Beverage Tax Research Articles

Successful implementation of the Healthy Diné Nation Act in stores on the Navajo Nation

In 2014, the Navajo Nation Council passed the Healthy Diné Nation Act (HDNA), a 2% tax on unhealthy foods and beverages and a waiver of the 5% sales tax on healthy foods and water, to support health promotion and disease prevention among the Navajo people. Very little research has assessed implementation accuracy of food or beverage taxes and none were implemented within a sovereign Tribal nation. This study assessed the accuracy ofHDNA tax implementation among 47 stores located on the Navajo Nation.A pair of tax-exempt items [e.g. a bottle of water and fresh fruit] and a pair of HDNA-tax eligible items [e.g. sugary beverage and candy bar] were purchased between July-December 2019. Receipts were retained to assess taxation. A total of 87.2% ofstores accurately implemented the 2% tax on unhealthy items while 55.3% of the stores accurately implemented the 6% tax waiver on healthy items. In all, 51.1% of the stores accurately applied both taxes. There were no significant differences across store type (convenience or grocery stores and trading posts) or geographic region. In conclusion, almost all stores on the Navajo Nation accurately applied a 2% tax on unhealthy foods and beverages, while the proportion of stores applying a waiver on healthy foods was lower. Successful HDNA tax implementation among stores remains an important priority in achieving the goal to support health promotion and disease prevention among Navajo communities.

Pre-emption strategies to block taxes on sugar-sweetened beverages: A framing analysis of Facebook advertising in support of Washington state initiative-1634

ABSTRACT In 2018, the sugar-sweetened beverage (SSB) industry introduced a ballot measure (I-1634) in Washington State of the United States to prevent further local taxes on groceries. The measure, which passed, is emblematic of new pre-emptive legislative strategies by the SSB industry to block soda taxes and conceal those strategies under the guise of preventing burdensome ‘grocery taxes’. This paper uses qualitative framing analysis to examine a public archive of 1218 Facebook advertisements to understand how I-1634 proponents shaped public discourse and engaged in misinformation efforts online during the lead up to the passage of I-1634. Coding strategies identified 7 compelling and inter-related framing strategies used by the campaign. These included strategies that misinformed the public about the threat of grocery taxation and the economic impacts it would have on the region. Strategies to conceal the true intent of the ballot measure and the sponsors of the campaign were aided by Facebook’s advertising platform, which does not moderate misinformation in advertising and allows advertisers to conceal their sponsors. We urge public health researchers and advocates to pay more attention to how Facebook and other social media platforms can be used by industries to target voters, misinform publics, and misconstrue industry support.

Uncalculated first‐party externalities given a beverage tax

AbstractObjectiveWith many characterizingobesity as a national priority, the U.S. Government is considering a 1, 2, or 3 cents‐per‐ounce (cpo) federal sin tax on soda products. Because prior research finds that consumers substitute equally, if not more, dangerous nicotine products with a tobacco sin tax and common alcohol‐like household goods with alcohol prohibition, this research sets out to determine whether the imposition of a soda sin tax produces similar first‐party externalities.MethodAdaptive conjoint analysis is utilized among respondents across several regions of the United States, including actual soda consumers.ResultsThis study finds that given a soda sin tax, soda consumers do not substitute healthier beverages, that is, beverages with relatively fewer calories and grams of sugar and sodium, such as water, pure fruit juice, or unsweetened tea. Instead, soda consumers switch to other sugary beverages not considered in most legislation, such as sweetened coffees, teas, or sports drinks, or continue consuming soda at tax rates of 2 and 3 cpo after the shock of a 1 cent tax wears off.ConclusionUnlike prior research examining decreased soda consumption across a general marketplace, this research offers insight into potential externalities among the key transacting actors in such an exchange: soda consumers.

Do sugar taxes work?

Do sugar taxes work?

