In the first year after Mexico imposed a 10% tax on sugar-sweetened beverages (1 peso/L), the average monthly purchases of sugary drinks dropped by 6%, new research published online January 6 in BMJ indicates.
The authors, led by M Arantxa Colchero, PhD, from the Instituto Nacional de Salud Pública, Cuernavaca, Mexico, analyzed data from more than 6000 urban households and compared actual purchases in 2014 (the first year of the tax) vs predicted purchases if the tax had not been imposed.
"Our results show that Mexican households are responding to the tax," Dr Colchero told Medscape Medical News.
Poorer households were most likely to reduce their consumption of sugary drinks. Consumers mainly switched to buying bottled water and not artificially sweetened sodas, which are more expensive, she noted. Moreover, the reductions in sugary-drink purchases increased during the course of the first year with this tax in place.
Thus, these early results of the effect of this tax on sugar-sweetened beverages "look promising" for Mexico and for other countries considering a similar policy, Dr Colchero said.
"This short-term change is moderate but important, and it will be critical to continue monitoring purchases to note whether the trend continues or stabilizes," she and her colleagues write. More research is also needed to see if this price increase ultimately affects health outcomes (obesity and diabetes), they conclude.
In an accompanying editorial, Franco Sassi, PhD, head of the Organization for Economic Cooperation and Development (OECD) Public Health Program, in Paris, France, writes that, importantly, this study shows that "consumers do respond to price changes that taxes can produce, and this new study contributes to a large evidence base."
But, stressing that he is expressing his personal opinion and not the official one of the OECD, he also cautions that while "taxes can be part of a public-health strategy — and Mexico's is a great example for other countries — they cannot be viewed as a magic bullet in the fight against obesity."
A broader strategy with other widespread complementary policies is also needed, "so that the focus of the policy debate might shift away from taxes in the future," according to Dr Sassi.
Tax to Tackle Overweight, Obesity, and Diabetes
The prevalence of overweight and obesity in Mexico is among the highest in the world, Dr Colchero and colleagues write. About one in three Mexican children of all ages from 2 to 18 is overweight or obese, and about one in 3 adults is obese.
Mexico also has the highest prevalence of diabetes (based on hospital admission) among OECD countries. Meanwhile, in 2011, the country also had the largest per capita consumption of soda (163 L) in the world.
Thus, to address obesity, in September 2013, despite strong opposition from industry, the Mexican congress passed an approximately 10% excise tax on sugar-sweetened beverages and an 8% tax on nonessential high-calorie foods (eg, chips, cookies, candies, ice cream), which came into effect January 1, 2014.
The current study aimed to determine how the tax on sugar-sweetened beverages affected overall drinks purchases by analyzing data from 6253 households in 53 large cities throughout the country, from 2012 through 2014. These households are part of the Nielsen Mexico Consumer Panel Services.
The average monthly purchases of sugar-sweetened beverages (adjusted for changes in macroeconomic and household sociodemographic variables) declined by 5.6% in June and by 12% in December, compared with the predicted purchases if there had been no added excise tax.
In 2014, the average urban Mexican purchased about 4.2 fewer liters of sugar-sweetened beverages than predicted from purchase trends before this new tax.
Meanwhile, purchases of untaxed beverages (eg, diet sodas, still or sparkling bottled water, milk, unsweetened fruit juice) increased by 4% during 2014, mainly driven by purchases of water.
In the lowest of three socioeconomic groups, in 2014, average monthly purchases of sugary drinks were 9.1% less than expected (based on pretax trends), and they were 17.4% less than expected in the month of December
This growing decline in purchases of taxed sugary drinks is similar to the fall in purchases seen in studies of price changes of tobacco, alcohol, and illicit drugs, the researchers note.
Need Other Nontax Strategies Too
In his editorial, Dr Sassi notes that the most valuable contribution that taxes make is that they give a powerful signal to "consumers and the entire food system ('from farm to fork') that a government is concerned about the harms associated with unhealthy diets and is serious about tackling them.
"This is the strongest incentive for consumers to reconsider choices often made automatically, based on habits or environmental influences, and for players in the food-supply chain to reorient their production toward healthier options."
However, other complementary policies are also needed to tackle the obesity epidemic, Dr Sassi urges. Governments can pass measures to regulate nutrition labeling, health claims, and advertising, and they can promote health education, research, changes in the food environment, and counseling by general practitioners of people at higher risk.
Just this week, campaigners in the United Kingdom have called for the establishment of a policy whereby manufacturers slowly and imperceptibly reduce the amount of sugar in sweetened beverages over a 5-year period — without the addition of artificial sweeteners — with the aim of dramatically cutting the prevalence of overweight, obesity, and type 2 diabetes in the population
The study was supported by grants from Bloomberg Philanthropies and the Robert Wood Johnson Foundation and by the Instituto Nacional de Salud Pública and the Carolina Population Center. The authors have relevant financial relationships, nor does Dr Sassi.
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Cite this: Sales of Sweet Drinks in Mexico Dip in First Year of 'Sugar' Tax - Medscape - Jan 08, 2016.
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