Editor’s Note: Tom Frieden, MD, MPH, is past director of the Centers for Disease Control and Prevention and past Commissioner of the New York City Health Department. The views expressed in this commentary are his own.
From Mexico to France, Oakland to Albany, governments have implemented taxes on sugary drinks
Tom Frieden: These taxes work in reducing calorie consumption and lowering overall health care costs
Around the world, obesity and diabetes are on the rise. Since 1980, rates of obesity and of diagnosed diabetes have doubled, with particularly sharp increases in low and middle-income populations. In one recent year, an estimated 1.5 million people died from diabetes, and millions more suffer from heart attack, stroke, blindness, kidney failure and lower-limb amputation.
Sugary drink consumption is directly linked to these obesity and diabetes epidemics. And research increasingly suggests that liquid calories don’t reduce hunger in the same way solid food does.
There are few strategies that have been proven to reduce calorie consumption for an entire community. One of the most effective strategies is taxing sugary drinks.
A recent rigorous analysis published in Health Affairs shows that soda taxes work. By the second year after implementation of a peso-per-liter tax in Mexico, consumption of sugary drinks decreased 9.7% and sales of non-sugary drinks increased by 2.1%. Mexicans were switching to healthier alternatives. Notably, soda purchases declined most among lower-income families who can least afford to get sick. These significant reductions in consumption, along with an increase in government revenue, occurred without any changes to employment in Mexico.
This study is big news. The almost 10% reduction in sugary beverage consumption could result in hundreds of thousands of fewer cases of diabetes and tens of thousands fewer strokes, heart attacks and deaths in 10 years, as well as savings of almost $1 billion in health care expenditures.
In 1776, Adam Smith wrote, “Sugar, rum, and tobacco are commodities which are nowhere necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.” Tobacco taxes are the single most effective way to prevent kids from smoking and help adults quit. So why not a tax on sugar?
A dozen years ago, Dr. Kelly Brownell and I suggested a penny-an-ounce tax on sugary drinks (Mexico’s tax is significantly lower). It’s encouraging to see the idea catch on, despite vigorous opposition from the companies that profit from selling these drinks.
And the higher the tax, the lower the consumption and the larger the health benefit (and public revenue). France, Chile, Mauritius, the Dominican Republican and seven US municipalities have already taxed sugary drinks, decreasing consumption by kids and adults and improving overall quality of health.
Meanwhile, South Africa intends to invest in the health of its citizens by taxing sugary drinks. Diabetes is now the country’s leading cause of death among females and causes the country approximately $1 billion dollars in health care costs annually. It is incumbent on the South African government to put its citizens’ health above that of the industry and pass a strong tax.
South Africa has been a leader in taxation of tobacco and alcohol, laws that weren’t easy to pass but have saved lives. Passage of an impactful sugary drink tax would complete the Adam Smith trifecta.
And the sugary drink tax doesn’t just reduce consumption of bad calories. Governments can use these tax dollars to fund important projects that benefit communities. Berkeley, California, for example, passed the United States’ first soda tax. Revenues have been used to improve nutrition in schools and support community groups’ health programs, including the Ecology Center, Healthy Black Families and the YMCA.
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Similarly, Philadelphia taxes soda and other sugar-sweetened drinks at a rate of 1.5 cents per ounce to fund pre-kindergarten programs, a community center and library investments. Recently, Oakland, California, and San Francisco passed 1-cent soda taxes. The revenue will help fund public health and nutrition education programs. And in Boulder, Colorado, a 2-cent-per-ounce soda tax will help fund public health and nutrition programs.
But whether the revenue generated is used for health, education or community programs or to run essential government operations, soda taxes are effective.
Because taxes work, the soda industry will continue to lobby aggressively against them. But governments that tax sugary drinks save lives, generate revenue and protect kids and adults.