Equitability of Individual and Population Interventions to Reduce Obesity: A Modeling Study in Mexico

Modeling studies have estimated the potential impact and cost effectiveness of interventions to reduce obesity; few have focused on their equity across socioeconomic groups. This study aims to compare the equitability of individual- and population-level interventions to reduce obesity in Mexico. Mathematical models were implemented to estimate the expected effect of 2 sugar-sweetened beverage tax scenarios (10% and 20%) and bariatric surgery, pharmacotherapy, and dietary advice as individual interventions to reduce body weight. Individual interventions were modeled using meta-analytical weight change, inclusion and exclusion criteria, and the probability of access to healthcare services. For the tax, investigators obtained the baseline consumption of sugar-sweetened beverages from the National Health Survey 2012 and applied the reduction in sales observed in 2016 to estimate the caloric change and weight reduction. Implementation costs and cost per person, per kilogram, and equity were calculated for all interventions over a 1-year timeframe. The 20% tax produced the largest estimated increase (4.50%) in normal BMI prevalence, was the most cost effective, and had the largest and most equitable decrease in obesity across socioeconomic categories. Pharmacotherapy and bariatric surgery produced sizable decreases in obesity prevalence (3.68% and 1.18%), particularly among the middle and high socioeconomic groups, whereas dietary advice had the lowest impact on normal and obese categories. Individual interventions were effective in reducing obesity; yet, they were more expensive and less equitable than population interventions. Obesity in Mexico affects all socioeconomic groups; available interventions need to be carefully analyzed to tailor a national strategy that is both effective and equitable.

Simulating international tax designs on sugar-sweetened beverages in Mexico.

In response to the high prevalence of overweight and obesity, Mexico implemented a volumetric tax of one Mexican peso (MP) per liter of sugar-sweetened beverage (SSB) in 2014. In contrast to Mexico's volumetric tax design, the United Kingdom (UK) and South Africa (ZA) implemented SSB taxes based on sugar density. This kind of tax is likely to yield larger health benefits than volumetric taxes by imposing a larger tax burden on high-sugar SSB and/or encouraging reformulation. However, sugar-density taxes might yield lower tax revenues. This study aims to simulate the effect of sugar-density taxes as those in the UK and ZA on SSB purchases (in terms of volume and sugar), SSB prices, and tax revenue in Mexico and compare this effect to its counterpart under the current volumetric SSB tax. Additionally, we simulate the effect of sugar-density taxes under different scenarios of reformulation. We conducted all these simulations based on a structural model of demand and supply using household purchase data for 2012-2015 in urban Mexico. We found that the current volumetric one-MP tax led to an SSB purchase reduction of 19% for both volume and sugar and an SSB price increases by MP $1.24. We simulated similar effects under the UK and ZA sugar-density taxes when these taxes were equivalent to the volumetric one-MP tax, and there was no reformulation. When assuming reformulation, the sugar reduction under the sugar-density taxes was up to twice larger than the volumetric one-MP tax. However, we found that the volumetric one-MP tax yielded the largest tax revenue across all tax designs. From a public health perspective, sugar-density taxes are likely to be more effective in tackling the overweight and obesity prevalence in Mexico; however, tax revenue might be lower under these taxes.

Online News Coverage of the Sugar-Sweetened Beverages Tax in Malaysia: Content Analysis.

BackgroundIn Malaysia, the Sugar-Sweetened Beverages (SSBs) tax was announced during the parliament's 2019 Budget Speech. The tax was slated to be enforced by April 2019 but was later postponed to July 2019. The announcement has since generated significant media coverage and public feedback.ObjectiveThis study presents a qualitative and quantitative cross-sectional study using netnography to examine how Malaysian online news articles responded to the SSBs tax after the announcement and postimplementation.MethodsOnline news articles published on popular online news platforms from November 2018 to August 2019 were downloaded using NCapture and imported into NVivo for analysis using the inductive approach and thematic content analysis following the initial SSBs implementation announcement.ResultsA total of 62 news articles were analyzed. Most of the articles positively portrayed the SSBs tax (46.8%) and highlighted its health impacts (76%). There were 7 key framing arguments identified in the articles. The positive arguments revolved around incentivizing manufacturers to introduce healthier products voluntarily, positive health consequences, the tax’s impact on government revenue, and the use of the generated revenue toward beneficial social programs. The opposing arguments included increased operating costs to the manufacturer, the increased retail price of drinks, and how the SSBs tax is not a robust solution to obesity. The top priority sector considered in introducing the tax was the health perspective, followed by economic purposes and creating policies such as regulating the food and drinks industry.ConclusionsThe majority of online news articles positively reported the implementation of the SSBs tax in Malaysia. This suggests media played a role in garnering support for the health policy. As such, relevant bodies can use negative findings to anticipate and reframe counteracting arguments opposing the SSBs tax.

