Abstract
BackgroundThe consumption of sugar-sweetened beverages (SSBs), which can lead to weight gain, is rising in middle-income countries (MICs). Taxing SSBs may help address this challenge. Systematic reviews focused on high-income countries indicate that taxing SSBs may reduce SSB consumption. Responsiveness to price changes may differ in MICs, where governments are considering the tax. To help inform their policy decisions, this review compiles evidence from MICs, assessing post-tax price increases (objective 1), changes in demand for SSBs and other products, overall and by socio-economic groups (objective 2), and effects on overweight and obesity prevalence (objective 3).Methods and FindingsWe conducted a systematic review on the effectiveness of SSB taxation in MICs (1990–2016) and identified nine studies from Brazil, Ecuador, India, Mexico, Peru, and South Africa. Estimates for own-price elasticity ranged from -0.6 to -1.2, and decreases in SSB consumption ranged from 5 to 39 kilojoules per person per day given a 10% increase in SSB prices. The review found that milk is a likely substitute, and foods prepared away from home, snacks, and candy are likely complements to SSBs. A quasi-experimental study and two modeling studies also found a negative relationship between SSB prices and obesity outcomes after accounting for substitution effects. Estimates are consistent despite variation in baseline obesity prevalence and per person per day consumption of SSBs across countries studied.ConclusionsThe review indicates that taxing SSBs will increase the prices of SSBs, especially sugary soda, in markets with few producers. Taxing SSBs will also reduce net energy intake by enough to prevent further growth in obesity prevalence, but not to reduce population weight permanently. Additional research using better survey data and stronger study designs is needed to ascertain the long-term effectiveness of an SSB tax on obesity prevalence in MICs.
Highlights
Consumption of sugar-sweetened beverages (SSBs) is rising in middle-income countries (MICs) [1]
The review indicates that taxing SSBs will increase the prices of SSBs, especially sugary soda, in markets with few producers
Seventyeight duplicates were removed and, based on a review of titles and abstracts, 1,059 records were excluded because they did not align with this review or data were not from MICs
Summary
Consumption of sugar-sweetened beverages (SSBs) is rising in middle-income countries (MICs) [1]. SSB consumption may rise further in MICs where multinational companies are targeting new investments [5], potentially accelerating the increase in the morbidity and mortality from obesity, type-2 diabetes, and cardiovascular disease. The consumption of sugar-sweetened beverages (SSBs), which can lead to weight gain, is rising in middle-income countries (MICs). Responsiveness to price changes may differ in MICs, where governments are considering the tax To help inform their policy decisions, this review compiles evidence from MICs, assessing post-tax price increases (objective 1), changes in demand for SSBs and other products, overall and by socio-economic groups (objective 2), and effects on overweight and obesity prevalence (objective 3)
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