Chris Macey looks at why a sugar tax could be a logical, effective first step to stop dental decay and child obesity
It’s a basic rule of economics that when the price of a product goes up, consumption falls. If taxation is used to reduce consumption of sugar-sweetened drinks (SSDs), children in particular will consume fewer calories and, over time, will be less likely to be overweight. A lower intake of sugar will also be good for their dental health.
The rationale for taxing SSDs really is that simple. Once policymakers accept that it will work, their only task is to choose between the health of the public and the wealth of powerful multinationals like Coca-Cola.
Sugar high
Of course, the case for the tax is based on more than economic truisms. The evidence of the impact of SSDs on obesity rates, particularly among children, is overwhelming. And it’s not hard to see why. The World Health Organization (WHO) recommends daily sugar intake of between four and seven teaspoons for young people, depending on age. But a 500ml bottle of fizzy orange, for example, can contain 16 teaspoons of sugar.
These cheap, readily available, heavily marketed drinks are energy dense, but with virtually no nutritional value. And because they don’t contribute to any feeling of fullness, they represent useless additional calories.
Nobody is claiming the tax will be a silver bullet to end obesity – it won’t
The impact of all this on children is deeply concerning. A recent study of eight to 10-year-olds in Cork found that 82% were consumers of SSDs, which contributed an average of 106kcal, 135kcal and 292kcal every day for normal weight, overweight and obese children respectively (Keane et al, 2014). These findings are consistent with international studies, including randomised control trials that show reducing SSD consumption decreases risk of weight gain and obesity in young people.
A health impact assessment carried out for the Department of Health showed that a 20% tax would reduce obesity here by 3% – the equivalent of 22,000 people (Institute of Public Health, 2012).
For and against
The generally misleading arguments by SSD producers can be summarised thus: the tax won’t be effective; it’s unproven; it’s unfair when other sugary products aren’t taxed; the industry is already reducing sugar content; and the tax is regressive.
Nobody is claiming the tax will be a silver bullet to end obesity – it won’t. It’s just one of many measures required, including reducing price promotions for high fat, sugar and salt products in retail outlets; restricting marketing to children; a programme to gradually reduce the sugar, salt and fat content of everyday food and drink products; ‘no fry’ zones around schools; traffic light labelling of food and drink; and promoting physical activity.
A 20% tax would reduce obesity here by 3% – the equivalent of 22,000 people
It’s also not a quick fix. It will take time for weight reduction across the population to occur and then robustly measuring that impact will be a complex process. So when spokespeople for SSD companies say there’s no proof a tax will work, what they’re really disingenuously saying is it hasn’t been tried for long enough yet – the same argument employed by the tobacco industry in opposing the workplace smoking ban that has saved thousands of lives.
Evidence
We’re on our way to getting the evidence. In 2014, Mexico became the first country to introduce a tax big enough to impact on sales. The 10% tax prompted a 6% reduction in consumption in the first year with the last monthly fall reaching 12%. Consumption in the lowest socioeconomic groups was 17% lower.
Opponents of the tax are also trying to confuse the issue on other fronts – including threats to sue the UK government because it’s unfair to tax their sugary products, and not products like chocolate and sweets.
When spokespeople for SSD companies say there’s no proof a tax will work, what they’re really disingenuously saying is it hasn’t been tried for long enough yet
This is where the complexities of nutritional values could scupper any action. Unlike SSDs, some high-sugar products like cereals can also be nutritious – and the potential for creating enough confusion to prevent any action is clear. While there will be a moderately regressive impact from SSD tax, this could be neutralised through the Irish Heart Foundation’s proposal to establish a children’s health fund financed by the tax, and including measures targeting disadvantaged areas like fruit and vegetable subsidies and greater investment in school meal programmes.
The first step
The environmental drivers of obesity are too big for a solution to be found in individual behaviour change generated by education and information campaigns. What we need is a multifaceted response to the root causes of rising obesity – the widespread availability, intense marketing and relative cheapness of these products.
Taxing SSDs is a logical first step. It can be effective in itself and, crucially, can bankroll the more comprehensive campaign needed to protect generations of young people from the prospect of lives of chronic disease, long-term ill health, and premature death.
Chris Macey is head of advocacy for the Irish Heart Foundation and spokesperson on issues such as stroke, heart failure, stroke and cardiac rehabilitation, tobacco control and measures to tackle childhood obesity. For references, email carlotta@irishdentist.ie.
