A Salient Sugar Tax Decreases Sugary-Drink Buying

Many governments have introduced sugary-drink excise taxes to reduce purchasing and consumption of such drinks; however, they do not typically stipulate how such taxes should be communicated at the point of purchase. Historical, field, and experimental data consisting of more than 225,000 purchase decisions indicated that introducing a $0.01-per-ounce sugar-sweetened beverage (SSB) tax—without making it salient on price tags—had no significant effect on purchasing (−1.26%, p = .28). However, when the phrase “includes sugary drink tax” was added to tax-inclusive price tags, SSB purchasing was lower than (a) in the pretax period (−9.78%, p < .001), (b) in a posttax period when drinks did not bear price tags (−5.04%, p < .001), and (c) in a posttax period when drinks bore tax-inclusive price tags that did not mention the tax (−3.83%, p = .002). Making the tax’s beneficiary (student programs) salient on price tags had no added effect. Two follow-up studies suggested that tax salience was effective partly because consumers overestimated the tax amount, leading to reduced purchase intentions.

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Higher Sugar-Sweetened Beverage Retail Prices After Excise Taxes in Oakland and San Francisco

American Journal of Public Health ◽

10.2105/ajph.2020.305602 ◽

2020 ◽

Vol 110 (7) ◽

pp. 1017-1023 ◽

Cited By ~ 1

Author(s):

Jennifer Falbe ◽

Matthew M. Lee ◽

Scott Kaplan ◽

Nadia A. Rojas ◽

Alberto M. Ortega Hinojosa ◽

...

Keyword(s):

San Francisco ◽

Fixed Effects ◽

Weighted Average ◽

High Dimensional ◽

Difference In Differences ◽

Sugar Sweetened Beverage ◽

Excise Taxes ◽

Sweetened Beverage ◽

Diet Soda ◽

Retail Prices

Objectives. To examine how much sugar-sweetened beverage (SSB) excise taxes increased SSB retail prices in Oakland and San Francisco, California. Methods. We collected pretax (April–May 2017) and posttax (April–May 2018) retail prices of SSBs and non-SSBs from 155 stores in Oakland, San Francisco, and comparison cities. We analyzed data using difference-in-differences high-dimensional fixed-effects regressions, weighted by regional beverage sales. Results. Across all beverage sizes, the weighted average price of SSBs increased by 0.92 cents per ounce (95% confidence interval [CI] = 0.28, 1.56) in Oakland and 1.00 cents per ounce (95% CI = 0.35, 1.65) in San Francisco, compared with prices in untaxed cities. The tax did not significantly alter prices of water, 100% juice, or milk of any size examined. Diet soda only, among non-SSBs, exhibited a higher price increase for some sizes in taxed cities. Conclusions. Within 4 to 10 months of implementation, Oakland’s and San Francisco’s SSB excise taxes significantly increased SSB retail prices by approximately the amount of the taxes, a key mechanism for reducing consumption.

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Sugar-sweetened beverage taxation in the Region of the Americas

10.37774/9789275122990 ◽

2021 ◽

Keyword(s):

Action Plan ◽

National Level ◽

The United States ◽

World Health ◽

Noncommunicable Diseases ◽

Sugar Sweetened Beverages ◽

Sugar Sweetened Beverage ◽

Excise Taxes ◽

Sweetened Beverage ◽

Sweetened Beverages

Sugar-sweetened beverage excise taxes are an effective evidence-based noncommunicable diseases (NCD) prevention policy. Along with tobacco and alcohol excise taxes, they are a tool to attain the Sustainable Development Goals, and are recommended by the World Health Organization to modify behavioral risk factors associated with obesity and NCDs, as featured in the WHO Global Action Plan. Taxes on sugar-sweetened beverages have been described as a triple win for governments, because they 1) improve population health, 2) generate revenue, and 3) have the potential to reduce long-term associated healthcare costs and productivity losses. Taxation of sugar-sweetened beverages has been implemented in more than 73 countries worldwide. In the Region of the Americas, 21 PAHO/WHO Member States apply national-level excise taxes on sugar-sweetened beverages and seven jurisdictions apply local sugar-sweetened beverage taxes in the United States of America. While the number of countries applying national excise taxes on sugar-sweetened beverages in the Region is promising, most of these taxes could be further leveraged to improve their impact on sugar-sweetened beverages consumption and health. This publication provides economic concepts related to the economic rationale for using sugar-sweetened beverage taxes and the costs associated with obesity; key considerations on tax design including tax types, bases, and rates; an overview of potential tax revenue and earmarking; evidence on the extent to which these taxes are expected to impact prices of taxed beverages, the demand for taxed beverages, and substitution to untaxed beverages; and responses to frequent questions about the economic impacts of sugar-sweetened beverage taxation.

