'Snack Tax' Will Have Much Greater Impact Than Levy on Soft Drinks

Veronica Hackethal, MD

September 05, 2019

Taxing sugary snacks like cookies and cakes may have a substantially larger impact in fighting obesity than levies on sweetened drinks, suggests a new study.

Using economic modeling, UK researchers found that increasing sugary snack prices by 20% had an effect on annual calorie intake, body mass index (BMI), and obesity prevalence much greater than that of a similar price increase in sweetened beverages.

Taxing sugary snacks would be linked to an estimated 2.7% decrease in the prevalence of obesity in the UK in the first year, they estimate.

"This analysis provides policymakers with estimates of the relative magnitude of plausible impacts if a scenario of price increase in high sugar snacks were to be implemented and suggests that this option is worthy of further research and consideration as part of an integrated approach to tackling obesity," write Pauline Scheelbeek, MPH, PhD, of the London School of Hygiene and Tropical Medicine, and colleagues in their article published online in BMJ.

In an accompanying editorial, J. Bernadette Moore, PhD, University of Leeds, UK, and Barbara A. Fielding, PhD, University of Surrey, UK, write: "The novelty in Scheelbeek and colleagues' data is the suggestion that increasing the price of sugary snacks might be more effective at reducing BMI than increasing the price of sugar sweetened beverages."

The results are likely relevant to other countries where consumption of sugar sweetened beverages has decreased in response to research, policy, and advocacy activities, they note.

Additional Interventions Needed to Reduce Sugar Intake

Between 1975 and 2016, rates of obesity tripled worldwide. In the UK, obesity is estimated to affect around one in four adults and one in five children aged 10 to 11 years, with higher rates among those living in more deprived areas.

The use of taxes to lower sugar and energy intake have mainly focused on sugar sweetened drinks and there is currently a "sugar" tax on such beverages in the UK, introduced in 2018.

But high sugar snacks, such as cakes, chocolates, and sweets, make up more free sugar and energy intake than soft drinks in the UK, so reducing these purchases has the potential to make a greater impact on population health, the researchers point out.

They add that several countries, including Mexico, Finland, and Hungary, have introduced taxes on unhealthy foods, including high sugar snacks. "Early evaluations show a major reduction in the purchase of such foods," they note.

Encouraged by the large reformulation efforts of the food industry after the soft drink industry levy was introduced, Public Health England developed a voluntary sugar reduction and reformulation program for snacks, "but the initiative has been only modestly successful...highlighting the need for additional interventions to reduce sugar intake," say Scheelbeek and coauthors.

Average Weight of UK Adult Would Drop by 1.3 kg a Year

Their analysis included nationally representative data from 36,324 households and 2544 adults in the UK. Researchers separated analyses by income group and BMI (overweight: BMI ≥ 25 and < 30 kg/m2; obesity: BMI ≥ 30 kg/m2).

Results for all income groups combined showed that increasing the price of sugary snacks by 20% would result in an average annual decrease in consumption of 8900 calories, an average decrease in weight of 1.3 kg (2.2 lb), and an average drop in BMI of 0.53 kg/m2, in the first year

These changes would lead to a drop in the prevalence of obesity of 2.68% in the first year, the researchers estimate.

Furthermore, the impact of taxing sugary snacks was much greater than a similar price increase for sugary drinks, which was linked to weight loss of only 0.2 kg (0.4 lb) in the first year.

They also found that the impact of taxing sugary snacks would be largest in low income groups. Among low income households, the prevalence of obesity would drop by 3.1%, compared with 2.5% in middle income households and 2.3% in high income households.

The authors note that these findings may also be applicable to countries with similar eating habits to the UK, such as Australia — where sugary snacks are a greater culprit in the contribution to obesity than soft drinks — but might not apply to countries where people drink a lot of sugary beverages, like Mexico. 

Taxing Sweet Snacks Doesn't up Consumption of Healthy Foods

In their editorial, however, Moore and Fielding also urge caution when interpreting the results. 

"The reformulation of products in response to consumer demand can...have unintended consequences, such as substituting one unhealthy ingredient for another," they observe.

And while fiscal policies aimed at reducing consumption of sugar, salt, and saturated fat "might be useful," they "fail to incentivize the consumption of healthy foods."

Ultimately, tackling obesity- and diet-related diseases requires close scrutiny of the social determinants of food environments and "a systemic, sustained group of initiatives aimed at reducing health inequalities," they conclude.

England's former chief medical officer, Professor Dame Sally Davies, has previously said the UK government should be prepared to impose higher taxes on unhealthy foods and use the proceeds to make fruit and vegetables more affordable.

One or more authors have reported receiving support from the National Institute for Health Research Policy Research Programme. Moore and Fielding have reported no relevant financial relationships.

BMJ 2019;366:l4786, l5298. Full text, Editorial

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