EXPERT REACTION: UK's new sugar tax - will it work, and would it work here?

This is a gesture that may, over time, reduce consumption of sugar in soft drinks. I support the idea of starting in a small way and observing the effects and side-effects before launching into bigger projects like a tax on sugar wherever it is used in processed food.

We know how important taxation has been in helping reduce tobacco smoking and it is reasonable to hope taxation may reduce the consumption of sugar in soft drinks in a similar way.

The first point I would make is that there is widespread public support and acceptance of the idea of taxing sugar among the Australian public. Surveys suggest around 80 per cent public support.

Secondly, there's no question that the data shows there's harm from consumption of sugared beverages and they're among the most commonly purchased items in supermarkets. In short, they're harmful and we consume a lot of them.

Drinking sugary drinks is not associated with any benefits, except for luxury and pleasure. Consumption should be occasional, and a tax would help achieve this. The most appropriate substance for hydration is water.

The example of Mexico, where a sugary drink tax is in place, shows that tax decreases consumption - it's an important example.

The argument that taxing sugary drinks is regressive is absurd. People on low incomes have worse health outcomes than more affluent people. We don't want to encourage people on low incomes to consume sugary drinks.

Opposition to an Australian sugar tax comes from manufacturers and the sugar industry - they're pressuring government not to adopt such a tax.

The Australian government has failed to take a leadership position on this issue, which is disappointing.

Taxation of sugar is a good thing in principle, but it needs to be part of a comprehensive package of measures, taxation along with the restriction of promotion of soft drinks for example.

The problem here is it is also a hypothecated tax (a ring fenced or ear marked tax) but it appears that it has not been set high enough to influence behaviour.

It is a revenue raising rather than a health issue. Evidence shows that the tax needs to be set at 20 per cent.

This is a minor dent in a multi-billion pound industry. Particularly as the tax will not be introduced for two years. 

The UK government has the right idea. Taxation sends a strong message to manufacturers, retailers and the general public about the health risks of certain types of foods.
Rocketing health care costs due to diet-related diseases add a significant economic burden to society.

Taxes on unhealthy foods have been shown to be effective ways to improve diet, reduce chronic disease, and raise revenue for government. Revenue gains are direct, from the tax itself, as well as from improved health and reduced illness.  Better health leads to increased workforce participation and overall productivity for a country.

These taxes prompt consumers to reassess their intake and to resist the overwhelming advertising and promotion of foods laden with added sugar.

Australia’s GST of 10% exempt’s fresh and basic foods to protect health.  But more is needed.  We need to make healthy food more affordable than junk food.

We need to tax foods detrimental to health.  Annual CPI for food has slowed to 1.6%, but over the last 13 years, healthy foods like fruit and vegetables have risen in price at a rate above that of junk foods (3.8 compared to 3%). In 2014, the ABS found Australians spent a much larger proportion of their food dollars on junk food (58%) than healthy food (17%)

Evidence suggests that unhealthy foods need to be taxed by 20-30% for effective changes in consumption and healthy foods should be subsided by 20%. Australia has room for improvement.

The World Cancer Research Fund International found in 2015, that 17 countries were using economic tools to increase healthy food affordability and purchase incentives  (13 health-related food tax (sugary drink), one voluntary health-related food tax (UK), 6  increased the import tariffs on unhealthy foods and one lowered them on healthy foods; and two subsidised healthy foods (UK and US)).

Australia is behind the times.

Overall, I applaud the UK in their decision to take action on a sugar tax, which has been long debated in other countries, including Australia.
 
I predict that two possible scenarios will occur from the tax, either (i) a reduction in the number of people buying soft drinks, or (ii) improvements in beverage formulation which will lower the amount of sugar in soft drinks. Ultimately, both of these scenarios will help consumers improve their health and assist in managing their weight. This is very important given the recognised association between excess energy intake and obesity, as well as obesity and many lifestyle-related chronic diseases such as type 2 diabetes and cardiovascular disease.
 
In addition, the sugar tax will assist other areas of our health care system to advocate patients to have a healthy diet. For example, doctors, dietitians and nutritionists will be able to advocate for healthy eating in a way that is consistent with this government action, and consumers will be receiving more consistent messages about healthy foods to consume.
 
Finally, introducing this tax highlights the government’s response to a national health priority, and should be considered by Australia’s government representatives.

The evidence that sugary drinks are contributing to the changing patterns of disease towards obesity, diabetes and cardiovascular illness is now strong.