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RF36 A cross-country comparison of self-reported exposure to sugary drink marketing and sugar-sweetened beverage intake

10.1136/jech-2018-ssmabstracts.124 ◽

2018 ◽

Author(s):

H Forde ◽

J Adams ◽

M White ◽

L Levy ◽

F Greaves

Keyword(s):

Sugar Sweetened Beverage ◽

Sweetened Beverage ◽

Country Comparison ◽

Sugary Drink ◽

Cross Country

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A Brief Motivational Intervention Differentially Reduces Sugar-sweetened Beverage (SSB) Consumption

Annals of Behavioral Medicine ◽

10.1093/abm/kaaa123 ◽

2021 ◽

Author(s):

Ashley E Mason ◽

Laura Schmidt ◽

Laura Ishkanian ◽

Laurie M Jacobs ◽

Cindy Leung ◽

...

Keyword(s):

Behavioral Interventions ◽

Environmental Intervention ◽

Motivational Intervention ◽

Sugar Sweetened Beverage ◽

Brief Motivational Intervention ◽

Sweetened Beverage ◽

Reduce Sugar ◽

Multi Level ◽

Clinical Trial Information

Abstract Background Environmental and behavioral interventions hold promise to reduce sugar-sweetened beverage (SSBs) consumption. Purpose To test, among frequent SSB consumers, whether motivations to consume SSBs moderated the effects of (a) a workplace SSB sales ban (environmental intervention) alone, and (b) a “brief motivational intervention” (BI) in addition to the sales ban, on changes in SSB consumption. Methods We assessed whether (1) baseline motivations to consume SSBs (craving, psychological stress, or taste enjoyment) impacted changes in daily SSB consumption at 6-month follow-up among frequent (>12oz of SSBs/day) SSB consumers (N = 214); (2) participants randomized to the BI (n = 109) versus to the sales ban only (n = 105) reported greater reductions in SSB consumption at follow-up; and (3) motivations to consume SSBs moderated any changes in SSB consumption. Results In response to the sales ban alone, individuals with stronger SSB cravings (+1 SD) at baseline showed significantly smaller reductions in daily SSB consumption at 6-month follow-up relative to individuals with weaker (−1 SD) SSB cravings (2.5 oz vs. 22.5 oz), p < .01. Receiving the BI significantly increased reductions for those with stronger SSB cravings: Among individuals with stronger cravings, those who received the BI evidenced significantly greater reductions in daily SSB consumption [M(SE) = −19.2 (2.74) oz] than those who did not [M(SE) = −2.5 (2.3) oz, p < .001], a difference of 16.72 oz. Conclusions Frequent SSB consumers with stronger SSB cravings report minimal reductions in daily SSB consumption with a sales ban only, but report greater reductions if they also receive a motivational intervention. Future multilevel interventions for institutions should consider both environmental and individualized multi-level interventions. Clinical Trial information NCT02585336.