The Australian ready-to-drink beverages tax missed its target age group

BackgroundDuring 2008 and 2009, the Australian Government increased the tax on ready-to-drink alcoholic beverages by 70% to discourage drinking among adolescents. MethodsTo evaluate the tax, we use the difference-in-difference and comparative interrupted time series estimators, where age is used to define the control and treatment groups. This methodology is applied to the Household Income and Labour Dynamics in Australia survey. ResultsWe show that the tax did not affect the alcohol consumption of those aged under 25 (the tax targeted age group) but substantially reduced drinking among those aged 25–69, reducing their average daily consumption of standard drinks by 8.9% from 2010 to 2018. ConclusionThe age group under 25 did not respond to the tax likely because of product substitution. Alcohol price policy may need to acknowledge complex substitute/complement relationships between beverages and consider a floor price on alcohol or a uniform volumetric tax per standard drink.

A qualitative study on retailer experiences with Philadelphia's sweetened beverage tax.

The Philadelphia Beverage Tax was implemented on January 1, 2017 for some sugar- and artificially-sweetened beverages. Few qualitative studies have assessed retailers' reactions to beverage taxes. We aimed to understand food retailers' knowledge and attitudes about the Philadelphia beverage tax and how they responded to it with the goal of informing the framing and implementation of beverage taxes in other interested jurisdictions. Researchers conducted semi-structured interviews with retailers within Philadelphia before (n = 15) and after (n = 11) the Philadelphia Beverage Tax was implemented. Purposeful sampling was used to recruit participants with different store locations and customer base characteristics. A priori codes based on the interview guide were used to organize data, and analytic memos were developed and reviewed to identify themes that emerged within the data using a grounded theory approach. Five themes emerged: (a) concerns about the tax purpose, amount, and use of revenue; (b) concerns about the tax's impact on finances and business operations; (c) business strategies implemented to lessen financial burden of the tax; (d) perceptions of customer responses to the tax based on income; and (e) confusion around tax implementation. Results highlighted ways to improve implementation. Retailers in Philadelphia implemented various strategies to offset negative effects on taxed beverage sales. Cities implementing a beverage tax would benefit from investment in educational outreach and support to business owners prior to tax implementation and ensure transparency in how tax revenue will be spent.

Exploring attitudes toward taxation of sugar-sweetened beverages in rural Michigan

BackgroundWhile policies to address “obesity” have existed for decades, they have commonly focused on behavioral interventions. More recently, the taxation of sugar-sweetened beverages is gaining traction globally. This study sought to explore individuals’ attitudes and beliefs about sugar-sweetened beverages being taxed in a rural Michigan setting.MethodsThis qualitative study was conducted using critical policy analysis. Data were collected in 25 semi-structured, audio-recorded interviews with adult Michiganders. Following data collection, transcripts were coded into themes using NVivo software.ResultsFour themes emerged in participants’ perspectives regarding sugar-sweetened beverages being taxed: resistance, unfamiliarity, tax effects, and need for education. While some participants were unfamiliar with sugar-sweetened beverage taxes, many viewed taxation as a “slippery slope” of government intervention, which invoked feelings of mistrust. In addition, participants predicted a sugar-sweetened beverage tax would be ineffective at reducing intake, particularly among regular consumers, who were frequently perceived as mostly low income and/or of higher weight.ConclusionsFurther research is needed to explore perceptions of sugar-sweetened beverage taxes in different geographic areas in the USA to examine how perceptions vary. Policymakers should be aware of the potential implications of this health policy with respect to government trust and stigma towards lower income and higher-weight individuals.

