The potential impact on obesity of a 10% tax on sugar-sweetened beverages in Ireland, an effect assessment modelling study

BMC Public Health

Peter Scarborough²  Mike Rayner²  Donal O’Shea³  David Madden⁴  Oliver T Mytton¹  Adam DM Briggs² 

[1] UK Health Forum, London, UK;British Heart Foundation Health Promotion Research Group, Nuffield Department of Population Health, University of Oxford, Oxford, UK;Department of Endocrinology, St Columcille’s Hospital, Health Service Executive, Loughlinstown, Ireland;School of Economics, University College Dublin, Dublin, Ireland

关键词: Sugar-sweetened beverages;    Nutrition;    Overweight;    Obesity;    Taxation;   

Others  :  1161765
DOI  :  10.1186/1471-2458-13-860

 received in 2013-01-18, accepted in 2013-09-10,  发布年份 2013

【 摘 要 】

Background

Some governments have recently shown a willingness to introduce taxes on unhealthy foods and drinks. In 2011, the Irish Minister for Health proposed a 10% tax on sugar sweetened beverages (SSBs) as a measure to combat childhood obesity. Whilst this proposed tax received considerable support, the Irish Department of Finance requested a Health Impact Assessment of this measure. As part of this assessment we set out to model the impact on obesity.

Methods

We used price elasticity estimates to calculate the effect of a 10% SSB tax on SSB consumption. SSBs were assumed to have an own-price elasticity of −0.9 and we assumed a tax pass-on rate to consumers of 90%. Baseline SSB consumption and obesity prevalence, by age, sex and income-group, for Ireland were taken from the 2007 Survey on Lifestyle and Attitude to Nutrition. A comparative risk assessment model was used to estimate the effect on obesity arising from the predicted change in calorie consumption, both for the whole population and for sub-groups (age, sex, income). Sensitivity analyses were conducted on price-elasticity estimates and tax pass-on rates.

Results

We estimate that a 10% tax on SSBs will result in a mean reduction in energy intake of 2.1 kcal/person/day. After adjustment for self-reported data, the 10% tax is predicted to reduce the percentage of the obese adult population (body mass index [BMI] ≥30 kg/m²) by 1.3%, equating to 9,900 adults (95% credible intervals: 7,750 to 12,940), and the overweight or obese population (BMI ≥ 25 kg/m²) by 0.7%, or 14,380 adults (9,790 to 17,820). Reductions in obesity are similar for men (1.2%) and women (1.3%), and similar for each income group (between 1.1% and 1.4% across income groups). Reductions in obesity are greater in young adults than older adults (e.g. 2.9% in adults aged 18–24 years vs 0.6% in adults aged 65 years and over).

Conclusions

This study suggests that a tax on SSBs in Ireland would have a small but meaningful effect on obesity. While such a tax would be perceived as affecting the whole population, from a health prospective the tax will predominantly affect younger adults who are the main consumers of SSBs.

