Abstract
An industry levy on sugar-sweetened beverages (SSB) was implemented in the UK in 2018. One year later, Brexit is likely to change the UK trade regime with potential implications for sugar price. We modelled the effect of potential changes in sugar price due to Brexit on SSB levy impacts upon CHD mortality and inequalities. We modelled a baseline SSB levy scenario; an SSB levy under 'soft' Brexit, where the UK establishes a free trading agreement with the EU; and an SSB levy under 'hard' Brexit, in which World Trade Organization tariffs are applied. We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to estimate the effect of each scenario on CHD deaths prevented or postponed and life-years gained, stratified by age, sex and socio-economic circumstance, in 2021. England. Adults aged 25 years or older. The SSB levy was associated with approximately 370 (95 % uncertainty interval 220, 560) fewer CHD deaths and 4490 (2690, 6710) life-years gained in 2021. Associated reductions in CHD mortality were 4 and 8 % greater under 'soft' and 'hard' Brexit scenarios, respectively. The SSB levy was associated with approximately 110 (50, 190) fewer CHD deaths in the most deprived quintile compared with 60 (20, 100) in the most affluent, under 'hard' Brexit. Our study found the SSB levy resilient to potential effects of Brexit upon sugar price. Even under 'hard' Brexit, the SSB levy would yield benefits for CHD mortality and inequalities. Brexit negotiations should deliver a fiscal and regulatory environment which promotes population health.
Highlights
We modelled the potential effects of the sugar-sweetened beverages (SSB) industry levy on SSB price and consumption and compared it with its effect under a ‘soft’ and a ‘hard’ Brexit scenario
Effect of modelled scenarios on price of sugar and sugar-sweetened beverages Imported sugar accounted for 64 % of the total UK sugar supply in 2015
With an estimated sugar content of SSB in the UK market at 93 g/l, we calculated an increase in SSB production costs of 1 and 2 p/l under ‘soft’ and ‘hard’ Brexit scenarios, respectively
Summary
We modelled the potential effects of the SSB industry levy on SSB price and consumption and compared it with its effect under a ‘soft’ and a ‘hard’ Brexit scenario. We estimated the effect of the SSB consumption changes on CHD mortality in England in 2021, stratified by age, sex and SEC. The IMPACT Food Policy model We extended the previously validated IMPACT Food Policy model[11,12,13,14,15] to estimate the effect of changes in the price of SSB on CHD mortality and life-years. The model has been validated among adults aged 25 years or above[16] and translates the estimated changes in SSB price into changes in SSB intake, using price effect estimates, and subsequently into changes in CHD mortality, using appropriate relative risks. All model assumptions are presented in the online supplementary material, Supplemental Table 1
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