Progress in the Pacific on sugar‐sweetened beverage taxes: a systematic review of policy changes from 2000 to 2019

ObjectiveTo systematically characterise sugar‐sweetened beverage (SSB) tax policy changes in Pacific Island countries and territories (PICTs) from 2000 to 2019. MethodsMedline, Google Scholar, Pacific Islands Legal Information Institute database, Factiva and news and government websites were systematically searched up to October 2019. Information was extracted on the date and SSB tax level change, tax type, included beverages, and earmarking; and checked for consistency with local experts. ResultsThree‐quarters of PICTs had an SSB tax (n=16/21) and 11 of these were excise taxes that included both imported and locally produced beverages. The level of tax was over 20% in 14 jurisdictions. SSB tax was increased by more than 20 percentage points in eight PICTs. Most taxes were ad valorem or volumetric, three were earmarked and only two taxes targeted sugar‐sweetened fruit juices. The majority of countries (14/21) had different tax rates for imported and locally produced beverages. ConclusionsMore than three‐quarters of PICTs have SSB taxes. More than one‐third increased these taxes since 2000 at an amount that is expected to reduce soft drink consumption. Implications for public healthDespite high‐quality tax design elements in some PICTs, SSB control policies could generally be strengthened to improve health benefits, e.g. by targeting all SSBs and earmarking revenue for health.

Stakeholder views on taxation of sugar-sweetened beverages and its adoption in the Netherlands

SummaryAn increasing number of governments worldwide have introduced a tax on sugar-sweetened beverages (SSB) for public health. However, the adoption of such a policy is still debated in many other countries, such as in the Netherlands. We investigated Dutch stakeholder views on taxation of SSB and perceived barriers and facilitators to its adoption in the Netherlands. Semi-structured interviews were conducted in 2019 with 27 stakeholders from health and consumer organizations, health professional associations, trade associations, academia, advisory bodies, ministries and parliamentary parties. Data were analysed using a thematic content approach. The findings reveal that, between and within sectors, stakeholders expressed contradictory views on the effectiveness, appropriateness and (socio)economic effects of an SSB tax. Perceived barriers to the adoption of an SSB tax in the Netherlands included an unfavourable political context, limited advocacy for an SSB tax, a strong lobby against an SSB tax, perceived public opposition, administrative load and difficulties in defining SSB. Perceived facilitators to its adoption included an increasing prevalence of overweight, disappointing results from voluntary industry actions, a change of government, state budget deficits, a shift in public opinion, international recommendations and a solid legal basis. In conclusion, this study shows that several challenges remain to be overcome for the adoption of an SSB tax in the Netherlands. Similar research on stakeholder views in other countries may further inform SSB tax policy processes.

Expansion of sugar tax a litmus test for government on prevention

Expansion of sugar tax a litmus test for government on prevention

Parental perspectives towards sugar-sweetened beverages and polices: a qualitative study.

This qualitative study aimed to understand parental perception of (1) sugar-sweetened beverages (SSB) and implications of SSB on health; (2) their role in shaping their children's consumption of SSB; (3) the influences on SSB consumption of their children; and (4) potential government policies targeted at controlling SSB consumption. English-speaking parents of pre-schoolers aged 2-6years were recruited. Semi-structured interviews based on the knowledge, attitude, practice framework were conducted, and transcripts were subjected to thematic analysis based on inductive approaches. Recruitment continued until data saturation was reached. Twenty parents participated in the study and themes addressing the objectives identified. (1) There were misconceptions regarding the healthfulness of certain non-packaged SSB such as traditional remedies and juices. Some were unaware about the association between SSB and dental caries. (2) The need to reduce and restrict sugar consumption for overall and oral health reasons was well-recognised, but the extent of control varied. (3) Multiple stakeholders including pre-schools, grandparents and domestic helpers were involved in shaping children's diet. Children's sugar intake was also influenced by environmental factors, such as the ubiquitously available SSB, targeted marketing and high cost of healthy alternatives. (4) Participants were less accepting towards SSB taxation than the ban of SSB sales. Despite the awareness of the types of SSBs and the general/oral health implications of sugar consumption, misconceptions exist. Although most parents possessed the knowledge and attitude, this did not translate into the practice of reducing sugar consumption in their children. There was no SSB reduction policy that had overwhelming acceptability.

