The effects of soda taxes on adolescent sugar intake and blood sugar

Abstract

Intake of added sugars is high in the US adolescent population, with sugarsweetened beverages being the primary source. We contribute to the literature by providing the first estimates of the impacts of soda sales taxes, which are commonly levied in the US states, on the total daily sugar intake and blood sugar of adolescents aged 12-19 years. Using a restricted-use version of the 1999-2014 National Health and Nutrition Examination Survey (NHANES) and exploiting within-state variation in soda sales tax rates over time, our results indicate that adolescent soft drink demand is tax-sensitive. Consistent with prior research using NHANES data, we find that adolescents reduce calories consumed from soft drinks when faced with a rise in soda sales taxes, but they offset this reduction with an increase in calorie intake from milk drinks. In accordance with this substitution behavior, we find that soda sales taxes cause small and insignificant changes in the total daily calorie intake, total daily sugar intake, or blood sugar levels of adolescents.

The effect of soda taxes beyond beverages in Philadelphia

“…Zhen et al (2014) estimated a structural demand system and forecasts decreases in calories and sugar intake despite an increase in consumption from additional sweetened foods that offsets nearly half of the decrease from soda. Restrepo and Cantor (2020) examined untaxed beverages in Philadelphia using survey data from National Health and Nutrition Examination Survey on adolescents and within-state variation on average sales tax rates levied on soda relative to other foods. They found that adolescents offset decreases in soda consumption with sweetened milks in up to 75% of the original decrease.…”

“…Specifically, we analyze items that are considered as the main sources of sugar by the American Heart Association (AHA) to see how sales of these foods change after the introduction of the tax. This margin has received considerably less attention with a few exceptions (Gibson et al., 2021 ; Restrepo & Cantor, 2020 ; Zhen et al., 2014 ). The AHA's list is comprehensive and includes traditional sources, such as desserts, cookies and sweeteners, as well as less traditional ones, such as condiments and dressings.…”

An umbrella review of the effectiveness of fiscal and pricing policies on food and non‐alcoholic beverages to improve health

“…These covered FPs implemented in India, 50 Spain, 51 France and Hungary, 52 Denmark, 53 South Africa, 54,55 Cook Islands, 56 Tonga, 57 Saudi Arabia, [58][59][60] Thailand, 61 Mexico, 62,63 and various jurisdictions within the US. [64][65][66][67][68][69][70][71][72][73] Almost all of these (n = 23) examined taxes on non-alcoholic beverages, namely SSBs. The other study, conducted on the Navajo Nation, examined the effect of subsidies on healthy food and found that the availability of F&V increased relative to neighboring unsubsidized jurisdictions.…”

“…64 Twenty studies found evidence to support the effectiveness of taxes in reducing consumption of taxed items. [51][52][53][54][55][56][57][59][60][61][62][63][65][66][67][68][69][70][71][72][73] Two of these showed that reformulation was part of the mechanism underlying reduced sugar intake. 55,66 Three studies showed that when a tax was reduced or repealed, there was a subsequent increase in consumption of taxed or previously taxed beverages.…”

“…53,56,67 Many studies found evidence of substitution whereby individuals switched to untaxed alternatives within stores, shopped in untaxed jurisdictions, or in some cases, substitution was implied because total sugar intake was unchanged after the tax, in spite of decreased purchases of taxed items or effects were negligible at a population level. 51,52,54,55,57,62,66,[68][69][70][71] Only one study examined final outcomes and it found no evidence that a SSB tax in South Africa (known as the Health Promotion Levy) reduced BMI at the levels implemented. 54 Finally, five of the studies examined the distributional impacts of the taxes.…”