per fluid ounce, representing a slight overshifting, followed by a posttax repeal level decrease of −1.19 cents per fluid ounce, with no resulting change pretax to posttax repeal
Volume sold of taxed beverages in Cook County compared with St Louis exhibited a posttax implementation level decrease of 25.7% (β = −0.297; 95% CI, −0.415 to −0.179) and a posttax repeal level increase of 30.5% (β = 0.266, 95% CI, 0.124 to 0.408), with no net change in volume sold from pretax to 8 months after repeal
Summary
Goals of health taxes are often 2-fold: (1) reduce consumption of the taxed products deemed to pose health risks and (2) raise tax revenue.[1] Health taxes have long been imposed on tobacco and alcohol and are increasingly being used as a public health tool to address high levels of sugar-sweetened beverage (SSB) consumption, with more than 40 countries worldwide and local jurisdictions imposing various forms of sweetened beverage taxes.[2] The health risks associated with SSB consumption, including but not limited to obesity, type 2 diabetes, and cardiovascular disease, have been well documented.[3,4,5,6]. These signals may be implicit—that is, consumers may infer that because the government is taxing such products they must want consumers to reduce consumption—or signals may be explicit, where information on health harms associated with consumption of the taxed products is provided by governments or stakeholders through media campaigns
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