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Plasma Metabolomic Signatures of Sugar-Sweetened Beverage Consumption and Risk of Type 2 Diabetes Among US Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_033 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1040-1040

Author(s):

Danielle Haslam ◽

Jun Li ◽

Marta Guasch-Ferre ◽

Liming Liang ◽

Clary B Clish ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cox Regression ◽

Pearson Correlation ◽

Metabolic Changes ◽

Plasma Metabolites ◽

Sugar Sweetened Beverage ◽

Sweetened Beverage ◽

Sugary Drinks

Abstract Objectives Sugar-sweetened beverage (SSB) consumption is associated with a higher risk of type 2 diabetes (T2D), but the metabolic changes linking SSB consumption to T2D are not fully understood. Thus, we aimed to identify a plasma metabolomic signature of SSB consumption and evaluate its association with incident T2D. Methods We used liquid chromatography–mass spectrometry to measure plasma metabolites (>200) among 3,434 participants from three US cohorts: Nurses’ Health Study (NHS), NHS II, and Health Professionals Follow-up Study (HPFS). SSB consumption (servings/day; sodas, fruit punches, and other sugary drinks) was estimated from food frequency questionnaires. We used elastic net regression with 10-fold-cross-validation to identify metabolites associated with higher SSB consumption among a training set of participants (n = 2068) and replicated the association in a testing set (n = 1366). A metabolomic signature score was calculated as the weighted sum of SSB-associated metabolites. Pearson correlation (r) coefficients and 95% confidence intervals (CI) between the metabolomic signature and self-reported SSB consumption were calculated. We used multivariable Cox regression models to estimate hazard ratios (HR) and CI of the identified metabolomic signature with incident T2D among all participants. Results We identified an SSB plasma metabolomic signature of 71 metabolites, primarily lipids and amino acids. Pearson correlation (r) coefficients between self-reported SSBs and the plasma metabolomic signature were 0.18 (95% CI: 0.14, 0.22; P < 0.0001) and 0.19 (95% CI: 0.14, 0.24; P < 0.0001) in the training and testing sets, respectively. After a median follow-up of 22 years, the metabolomic signature was significantly associated with higher T2D risk [HR for quartile (Q) 1 versus 4 (95% CI): 1.45 (1.02, 2.05); P = 0.04] in models adjusting for factors related to demographics, lifestyle, diet, and body mass index. The association persisted when further adjusting for self-reported SSB consumption [HR for Q1 versus Q4 (95% CI): 1.42 (1.00, 2.02); P = 0.05]. Conclusions We identified a novel metabolomic signature of SSB consumption in US adults that associated with elevated incident T2D risk. This signature may reflect both SSB consumption and metabolic changes related to T2D risk, although residual confounding cannot be ruled out. Funding Sources NIH.

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Randomized Controlled Trial of a Clinic-Based Intervention to Promote Healthy Beverage Consumption Among Latino Children

Clinical Pediatrics ◽

10.1177/0009922817709796 ◽

2017 ◽

Vol 56 (9) ◽

pp. 838-844 ◽

Cited By ~ 6

Author(s):

Amy L. Beck ◽

Alicia Fernandez ◽

Jenssy Rojina ◽

Michael Cabana

Keyword(s):

Fruit Juice ◽

Controlled Trial ◽

Total Sugar ◽

Latino Parents ◽

Educational Module ◽

Sugar Sweetened Beverage ◽

Beverage Consumption ◽

Sweetened Beverage ◽

And Control

The objective of this study was to evaluate an educational module for Latino parents about the health effects of sweet beverages. Latino parents were randomized to receive the beverage module or a control module. Child beverage consumption was assessed at baseline, 2 weeks, 2 months, and 3 months via a beverage recall survey. At 2-week follow-up, children of intervention participants had a mean reduction in 7-day total sugar-sweetened beverage and 100% fruit juice consumption of 16 ounces while controls had a mean increase of 4 ounces ( P = .01). At 2-month and 3-month follow-up, there was a reduction in mean total sugar-sweetened beverage and 100% fruit juice consumption among both intervention and control children. An educational module on beverages for Latino parents reduced child consumption of sweet beverages at 2-week follow-up. However, study participation appears to have also reduced controls’ beverage consumption suggesting that frequent intensive surveys of beverage intake may be an intervention unto itself.

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Added sugars and sugar-sweetened beverage consumption, dietary carbohydrate index and depression risk in the Seguimiento Universidad de Navarra (SUN) Project

British Journal Of Nutrition ◽

10.1017/s0007114517003361 ◽

2017 ◽

Vol 119 (2) ◽

pp. 211-221 ◽

Cited By ~ 17

Author(s):

Almudena Sanchez-Villegas ◽

Itziar Zazpe ◽

Susana Santiago ◽

Aurora Perez-Cornago ◽

Miguel A. Martinez-Gonzalez ◽

...