Additionally, they lower the overall nutritional quality of the diet, not just by way of nutrients, but also the lack of  food structure, which is important for health. This applies even to the choice of  juice over fruit. Taxing them will provide a disincentive to purchase and an opportunity to turn the revenue collected to health-promoting initiatives.

The news that the UK is going to introduce a tax on sugary drinks should be welcomed by those involved in maternity care. Overweight and obesity are major risk factors for many adverse outcomes of pregnancy including stillbirth. Reducing maternal weight when beginning a pregnancy has to be an important part of any prevention strategy and providing a cost-signal on soft drinks loaded with sugar should be effective. The Australian government should seriously consider introducing the same measure as an important public health intervention. Obesity is the new smoking in relation to pregnancy outcomes and similar tactics need to be employed to reduce this major risk factor.

Young people are the biggest consumers of sugar-sweetened soft drinks in Australia. A “sugar tax” may deter young people from choosing to purchase and consume soft drinks - as they are often a cheap, tasty beverage and come in large volumes. For example - a can of Coca Cola has 40g of sugar in 330ml! 
 
Sugary treats are known to be rewarding, but the abundance of sugar in our diets is often underestimated, due to its addition in many foods, in particular soft drinks. Current research indicates that high sugar diets may be particularly damaging to areas of the brain responsible for learning, memory and emotional processing. Youth is a critical period for learning, and studies in my laboratory have shown that young rats that drink sugary beverages at an amount that aligns with the World Health Organisation daily recommended amount, which is 10 per cent of total energy intake, have long lasting disruption of learning and memory processes measured in behavioural tasks.

The current evidence from Mexico suggests that a well-designed sugary drinks tax is likely to reduce consumption of sugary drinks across the population.

We have further information suggesting that it may also reduce socioeconomic inequalities in health while only adding a small amount to the annual food budget.

Taxes such as the one proposed by the UK are likely to have the additional benefit of promoting reformulation by the beverages industry.

And announcements of support for a sugary drinks tax are also likely to play a strong role in the culture change we need to promote a culture of healthy eating and decreased desirability of sugary drinks for children and adults.

The public health consensus is that introducing a sugary drinks tax in Australia is an important piece of a comprehensive obesity prevention approach and for the reasons outlined above is likely to play a role in decreasing consumption of sugary drinks and reducing obesity in children and adults.

A sugar tax is one step on the road to change the obesogenic environment [an environment that encourages obesity] we live in. Many people drink large  amounts of nutritionally empty sugar/water every day. A tax and subsequent price rise could lessen the amount drunk and motivate manufacturers to lessen sugar content.
 
However, more must be done: I have seen people drink such drinks as if addicted, despite having diabetes or heart disease. The advertising is designed to capture young people...for life.

The main reason governments have been so reluctant to consider this tax was due to the lack of hard data to show that it will work. It was a catch 22 situation for most governments - no one wanted to act until someone else acted. Well, the first evidence came from a similar tax in Mexico earlier this year (see link). That may have been the catalyst to move this forward in the UK. But now the ball is firmly in our (Australia's) court to follow the UK's lead and to try and make a difference. Hopefully, any increased revenue will be reinvested in education and social programs to promote further change.

This is a significant move by the UK Government to combat high levels of overweight and obesity, and will be particularly important for curbing excess weight gain in children and adolescents.  We’ve seen soda taxes introduced in a number of countries worldwide, including in Mexico where a 10 per cent tax on soda has led to a 12 per cent decline in soda sales a year later. This shows that soda consumption is sensitive to price changes. Taxing tobacco has worked to reduce demand and consumption and now we are seeing the same for taxes on soda. The extra tax revenue that will be directed to school sport in the UK is an added bonus for children’s health.  This is a bold move by the UK Government and one that should be considered in Australia given the mounting evidence that this is an effective approach for obesity prevention.
 
See for example http://www.bmj.com/content/344/bmj.e2931

Is the UK SSB tax likely to work? The evidence suggests it will. The latest evaluation of the Mexico SSB tax showed that the tax was effective at reducing the purchase of sugary drinks and increasing sales of non-sugary drinks, 12 months post policy implementation. Importantly, this effect was greater for those with a lower socioeconomic status, where the burden of obesity and non-communicable diseases is also greater. Whether the shift in SSB purchases will translate to a reduction in population weight is still unclear, however epidemiological modelling studies of hypothetical taxes suggest that the impacts on weight and health are likely to be important. We need a comprehensive package of population-level and individual-level strategies to address the burden of obesity and non-communicable disease, and the UK’s recent announcement of a SSB tax and is a critical step in the right direction to such a package.