【 授权许可】

   
2013 Briggs et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Villanueva T: European nations launch tax attack on unhealthy foods. CMAJ 2011, 183(17):E1229-E1230.
• [2]Mytton OT, Clarke D, Rayner M: Taxing unhealthy food and drinks to improve health. BMJ 2012, 344:e2931.
• [3]Lake A, Townshend T: Obesogenic environments: exploring the built and food environment. J Royal Soc Promot Health 2006, 126(6):262-267.
• [4]Stuckler D, Nestle M: Big food, food systems, and global health. PLoS Med 2012, 9(6):e1001242.
• [5]Hu FB, Malik VS: Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav 2010, 100(1):47-54.
• [6]Malik VS, Popkin BM, Bray GA, Despres JP, Hu FB: Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 2010, 121(11):1356-1364.
• [7]Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB: Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care 2010, 33(11):2477-2483.
• [8]Ebbeling CB, Feldman HA, Chomitz VR, Antonelli TA, Gortmaker SL, Osganian SK, Ludwig DS: A randomized trial of sugar-sweetened beverages and adolescent body weight. N Engl J Med 2012, 367(15):1407-1416.
• [9]de Ruyter JC, Olthof MR, Kuijper LD, Katan MB: Effect of sugar-sweetened beverages on body weight in children: design and baseline characteristics of the Double-blind, Randomized INtervention study in Kids. Contemp Clin Trials 2012, 33(1):247-257.
• [10]Brownell KD, Farley T, Willett WC, Popkin BM, Chaloupka FJ, Thompson JW, Ludwig DS: The public health and economic benefits of taxing sugar-sweetened beverages. N Engl J Med 2009, 361(16):1599-1605.
• [11]Sustain: A Children's Future Fund. London: Sustain; 2013.
• [12]Academy of Medical Royal Colleges: Measuring Up. London: Academy of Medical Royal Colleges; 2013.
• [13]Limb M: Public health doctors call for a levy on sugar sweetened drinks. BMJ 2013, 347:f4394.
• [14]Buck D: Obesity and public health: a taxing issue. In The Guardian. London: Guardian News and Media Ltd; 2001.
• [15]Farley T, Just DR, Wansink B: Clinical decisions. Regulation of sugar-sweetened beverages. N Engl J Med 2012, 367(15):1464-1466.
• [16]Howell F: Ireland's workplaces, going smoke free. BMJ 2004, 328(7444):847-848.
• [17]O'Halloran M: Minister to end alcohol sponsorship of sport. In The Irish Times. Dublin: The Irish Times Limited; 2012.
• [18]O'Carroll S: Government considering sugar tax to tackle obesity. Dublin: TheJournal.ie; 2011.
• [19]Layte R, McCrory C: Growing Up in Ireland: Overweight and Obesity Among 9-year-olds. Dublin: Department of Children and Youth Affairs; 2011.
• [20]Morgan K, McGee H, Watson DJ, Perry I, Barry M, Shelley E, Harrington J, Molcho M, Layte R, Tully N, et al.: Slán 2007 Survey of Lifestyle, Attitudes and Nutrition in Ireland. Dublin: Department of Health and Children; 2008.
• [21]Hall M, Felton AM: Diabetes - the policy puzzle is Europe making progress. Second Edition. IDF Europe and FEND; 2008.
• [22]Felton AM, Hall M: Diabetes - the policy puzzle is Europe making progress. Third Edition. IDF Europe and FEND; 2012.
• [23]O'Regan E: 10pc fizzy drink tax 'would curb obesity crisis'. In The Independent. Dublin: Independent.ie; 2013.
• [24]VAT Rates. http://www.revenue.ie/en/tax/vat/rates/index.jsp webcite
• [25]Briggs A, Mytton O, Scarborough P, Rayner M: Modelling the effects of a 10% sugar sweetened drinks tax on obesity and overweight in Ireland: a report to inform the Health Impact Assessment. In Proposed Sugar Sweetened Drinks Tax: Health Impact Assessment (HIA). Dublin: The Institute of Public Health in Ireland; 2012:116-153.
• [26]Andreyeva T, Chaloupka FJ, Brownell KD: Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue. Prev Med 2011, 52(6):413-416.
• [27]Lin BH, Smith TA, Lee JY, Hall KD: Measuring weight outcomes for obesity intervention strategies: the case of a sugar-sweetened beverage tax. Econ Hum Biol 2011, 9(4):329-341.
• [28]Dharmasena S, Capps O Jr: Intended and unintended consequences of a proposed national tax on sugar-sweetened beverages to combat the U.S. obesity problem. Health Econ 2012, 21(6):669-694.
• [29]Andreyeva T, Long MW, Brownell KD: The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food. Am J Public Health 2010, 100(2):216-222.
• [30]Bahl R: The Uneasy Case Against Discriminatory Excise Taxation: Soft Drink Taxes in Ireland. Public Finance Review 2003, 31:510-533.
• [31]Eyles H, Ni Mhurchu C, Nghiem N, Blakely T: Food pricing strategies, population diets, and non-communicable disease: a systematic review of simulation studies. PLoS Med 2012, 9(12):e1001353.
• [32]Besley T, Rosen H: Sales Taxes and Prices: An Empirical Analysis. Natl Tax J 1999, 52(2):157-178.
