Countries around the world—from the Americas to Europe to Southeast Asia and beyond—have instituted taxes aimed at curbing the consumption of sugary beverages as part of a larger effort to combat the negative health outcomes associated with high sugar consumption.

A panel of health policy researchers reported on the effects of sweetened beverage taxes during the Scientific Sessions symposium Can Taxes Alter Dietary Behaviors and Outcomes? The presentation can be viewed by registered meeting attendees at ADA2020.org through September 10, 2020. If you haven’t registered for the Virtual 80th Scientific Sessions, register today to access all of the valuable meeting content.

Using a case study from Seattle, Lisa M. Powell, PhD, Distinguished Professor and Director of Health Policy and Administration in the School of Public Health at the University of Illinois at Chicago, discussed factors affecting whether taxes on sugar-sweetened beverages change consumer behavior. For the taxes to be effective, Dr. Powell said the total price of the taxed beverage needs to be seen at the point of purchase and not only at the cash register, where the consumer may not notice which item was taxed.

“You want that tax incorporated into the shelf price,” said Dr. Powell, who noted that a consumer’s ability to buy sugary beverages in a nearby jurisdiction without a tax is one obstacle to effectively reducing sugar consumption through taxes.

Martin White, MD, FFPH, Professor of Population Health Research at the University of Cambridge in the United Kingdom, outlined how the U.K.’s Soft Drinks Industry Levy, implemented in April 2018, has helped reduce consumption of sugary beverages.

Rather than targeting consumers, the tiered levy takes aim at drink formulas. After initial opposition from manufacturers, Dr. White said adaptation followed. The response varied, with some manufacturers simply bottling their products in smaller containers.

“Industry spokespeople were saying, ‘It’s OK, we’ve got this. We’re reformatting our drinks. We’re supporting public health,’” he said.

Overall, consumers are switching to drinks with less sugar, said Dr. White, crediting reformulated drinks and messaging.

“We think the media coverage of the levy and the increasing talk of sugar prior to the levy has led to a decrease in consumption,” he said.

Rafael Meza, PhD, Associate Chair and Associate Professor of Epidemiology at the University of Michigan School of Public Health, presented data on the impact of Mexico’s sugary beverage tax, now 1.2616 pesos (about 5 cents) per liter.

Mexico ranks as one of the top consumers of sugary beverages in the world and has seen a corresponding increase in obesity and chronic disease. More than 70% of adults 20 and older are overweight or obese, Dr. Meza said, and diabetes prevalence is on the rise, increasing from 7.34% in 2006 to 10.3% in 2018.

Implemented in 2014, Mexico’s tax first targeted sugary drinks and has expanded to include junk food. Evidence of the tax’s impact on health outcomes is still limited, Dr. Meza said. Obesity and self-reported diabetes continue to increase, and he said it’s challenging to separate the effects of the tax from other trends.

Christina A. Roberto, PhD, the Mitchell J. Blutt & Margo Krody Blutt Presidential Associate Professor of Health Policy at the University of Pennsylvania, presented data on the effects of Philadelphia’s tax of 1.5 cents per ounce on sugar and artificially sweetened beverages. The tax was implemented in January 2017.

“Beverage excise taxes are an effective policy tool to decrease sweetened drink purchases in urban settings,” said Dr. Roberto, citing research on drink purchases at large and small retailers.

Seven U.S. cities have a tax on sweetened drinks. In addition to Philadelphia and Seattle, four cities in California and one in Colorado have implemented taxes.

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