Abstract
In January 2017, Philadelphia (Pennsylvania) implemented an excise tax ($ 0.015/ounce) on sugar-sweetened and diet beverages. This study is a general population-based study to report on the longer-term impacts of the tax on within-person changes in consumption 12 months after implementation. A quasi-experimental difference-in-difference design was used to contrast Philadelphia vs. nearby comparison cities (Trenton, New Jersey; Camden, New Jersey; and Wilmington, Delaware) at baseline (December 2016–January 2017) vs. 12-month follow-up (December 2017–February 2018). A random-digit-dialing phone survey was administered to a population-based cohort. Analyses assessed changes in 30-day consumption frequency and ounces of sugar-sweetened and diet beverages (and a substitution beverage, bottled water) in the analytic sample (N = 515). After 12 months, relative to the comparison group, Philadelphians were slightly more likely to decrease their frequency of sugar-sweetened beverage consumption (39.2% vs. 33.5%), and slightly less likely to increase their frequency of sugar-sweetened beverage consumption (38.9% vs. 43.0%). The effects of the tax estimated in the adjusted difference-in-difference analysis were very small (for example, changes in monthly sugar-sweetened beverage consumption in Philadelphia relative to comparison cities was −3.03 times or −51.65 ounces) and confidence intervals were very wide. Results suggested that, one year after implementation, there was no major overall impact of the tax on general population-level consumption of sugar-sweetened or diet beverages, or bottled water. Future studies should test whether the tax’s effect differs in vulnerable sub-populations.
Highlights
Sugar-sweetened beverages (SSB) are significant sources of added sugar and calories in the American diet [1,2]
We examined the within-person change in bottled water and sugar-sweetened and diet beverages (SSDB) consumption in Philadelphia, relative to nearby comparison cities, one year after Philadelphia’s SSDB tax
Forty-nine percent were male, 52.2% were white, 42.5% were older than 50 years, 19.8% had income per capita lower than $15,000, 28.0% had educational attainment at high school level or lower, 28.7% were obese, 13.8% reported fair or poor self-rated health status, 40.4% reported having been told by a health professional that they had chronic health condition, 15.5% were currently smoking and 23.7% had higher alcohol use
Summary
Sugar-sweetened beverages (SSB) are significant sources of added sugar and calories in the American diet [1,2]. Reasons for high consumption include the low price of SSB relative to healthier beverages, high availability, and aggressive marketing [9,10,11]. A systematic literature review of food price elasticity found that the demand for SSB is responsive to price changes [12], which forms the basis for implementing a beverage tax to reduce consumption. The Philadelphia beverage tax proposal was introduced with the explicit goal of financing universal pre-kindergarten programs and improvements to parks and recreation facilities, but did not mention potential benefits to health
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