If taxes are to be imposed on foods associated with weight gain why stop at soft drinks? Why not tax potatoes, white bread, red meat, butter, biscuits, grains, confectionery and fruit juice?

This looks a case of revenue-raising dressed up as public health. Over time I expect the funds raised will end up in general revenue.

As consumption of sugar-sweetened beverages in Australia is in long-term decline I doubt that this strategy will be attractive to policy makers in this country.

Declaration of interest: Bill is an advisor to the Sugar Research Advisory Service, which is funded by The Australian Sugar Industry Alliance and New Zealand Sugar.

This is a step in the right direction, however it is important to consider other approaches that would have a greater potential impact especially reformulation too. Looking to reformulate products to reduce energy, fat, sugar and salt levels, as proposed in England as part of the Responsibility Deal, has the potential to improve health more than a tax, however taxation continues to receive more public attention.

The framing of the tax needs to be considered very carefully so it does not impact most on the most disadvantaged in society, the increase in price of cheaper value type sugary drinks will rise relatively more than brands, and artesian small producers have been made exempt from the tax completely! Also the boundaries between fruit juice and soft drinks will need to be carefully policed as recommendations about free sugars which are linked to oral health and obesity has classified these both together. It is possible that manufacturers may try reformulating drinks to be juice based to avoid such taxes but still contain similar sugar levels.
 
The other risk with a sugar tax is that it focuses only one area of the diet, whilst it is right to limit sugar intake, we need to consider the effect of our overall diet on health for example by eating less processed foods and more vegetables and fruit. Too much focus on sugar and sugar taxes may dilute equally important messages about health and food. It can be part of a solution and should be seen as one piece in a complex jigsaw. If it is to be mirrored in Australia, the inclusions and loopholes need to be carefully considered along with how it fits into an overall public health policy with respect to food. Other practices which could be adapted from the UK could be sugary and high energy snacks and drinks being removed from shop checkouts, a voluntary practice which has become common in the UK and warmly welcomed by many parents.
 
The adoption of a sugary drink tax, shows the effect of public and media pressure in raising of the importance of nutrition by many individuals and groups, but it not the magic bullet solution for health and obesity. There is much more to be done, and food industry and chefs alike need to look at reformulating recipes to make more foods healthier, not just drinks that are low sugar

Public health experts in Australia, for some years now,  have been calling for the introduction of a tax on sugary drinks.

There is strong evidence that sugary drinks are associated with increased risk of weight gain in both children and adults, and are among the primary drivers of obesity.

In Australia 25 per cent of Australian children and  63 per cent of Australian adults are now overweight or obese. These high obesity rates are contributing to increasing rates of chronic disease, including type 2 diabetes, cardiovascular disease and some types of cancers, management of which is a huge drain on the public health purse.

More generally, poor diet is now the number one risk factor contributing to burden of disease globally and in Australia. But less than 7 per cent of Australians currently consume diets consistent with the NHMRC Australian Dietary Guidelines.

At least 35 per cent of the energy intake of adults, and at least 39 per cent of the energy intake of children, are now derived from discretionary (junk) food and drinks. Around 5 per cent of the energy from discretionary food comes from sugary drinks, and this figure is highest in teenage boys at around 11 per cent.

Out new data shows that Australian families are spending 4 per cent of their food dollars on sugary drinks. Taxing this would help drive consumption down.

We know this from results in Mexico, where sugary drinks have been taxed for over a year and sales are down by 12 per cent. Importantly, in Mexico the biggest reductions in consumption have occurred among the poor, who can least afford health care.

In Australia, the revenue raised could be used for health promotion to improve diet-related disease outcomes.

Price manipulations influence food and drink purchasing choices. For example, sales of sugar-sweetened beverages dropped a year after implementation of the tax on these beverages in Mexico. There are also suggestions the impact was greater among socioeconomically disadvantaged groups, which is an important consideration given the relatively poorer diets and higher disease risk experienced by these groups.  In New Zealand, researchers estimated that a 20 per cent tax on fizzy drinks would reduce energy consumption by 20kJ a day and help avert or postpone about 67 deaths from cardiovascular disease, diabetes and diet-related cancers per year.

While the proposal to invest the tax revenue towards school sport is positive, ideally investment might be broader, to other physical activity settings, given the relatively small role that school sport plays and the desirability of promoting overall physical activity from early in life.

A similar tax should be considered in Australia, with the caveat that diet is influenced by many factors, and any single initiative alone will not solve epidemics of poor diet and obesity; however this could make an important contribution to a comprehensive suite of approaches aimed at improving diet and health.