Taxing sugar-sweetened beverages as a policy to reduce overweight and obesity in countries of different income classifications: a systematic review.

To evaluate the potential impact of sugar-sweetened beverage (SSB) taxes on overweight and obesity prevalence in countries of different income classifications. Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO number CRD42020161612). Five databases (Cochrane Library, Embase, LILACS (via Virtual Health Library) and MEDLINE (via PubMed), and Web of Science were searched, from January 2009 to December 2019. Articles that reported changes in purchases, sales, intake, body weight, BMI, overweight and/or obesity prevalence due to a tax on or price change in SSB were included. Studies conducted in countries of different income classifications. The search yielded 8349 articles of which 21 met inclusion criteria. Among the sixteen studies selected, only two did not show that consumption, sales and purchase decreased as the price of SSB increased. In eight of the thirteen studies selected, a positive effect of an SSB tax on decreasing overweight and obesity prevalence was expected. It is estimated that a 20 % taxation on SSB would result in a greater decrease in the prevalence of overweight and obesity compared to a 10 % rate. Studies with no significant effect of taxing on sales, purchases, consumption and prevalence of obesity were from high-income countries, while significant effects of taxing on reducing purchase, consumption and/or obesity prevalence were found in studies from upper-middle- and middle-income countries. A high SSB tax might be an effective fiscal policy to decrease purchase and consumption of SSB and reduce overweight/obesity prevalence, especially if the tax were specific for beverage volume.

Expanding our understanding of industry opposition to help implement sugar-sweetened beverage taxation.

Expanding our understanding of industry opposition to help implement sugar-sweetened beverage taxation.

Polish ‘sugar fee’ in the light of global experience with sugar sweetened beverages taxation

Motivation: Obesity is one of the gravest public health challenges facing the world today. Out of different policy action undertaken by counties to counteract these threats, taxes imposed on sugar sweetened beverages (SSBs) has gaining growing popularity. They are currently imposed on 47 countries worldwide. The Polish ‘sugar fee’ came into force on January 1, 2021.
 Aim: The aim of the article is to synthesize the global experience with sugar-sweetened beverages taxation, to assess on that basis the construction of Polish ‘sugar fee’ and to identify key opportunities and threats connected with its implementation.
 Results: Introduction of ‘sugar fee’ in Poland is consistent with the latest global trends in taxation. Its formula gives an opportunity to stimulate consumers to displace SSBs by other healthier beverages and to incentivize drink manufacturers to reformulate their products and change their marketing strategies. There is growing that evidence ‘sugar taxes’ can be effective tools to achieve public health goals, however its effect must be strengthen by multifaceted instruments (e.g. broad information action). The fiscal potential of ‘sugar fee’ is limited, if we assume that its main purpose is to stimulate healthier consumption patterns.

How will the introduction of the sugar tax affect the consumption habits of households in Poland?

