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April 01, 2010
12:01 AM PST

Sue Ducat
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From Health Affairs

Soda Taxes: How Effective A Remedy To Help Combat Child Obesity?


Bethesda, MD - With child obesity considered one of the most pressing public health problems in this country today, many experts think that sugar-sweetened beverages may be a factor, since consumption has increased 500 percent in the past fifty years. Some have proposed new taxes on these beverages as a way to combat obesity - but two papers published today by Health Affairs find that the current policy recommendations would not have a measurable impact as is - but that larger taxes might have an impact. These two articles are part of Health Affairs' examination of child obesity.


Taxing Soft Drinks And Restricting Access To Vending Machines To Curb Child Obesity
By Jason M. Fletcher, David Frisvold, and Nathan Tefft


Jason M. Fletcher is an assistant professor of public health at Yale University in New Haven, Conn.; David Frisvold is an assistant professor of economics at Emory University in Atlanta; and Nathan Tefft is an assistant professor of economics at Bates College in Lewiston, Maine. Funding was made possible with the support of the Robert Wood Johnson Foundation and the Emory Global Health Institute.


To assess the effects of policies aimed at reducing sugared beverage consumption, the authors examined data from the Early Childhood Longitudinal Study-Kindergarten Cohort. This national sample was begun in 1998 when the students were in kindergarten. The authors focused on fifth grade (2004) and eighth grade (2007) survey waves. In both surveys, the children were asked how often they had purchased sweetened drinks at school in the past week, and also about additional consumption of these beverages during the same time period, both at school and elsewhere. A total of 84 percent of those students reported some consumption of sweetened drinks, and 13 percent of fifth graders and 25 percent of eighth graders reported purchasing drinks at school. However, Fletcher et al found that policies restricting vending machine access in school do not reduce consumption because of the many other ways to obtain these drinks. With some states taxing sugared soft drinks and others not doing so, the authors looked at data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and IV (1999-2006) which measured height and weight as well as twenty-four hour dietary recall. The results showed that there was little difference in obesity for states with this tax compared to those without it. Concluded the authors: "as currently practiced, neither vending machine restrictions nor soft drink taxes will lead to noticeable weight reduction in children. In particular, our results suggest that typically imposed beverage taxes are neither large enough nor transparent enough to lead to meaningful behavior change." The authors proposed the following policy recommendations: "(1) If states or schools implement policies aimed at reducing access to soft drinks…[s]oft drinks should be completely removed from the school; and (2) while incremental taxes do not seem to work, this does not preclude the effectiveness of very large increases in taxation on these products."


Soda Taxes, Soft Drink Consumption, And Children's Body Mass Index
By Roland Sturm, Lisa M. Powell, Jamie F. Chriqui, and Frank J. Chaloupka


Roland Sturm is a senior economist at the RAND Corporation; Lisa Powell and Jamie Chriqui are affiliated with the Institute for Health research and Policy at the University of Chicago; and Frank Chaloupka is economics and public health director at the Health Policy Center, University of Illinois at Chicago. Funding was provided by the National Institute of Child Health and Human Development; the National Heart, Lung, and Blood Institute; and the Robert Wood Johnson Foundation.


This study examined whether small taxes, in the range of existing sales taxes that apply to soda but not other food items in grocery stores, would be likely to change consumption and weight gain, or whether only larger taxes would make a noticeable difference in consumption among children. These researchers used the fifth grade wave (2004) data of the Early Childhood Longitudinal Study - Kindergarten Cohort - and matched it with information about tax rates that were in effect at that time. They found that there was no significant relationship between differential soda taxes and soda consumption for the whole population. However, the authors did find statistically significant effects of differential sales taxes among subgroups of the population: children who are heavier, have lower family income, are African American, or watch a great deal of television. For African Americans, the decline in soda purchases at school associated with any differential tax accounted for more than half of the decline in total consumption. In order for a soda tax to be an effective vehicle for curtailing obesity throughout the population, the authors recommended that the tax be larger, and is structured as an excise tax, not a sales tax, because it would be more visible to customers. They concluded: "to have a measurable effect on consumption, taxes need to be tied to consumption, and they need to be larger than the existing state variation in sales tax."

About Health Affairs

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears each month in print, with additional Web First papers published weekly at The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.