Sugar-Sweetened Beverage Taxes: the Potential for Cardiovascular Health
Purpose of Review
Global sugar-sweetened beverage (SSB) consumption is high, with important implications for cardiovascular health. International momentum with the adoption and implementation of SSB taxes has been mounting in recent years, as has the evidence supporting such a policy for population health. In this review, we summarise the influence of regular SSB consumption on cardiovascular health and provide a global perspective on SSB consumption and SSB tax action and evidence. We further discuss the might and organised opposition of the beverage industry and the policy enablers for affirmative action.
Compelling evidence demonstrates a link between regular SSB consumption and adverse cardiovascular health. Although global SSB consumption appears to be declining slightly, consumption remains high. Forty-five jurisdictions around the world have now implemented a notable tax on SSBs and consistent evidence demonstrates the effectiveness of this policy at reducing the purchase or consumption of SSBs at the population level. However, the political influence of industry remains a major barrier to further action. Enablers to policy action include the realisation of the revenue-raising potential of taxes, evidence base advocacy framing from trusted sources, broad-based advocacy coalitions and the communication of clear policy objectives.
SSB taxes represent a promising strategy, alongside a broader comprehensive approach, for improving population diets and cardiovascular health, but face stiff industry opposition. Future research must focus on the influence of different SSB tax designs and context on population diet and health.
KeywordsSugar-sweetened beverage Fiscal policy Tax Obesity Food policy Global
Compliance with Ethical Standards
Conflict of Interest
Kathryn Backholer and Phillip Baker declare that they have no conflict of interest. This article does not contain any studies with human or animal subjects performed by any of the authors.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(10010):2287–323.CrossRefGoogle Scholar
- 2.McKinsey Global Institute. Overcoming obesity: An initial economic analysis. 2018.Google Scholar
- 5.Australian Bureau of Statistics. Australian Health Survey: Consumption of Added Sugars 2011–12 Report No.4363.0.55.011. Canberra, Australia; 2016.Google Scholar
- 6.Australian Institute of Health and Welfare. Australia’s health no. 15. Cat. no. AUS 199. Canberra; 2016.Google Scholar
- 16.Varsamis P, Formosa MF, Larsen RN, Reddy-Luthmoodoo M, Jennings GL, Cohen ND, et al. Between-meal sucrose-sweetened beverage consumption impairs glycaemia and lipid metabolism during prolonged sitting: a randomized controlled trial. Clin Nutr. 2018.Google Scholar
- 18.Australian Heart Foundation. Healthy drinks [Available from: https://www.heartfoundation.org.au/healthy-eating/food-and-nutrition/drinks.
- 19.Foundation BH. [Available from: https://www.bhf.org.uk/heart-health/preventing-heart-disease/healthy-eating/sugar
- 22.Responsibility OfB. Economic and fiscal outlook. United Kingdom; 2017.Google Scholar
- 23.•• Colchero MA, Popkin BM, Rivera JA, Ng SW. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ. 2016;352:h6704 First real-world evaluations of SSB taxes, demonstrating significant post implementation declines in SSB sales in Mexico, the city of Berkeley (CA, USA), and Chile respectively. CrossRefGoogle Scholar
- 25.•• Falbe J, Thompson HR, Becker CM, Rojas N, McCulloch CE, Madsen KA. Impact of the Berkeley excise tax on sugar-sweetened beverage consumption. Am J Public Health. 2016;106:e1–7 First real-world evaluations of SSB taxes, demonstrating significant post implementation declines in SSB sales in Mexico, the city of Berkeley (CA, USA), and Chile respectively. CrossRefGoogle Scholar
- 26.•• Nakamura R, Mirelman AJ, Cuadrado C, Silva-Illanes N, Dunstan J, Suhrcke M. Evaluating the 2014 sugar-sweetened beverage tax in Chile: an observational study in urban areas. PLoS Med. 2018;15(7):e1002596 First real-world evaluations of SSB taxes, demonstrating significant post implementation declines in SSB sales in Mexico, the city of Berkeley (CA, USA), and Chile respectively. CrossRefGoogle Scholar
- 32.Centre for science in the public interest. Big Soda vs. Public Health (2016 Edition). 2016.Google Scholar
- 33.Bes-Rastrollo M, Schulze MB, Ruiz-Canela M, Martinez-Gonzalez MA. Financial conflicts of interest and reporting bias regarding the association between sugar-sweetened beverages and weight gain: a systematic review of systematic reviews. PLoS Med. 2013;10(12):e1001578; dicsussion e.CrossRefGoogle Scholar
- 34.Council AB. Australian Beverages 2016 Annual report. Waterloo, New South Wales; 2017.Google Scholar
- 35.California legislative information. Assembly Bill No. 1838, Chapter 61. California; June 28, 2018.Google Scholar
- 38.Donaldson E. Advocating for sugar-sweetened beverage taxation: a case study of Mexico: John Hopkins Bloomberg School of Public Health; 2017.Google Scholar
- 40.Jou J, Niederdeppe J, Barry CL, Gollust SE. Strategic messaging to promote taxation of sugar-sweetened beverages: lessons from recent political campaigns. J Inf Secur. 2014;104(5):847–53.Google Scholar
- 42.World Health Organization Regional Office for Europe. Using pricing policies to promote healthy diets. Copenhagen 2015.Google Scholar
- 44.Baker P, Jones A, Thow AM. Accelerating the Worldwide Adoption of Sugar-Sweetened Beverage Taxes: Strengthening Commitment and Capacity; Comment on “The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior”. International Journal of Health Policy and Management. 2017.Google Scholar