Writing in a leading medical journal, the Health Commissioner for the City of New York argues in support of taxing sweetened beverages, suggesting that a “penny per ounce” excise tax could reduce their consumption by more than ten per cent, a much bigger change than could be achieved by education alone, in the fight to tackle the rising problem of obesity.

The article by New York City Health Commissioner Dr Thomas R Frieden, and co-author Dr Kelly D Brownell, professor and director of the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Connecticut, was published online yesterday, 8 April, in the New England Journal of Medicine, NEJM.

Frieden and Bronwell wrote that taxes on tobacco reduced consumption, and evidence suggests that higher prices reduces soda consumption.

The idea of taxing sugared beverages and “unhealthy” foods as a way to discourage unhealthy consumption is not new, forty states already have small taxes on sweetened beverages and snack foods. However, a push toward larger taxes has prompted discussions in some states, including Maine and New York, where proposals are already on the table.

The debate has become very controversial and polarised, with mostly health protagonists on one side and the beverage industry on the other.

President of the American Beverage Association, Susan Neely, responded to the article on Wednesday. In a press statement reported by the New York Times she said while she agreed obesity was a serious and complex problem, she disputed the link between sugary drinks and obesity since sales have been declining for much of this decade and obesity has been rising.

“It defies both science and common sense,” said Neely, “to think singling out one product as a unique contributor to obesity will make a dent in the problem.”

But Frieden and Bronwell argue, based on the experience of tobacco taxes, that a tax on soda would be an effective way to reduce the 79 billion dollars spent on obesity- and overweight-related health care in the US every year.

They wrote that:

“Americans consume about 250 to 300 more calories daily today than they did several decades ago, and nearly half this increase is accounted for by consumption of sugared beverages; and though no single intervention will solve the obesity problem, that is hardly a reason to take no action.”

They also pointed out that:

“Sugared beverages are marketed extensively to children and adolescents, and in the mid-1990s, children’s intake of sugared beverages surpassed that of milk.”

Beverages now account for up to 15 per cent of the calories consumed by American children and teenagers, they added, citing evidence that for each extra can or glass of sugared drink they have per day, the chances of them becoming obese goes up by 60 per cent.

Their argument appears to center around the idea that if the unhealthy foods are priced higher, then people will be more likely to buy the healthier foods such as fruit and vegetables, which currently lose out because they are perceived to be more expensive and less value for money.

“Even if one quarter of the calories consumed from sugared beverages are replaced by other food, the decrease in consumption would lead to an estimated reduction of 8,000 calories per person per year — slightly more than 2 lb [1 kg] each year for the average person,” they noted, suggesting that a reduction of this size would make a significant impact on reducing risk of obesity and diabetes, and possibly heart diseases and other conditions.

Frieden and Bronwell concluded:

“A penny-per-ounce excise tax could reduce consumption of sugared beverages by more than 10%. It is difficult to imagine producing behavior change of this magnitude through education alone, even if government devoted massive resources to the task.”

” In contrast, a sales tax on sugared drinks would generate considerable revenue, and as with the tax on tobacco, it could become a key tool in efforts to improve health,” they added.

“Ounces of Prevention — The Public Policy Case for Taxes on Sugared Beverages.”
Brownell, Kelly D., Frieden, Thomas R.
N Engl J Med2009, published online, 8 April.
DOI: 10.1056/NEJMp0902392

Sources: NEJM, New York Times.

Written by: Catharine Paddock, PhD