Sugary Drink Taxes Lead to Reduction in Sales

Taxes on sugar-sweetened beverages lead to a 15% decline in sugary drink purchasing and increased prices of targeted drinks, as indicated by a tax pass-through of 82%, a meta-analysis and systematic review suggest.

There was a –1.59 price elasticity of demand, reported Tatiana Andreyeva, PhD, of the University of Connecticut in Hartford, and colleagues.

These data were published online June 1 in JAMA Network Open.

The analysis takes into account sugar-sweetened beverage policies implemented over the last 4 or 5 years worldwide, and not just the United States, noted Andreyeva.

“There’s some variation in the structure, even with the variation of the amount of the tax and what products are included, we still see a very consistent result of higher prices and lower sales,” Andreyeva told Medscape Medical News in a phone interview.

Andreyeva pointed out consumption is harder to measure as the studies are expensive and time-consuming.

Decreased Consumption May Lead to Better Diet

Sugary drinks warrant policy action as they play a major role in the increase in diet-associated chronic disease, noted Joshua Petimar, ScD, of Harvard Medical School & Harvard Pilgrim Health Care Institute in Boston, Massachusetts, and colleagues in an accompanying editorial. The findings highlight a cost increase and decreased sales, which may lead to better diet and health outcomes, they say.

“It is difficult, though not impossible, for any one policy to substantially move the needle on population-level health outcomes, but improving dietary choices is a worthy goal in and of itself,” the editorialists write.

“We know people are buying this less and that’s probably going to result in some improved health outcomes, but the evidence is just too new to say for sure,” Pasquale E. Rummo, MPH, PhD, an assistant professor at New York University Grossman School of Medicine told Medscape Medical News in a phone interview.

Change in consumption and change in health outcomes are harder to measure and take more time to unfold, echoed editorialist Laura A. Gibson, PhD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues.

Dental cavities, type 2 diabetes, and body mass index may be areas of interest for future studies, Gibson pointed out. 

“There’s a lot of previous evidence that suggests that consuming less sugar would have an effect on those health outcomes, so it doesn’t seem unreasonable that is where we would see the changes, but there are a lot of other influences on people’s weight and diabetes, and dental hygiene,” Gibson told Medscape Medical News in a phone interview.

No Switch to Untaxed Beverages

The meta-analysis included 62 studies, and the systemic review included 86 studies.

Researchers collected data from Scopus, PubMed, CINAHL, Cochrane Central Register of Controlled Trial, EconLit, Business Source Complete, PsycINFO, and Cochrane Database of Systematic Reviews. They also used 14 government websites and sources to evaluate grey literature.

They relied on the Preferred Reporting Items for Systematic Reviews and Meta-analyses standards for the systematic review. Using a three-level random-effects model, the researchers meta-analyzed sales, prices, and consumption findings. They used the outcome level to evaluate study quality.

The findings also showed that sugar-sweetened beverage consumption variation was not significant, and there were no indicators of consumers switching to untaxed beverages.

Decreased sugar content and reformulation of taxed drinks for tiered taxes and cross-border purchasing in most investigations of local taxes were reported in the narrative synthesis. 

Notably, when looking across subpopulations, there was limited information on the heterogeneity of these tax outcomes.

Study limitations included that the researchers were unable to stratify for study design or store type, considering the small number of investigations in each subcategory. The WHO Nutrition Guidance Expert Advisory Group committee preselected outcomes, and so the systematic review did not include outcomes such as tax revenue, and given the low amount of available research studies, only a limited number of outcomes were analyzed, the researchers note.

“Further research on sugar-sweetened beverage taxes is needed to understand associations with diet and health outcomes and to assess heterogeneity of consumer responses to improve policy reach and effectiveness,” the study authors conclude.

Andreyeva and Rummo have reported no relevant financial relationships. Roberto and Gibson have disclosed relationships with Bloomberg Philanthropies.

JAMA Netw Open. 2022;5:e2215276, e2215284. Full text, Commentary

Ashley Lyles is an award-winning medical journalist. She is a graduate of New York University’s Science, Health, and Environmental Reporting Program. Previously, she studied professional writing at Michigan State University, where she also took premedical classes. Her work has taken her to Honduras, Cambodia, France, and Ghana and has appeared in outlets like The New York Times Daily 360, PBS NewsHour, The Huffington Post, Undark, The Root, Psychology Today, TCTMD, Insider, and Tonic (Health by Vice), among other publications.

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