Opinion

The big question: will the ‘sugar tax’ have the desired effect on public health?

Three members offer their insight on whether the sugar tax will be positive or not.

Sugar Tax iStock

Sara Patience
Sara Patience

Bank health visitor and registered nutritionist working in south-west London

Evidence suggests that sugar-sweetened drinks (SSDs) have a deleterious effect on public health. There is an association between greater consumption of SSDs and an increased risk of type 2 diabetes; and the consumption of SSDs in children resulting in greater weight gain and increased BMI compared to consumption of non-SSDs. SSDs are one of the main sources of sugar in a child’s (11-18 years) diet (SACN, 2015).

Other countries including Mexico have already introduced a sugar tax. Analysis from Mexico demonstrates a reduction in the purchase of soft drinks with the greatest reduction in disadvantaged groups (PHE, 2015).

The sugar tax is intended to be one of a number of solutions to reduce obesity, not a solitary panacea. In my opinion, it is worth trying. Sugar is not a nutrient and there is no harm in reducing sugar intake.
Although there is concern that the sugar tax will hit disadvantaged groups the most, the intention is to encourage SSD manufacturers to reduce sugar in their products or reduce portion sizes, rather than pass costs onto consumers.

Even if you don’t believe it will reduce obesity, remember that sugar consumption is a leading cause of tooth decay, and that in England a child has a tooth removed through decay once every 10 minutes (PHE 2018). That’s enough to convince me.


Barbara Potter
Barbara Potter

Associate lecturer of a third-year undergraduate course module at the Open University

The logic for a tax on sugar to reduce consumption, improve health and raise revenue to fund healthcare seems compelling. But would it work?

Health-related food taxes have been introduced in Hungary, France, Finland, Mexico and some states in the USA. They raise revenue, but there is no data yet on whether it can reduce consumption long term. It’s a complex picture.

Small changes in prices affecting high-income groups tend to have little impact on consumption. But low-income populations are more sensitive to them because they spend more of their income on food; they also buy more high-energy foods from cheaper, less healthy sources so they feel the impact more (Gao, 2012). But this doesn’t take food preferences into account.

Heavy consumers of sugary foods are far less responsive to price changes than moderate consumers, which weakens the consumer welfare argument. They may also buy alternative cheaper foods instead which may be unhealthier, like chips covered in salt; or continue to buy the expensive food and fewer healthy foods (Green et al, 2013; Bonner and Requillart, 2011).

Tax is not a simple fix that will improve health without many other environmental social and cultural considerations affecting our food choices (Jensen and Smed, 2013).


Amy Steeden-Smith
Amy Steeden-Smith

Specialist community public health nurse/health visitor working in Blackpool

The idea of taxing sugar products is not a new public health concept and already operates in other countries. It could be argued that health systems and cultures in these countries differ greatly to the UK, however, a report by WHO (2015) has endorsed sugar tax, promoting lowering rates of obesity, tooth decay and improved health outcomes.

Nonetheless, the sustainability of health behaviours through a tax rise alone is questionable. Prochaska and DiClemente (1983) would suggest that when an individual changes their sugar diet, they require health promotion and education throughout their journey from precontemplation to avoid a relapse and to promote sustainability. Diet and health behaviours, may be inter-generational, and deeply ingrained within cultures, meaning individuals may be reluctant to change their eating habits.

While some individuals may be shocked into action by price increases of sugar, others may pay the higher levy for favourite products that they consider essential or staple within their diet, similar to alcohol and tobacco. This may lead to further inequalities and deprivation within society. The impact of the tax within the UK remains to be seen, but it's clear that there is a need for continuing investment in public health services, such as health visiting, in order to have the desired effect of improving health outcomes in society.


References:

Sara Patience:

Public Health England. (2015) Sugar Reduction. The evidence for action PHE, London SACN (2015) Carbohydrates and health. SACN

Barbara Potter:

Mytton O, Clarke D, Rayner M. Taxing unhealthy food and drinks to improve health BMJ 2012;344:e2931

WHO Hungarian food tax changes consumption patterns 2013 http://www.euro.who.int/en/countries/hungary/news/news/2013/05/hungarian-food-tax-changes-consumption-patterns (accessed 12/04/2018)

Gao G. World Food Demand Am J Agric Economy 2012(94): 25-51

Green R, Cornelsen L, Dangour A et al The effect of rising food prices on food consumption: systematic review with meta regression BMJ 2013; 346:f3703

Bonner C, Requillart V, Does the EU sugar policy reform or increase added sugar consumption? An empirical evidence on the soft drink market Health Econ 2011(20): 1012-24

Jensen J, Smed S. The Danish Tax on saturated fat – short run effects on consumption, substitution patterns and consumer prices of fats Fixed Policy 2013(42): 18-31Flannery N. Mexico may make Coca-Cola give up cane sugar 2013  https://www.forbes.com/sites/nathanielparishflannery/2013/11/07/in-response-to-new-soda-tax-coca-cola-bottler-considers-switch-from-sugar-to-high-fructose-corn-syrup-in-mexico/#4c309fd812a0

Picture credit | iStock

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Three members offer their insight on whether the sugar tax will be positive or not.

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