Keyword(s):

Cox Regression ◽

University Graduates ◽

Sugar Sweetened Beverage ◽

Added Sugars ◽

Beverage Consumption ◽

Sweetened Beverage ◽

Depression Risk ◽

Carbohydrate Quality ◽

Incident Cases

AbstractThe association between added sugars or sugar-sweetened beverage consumption and the risk of depression, as well as the role of carbohydrate quality in depression risk, remains unclear. Among 15 546 Spanish university graduates from the Seguimiento Universidad de Navarra (SUN) prospective cohort study, diet was assessed with a validated 136-item semi-quantitative FFQ at baseline and at 10-year follow-up. Cumulative average consumption of added sugars, sweetened drinks and an overall carbohydrate quality index (CQI) were calculated. A better CQI was associated with higher whole-grain consumption and fibre intake and lower glycaemic index and consumption of solid (instead of liquid) carbohydrates. Clinical diagnoses of depression during follow-up were classified as incident cases. Multivariable time-dependent Cox regression models were used to estimate hazard ratios (HR) of depression according to consumption of added sugars, sweetened drinks and CQI. We observed 769 incident cases of depression. Participants in the highest quartile of added sugars consumption showed a significant increment in the risk of depression (HR=1·35; 95 % CI 1·09, 1·67, P=0·034), whereas those in the highest quartile of CQI (upper quartile of the CQI) showed a relative risk reduction of 30 % compared with those in the lowest quartile of the CQI (HR=0·70; 95 % CI 0·56, 0·88). No significant association between sugar-sweetened beverage consumption and depression risk was found. Higher added sugars and lower quality of carbohydrate consumption were associated with depression risk in the SUN Cohort. Further studies are necessary to confirm the reported results.

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Cognitive and home environmental predictors of change in sugar-sweetened beverage consumption among adolescents

British Journal Of Nutrition ◽

10.1017/s0007114509992297 ◽

2009 ◽

Vol 103 (5) ◽

pp. 768-774 ◽

Cited By ~ 47

Author(s):

Nicole P. M. Ezendam ◽

Alexandra E. Evans ◽

Melissa H. Stigler ◽

Johannes Brug ◽

Anke Oenema

Keyword(s):

Environmental Factors ◽

Behavioural Control ◽

Environmental Predictors ◽

Sugar Sweetened Beverage ◽

Perceived Behavioural Control ◽

Mediation Analyses ◽

Sweetened Beverage ◽

Cognitive Determinants ◽

Home Availability

Sugar-sweetened beverage (SSB) consumption may increase risk for unnecessary weight gain. To develop interventions discouraging consumption, more insight is needed about cognitive and environmental predictors related to the decrease in SSB consumption. The present paper aims (1) to describe the relationship between potential cognitive determinants of change (attitudes, subjective norms, perceived behavioural control and intentions) and perceived environmental factors (family food rule and home availability of SSB) with changes in SSB consumption between baseline and 4-month follow-up and (2) to study whether the relationships between the environmental factors and SSB consumption are mediated by the cognitive determinants. Information on possible predictors and SSB intake at baseline and 4-month follow-up was provided by 348 Dutch adolescents (aged 12–13 years) through online questionnaires that were completed at school. Multilevel logistic regression and mediation analyses were used to determine direct and indirect associations between predictors and behaviour. The present results show that a high perceived behavioural control to decrease intake at baseline was associated with a decrease in consumption of SSB between baseline and follow-up (OR = 0·53). Low availability and a stricter family food rule were associated with a decrease in SSB consumption between baseline and follow-up (OR = 2·39, 0·54). The association between availability and decrease in SSB consumption was for 68 % mediated by perceived behavioural control to drink less. In conclusion, interventions to decrease SSB intake should focus on improving attitudes and perceived behavioural control to reduce intake, and on limiting home availability and stimulating stricter family food rules regarding SSB consumption.

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