• [33]Crawford I, Keen M, Smith S: Value Added Tax and Excises. In Dimensions of Tax Design – The Mirrlees Review. London: The Institute for Fiscal Studies; 2011.
• [34]Berardi N, Sevestere P, Tepaut M, Vigneron A: The Impact of a 'Soda Tax' on Prices: Evidence from French Micro Data. In Banque de France Working Paper No 415. Paris: Banque de France; 2012.
• [35]Kenkel D: Are Alcohol Tax Hikes Fully Passed Through to Prices? Evidence from Alaska. Am Econ Rev 2005, 95(2):273-277.
• [36]Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE: Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985, 122(1):51-65.
• [37]Shiely F, Perry IJ, Lutomski J, Harrington J, Kelleher CC, McGee H, Hayes K: Temporal trends in misclassification patterns of measured and self-report based body mass index categories–findings from three population surveys in Ireland. BMC Public Health 2010, 10:560. BioMed Central Full Text
• [38]Central Statistics Office (Ed): The Census. Dublin: Central Statistics Office; 2011.
• [39]Scarborough P, Morgan RD, Webster P, Rayner M: Differences in coronary heart disease, stroke and cancer mortality rates between England, Wales, Scotland and Northern Ireland: the role of diet and nutrition. BMJ Open 2011, 1(1):e000263.
• [40]Nichols M, Scarborough P, Allender S, Rayner M: What is the optimal level of population alcohol consumption for chronic disease prevention in England? Modelling the impact of changes in average consumption levels. BMJ Open 2012, 2(3):e000957.
• [41]Scarborough P, Allender S, Clarke D, Wickramasinghe K, Rayner M: Modelling the health impact of environmentally sustainable dietary scenarios in the UK. Eur J Clin Nutr 2012, 66(6):710-715.
• [42]Christiansen E, Garby L: Prediction of body weight changes caused by changes in energy balance. Eur J Clin Invest 2002, 32(11):826-830.
• [43]Hall KD, Sacks G, Chandramohan D, Chow CC, Wang YC, Gortmaker SL, Swinburn BA: Quantification of the effect of energy imbalance on bodyweight. Lancet 2011, 378(9793):826-837.
• [44]Body Weight Simulator. http://bwsimulator.niddk.nih.gov/ webcite
• [45]Powell LM, Chriqui JF, Khan T, Wada R, Chaloupka FJ: Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand and body weight outcomes. Obes Rev 2013, 14:110-128.
• [46]Gearhardt A, Corbin W, Brownell K: Food addiction: an examination of the diagnostic criteria for dependence. J Addict Med 2009, 3(1):1-7.
• [47]Finkelstein EA, Zhen C, Bilger M, Nonnemaker J, Farooqui AM, Todd JE: Implications of a sugar-sweetened beverage (SSB) tax when substitutions to non-beverage items are considered. J Health Econ 2013, 32(1):219-239.
• [48]Kaiser KA, Shikany JM, Keating KD, Allison DB: Will reducing sugar-sweetened beverage consumption reduce obesity? Evidence supporting conjecture is strong, but evidence when testing effect is weak. Obes Rev 2013, 14:620-633.
• [49]Zhen C, Wohlgenant M, Karns S, Kaufman P: Habit formation and demand for sugar-sweetened beverages. Am J Agric Econ 2011, 93(1):175-193.
• [50]Powell LM, Chaloupka FJ: Food prices and obesity: evidence and policy implications for taxes and subsidies. Milbank Q 2009, 87(1):229-257.
• [51]Smed S, Jensen JD, Denver S: Socio-economic characteristics and the effect of taxation as a health policy instrument Food Policy. Food Policy 2007, 32(5–6):624-639.
• [52]Finkelstein EA, Zhen C, Nonnemaker J, Todd JE: Impact of targeted beverage taxes on higher- and lower-income households. Arch Intern Med 2010, 170(22):2028-2034.
• [53]Gustavsen G, Rickertsen K: The effects of taxes on purchases of sugar-sweetened carbonated soft drinks: A quantile regression approach. Appl Econ 2009, 43(6):707-716.
• [54]Berardi N, Sevestere P, Tepaut M, Vigneron A: The impact of a 'soda tax' on prices: evidence from French micro data. Paris: Banque de France; 2012.
• [55]Jensen J, Smed S: The Danish tax on saturated fat. Short run effects on consumption and consumer prices of fats. FOI Working paper, no.14/2012. 2012.
• [56]Soda/Snack Taxes. http://www.bridgingthegapresearch.org/research/sodasnack_taxes/ webcite
• [57]Madden D: The Poverty Effects of a ‘Fat-Tax’. Health Econin press
• [58]Ng SW, Ni Mhurchu C, Jebb SA, Popkin BM: Patterns and trends of beverage consumption among children and adults in Great Britain, 1986–2009. Br J Nutr 2012, 108(3):536-551.
• [59]Scarborough P, Burg MR, Foster C, Swinburn B, Sacks G, Rayner M, Webster P, Allender S: Increased energy intake entirely accounts for increase in body weight in women but not in men in the UK between 1986 and 2000. Br J Nutr 2011, 105(9):1399-1404.
• [60]Morenga LT, Mallard S, Mann J: Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 2013, 346:e7492.
• [61]Rose G: Sick individuals and sick populations. Int J Epidemiol 1985, 14(1):32-38.