Motivation: Numerous scientific studies indicate a significant relationship between the number of sugar-sweetened beverages consumed and the problem of overweight and obesity. This, in turn, is a significant risk factor for many diseases, especially type 2 diabetes. Poland is a country where the consumption of sugar, especially in a processed form that is dangerous to health, is constantly growing. As a result, now two-thirds of the society are struggling with the problem of overweight, while obesity can be said in every fourth case, the forecasts are even more pessimistic. Recently, a fiscal policy with the use of the “sugar tax” is a popular tool to combat the growing consumption of sweetened beverages. The Polish government is also following this path, and the tax is scheduled to be in force at the beginning of 2021.
 Aim: The aim of the study is to analyse the impact of the sugar tax on prices and, consequently, on the future consumption of sweetened beverages and other related goods.
 Results: Based on the data of the Central Statistical Office concerning household expenditure in 2018, the complete demand model was estimated, considering demographic variables. As a result, the price and profit elasticities of demand for sweetened drinks and related goods were estimated. The results obtained in the study indicate that the introduction of the sugar tax will reduce the consumption of SSB, and the size of the changes depends on the analysed demographic factors. The decrease in consumption of sweetened beverages will increase the interest in beverages with a lower sugar content.

Sugar sweetened beverages and increasing prevalence of type 2 diabetes in the Indigenous community of Australia

AimsThe aim of this viewpoint was to discuss a profound health gap in type 2 diabetes that exists between Indigenous and non-Indigenous Australians. Data synthesisIn Australia, type 2 diabetes is ranked as the fastest growing chronic condition, with the rates of type 2 diabetes higher among Indigenous than non-Indigenous Australians. Improvements to diet could aid in reducing overweight and obesity in the Indigenous community, with sugar sweetened beverages (SSBs) examples of discretionary foods that contain a high amount of sugar. The marked increase in type 2 diabetes, obesity and consumption of SSBs in the Indigenous community may suggest that type 2 diabetes may result from weight gain caused by SSB consumption. Recent evidence suggests that higher consumption of SSBs was associated with greater incidence of type 2 diabetes independent of adiposity. Some determinants influencing increased SSBs consumption in the Indigenous population include advertising, marketing, availability and affordability. ConclusionsThe prevalence rates of type 2 diabetes continue to be higher among Indigenous than non-Indigenous Australians and overall, a link between SSBs and risk of type 2 diabetes is reported. Three solutions to high SSBs consumption in Indigenous communities include increased availability, affordability, and accessibility of healthy food and drink, engagement of Indigenous people in offering solutions including discussion of a sugar tax on SSBs framed with Indigenous input, and the provision of clean community water supply and water bubblers.

Impact evaluation of soft drink taxes as part of nutrition policies in Gulf Cooperation Council countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates

Background: Prevalence of overweight and obesity is high in the Eastern Mediterranean Region, and there are higher rates in Gulf Cooperation Council (GCC) countries. This had led GCC countries to impose policies that aim to decrease obesity, overweight, and diabetes rates. The objective of this research is to measure the impact of such implemented policy to reduce obesity, namely taxes applied to sugar-sweetened beverages (SSB) in GCC. Methods: The impact of SSB taxes has been measured using a panel data set that covers sales volumes of soft drinks in GCC countries from 2010 to 2020. Results: annual growth in soft drink sales volumes decreased; from 5.44% to 1.33% in Saudi Arabia, 7.37% to 5.93% in United Arab Emirates, and 5.25% to 5.09% in Bahrain from 2016 to 2017. In Qatar, a tax was implemented in 2019, and a reduction in sales volume growth was observed between 2019 and 2020 (3.78% to 2.45%), and in Oman a reduction was observed between 2018 and 2019 (3.60% to 2.99%). Kuwait was the last GCC country to implement taxes in 2020, and the growth in sales volumes decreased from 6.31% to 5.47% from 2019 to 2020. Conclusions: The introduction of health-related taxes on soft drinks has been followed by a drop in the growth rates of sales in GCC countries. This, in turn, can be expected to contribute to a reduction in the prevalence of overweight and obesity, especially when combined with complementary public health policies and interventions. Hence, awareness campaigns should promote the reduction of the consumption sales of SSB and substitute with more consumption of fresh juices. These recommendations align with the recommended priority actions by the World Health Organization Strategy on nutrition for the Eastern Mediterranean Region 2020-2030 adopted by the countries of the Region in October 2019.