This piece is written by one of our conttributors; registered dietitian – Holly Angus.
In the past four years, over 20 countries around the world have introduced a sugar tax (1) with the United Arab Emirates set to introduce an additional sugar tax on all products which contain sugar and artificial sweetener in January 2020 (2). But what does that really mean to the average consumer and does it really work?
What is a sugar tax?
In 2018, the UK introduced a tax on all imported soft drinks with added sugar, with a flat rate of 18p per litre for drinks containing 5-8 g of sugar per 100ml, and 24p per litre for drinks containing more than 8g of sugar per 100ml (3). In the United States, individual cities have introduced sugar taxes on sugar sweetened beverages (SSB), but it is yet to become a nationwide tax due to strong resistance from major drinks companies.
Many countries have chosen to tax soft drinks with added sugar such as fizzy drinks, whilst some have gone one step further and taxed drinks with natural sugars such as fruit juices and milk drinks. Singapore have taken further action (4) and are due to ban the advertisement of high sugar drinks across all media platforms such as TV, radios, online and outdoor adverts.
According to the latest statistics from the World Health Organisation (5), there are more than 1.9 billion adults in the world who are overweight, with over 650 million classed as obese. More disturbingly, in 2016 there were estimated to be 41 million children under the age of 5 who are overweight or obese. That is over 4 and a half times more than the entire population of London. Obesity isn’t a new problem for the Western world, but it is fast becoming an increasingly serious problem in the Middle East, where Western ways have combined with the new wealthy generation to create a culture and environment where people want and can have things instantly. This of course means the fast food of the West, and any food or drink you can think of delivered to your door. A recent study (6) conducted by a hospital in Abu Dhabi, United Arab Emirates, found 71% of 33,000 men were overweight or obese. In addition to this startling statistic, in 2017 the International Diabetes Federation found that 15.6% of the whole population of the UAE has type 2 diabetes, a largely preventable disease. (7)
Sugar taxes have been introduced to not only encourage a change in purchase and consumption of these SSB, but also to encourage soft drink manufacturers to change their recipes. For example, Ribena and Lucozade have already reduced the sugar content of their products, Pepsi and Coca-Cola have not made a change to their classic recipes.
In Ireland, a survey (8) looked at the reduction in sugar added to energy drinks since 2015 since the sugar sweetened tax was introduced and it found that the average content of sugar within the drinks had been reduced. It found that since the tax was introduced there has been over a 30% reduction in the number of drinks eligible to be taxed, demonstrating the tax has had some impact on manufacturers recipes. However it also found there has been an increase in larger volume energy drinks being sold, which in itself is a public health issue.
Does it work?
There are limited long term studies available about the success of introducing a sugar tax but early observations indicate a shift in both consumption and in obesity related diseases and complications.
A study in 2014 (9) was conducted in Mexico by the Mexican National Institute of Public Health and the University of North Carolina, two years after the introduction of tax on sugar sweetened beverages. It showed an average reduction of 7.6% in the purchase of sugary drinks and also found a shift in consumption of non-taxed drinks such as bottled water and fruit juices. In Mexico alone, over US$ 2.6 billion was raised from the tax with some of this money being invested in installing water fountains in schools across Mexico.
Another study out of Berkeley, California (10), a city which implemented a tax in 2015, also found there was a significant reduction in the consumption of sugar sweetened beverages and an increase in water consumption when compared to neighbouring cities which have not brought in the tax.
Early indications from a number of countries suggest taxing SSB, a major contributor to obesity across the world, has made a difference in people’s buying habits. However, with companies reformulating their recipes to contain lower amounts of sugar, the sales of beverages such as fizzy drinks are not likely to drastically change in the long term.
In conclusion, this tax does not address the other number of contributing factors to obesity and related diseases, such as high saturated fat content of foods, sedentary lifestyles and socio-economic contributors to obesity. The likelihood taxing only one contributing factor will make a significant difference long term, is small and will not solve the world’s pandemic of obesity and its related diseases. It will be interesting to see the effect the tax on all sugar containing items not just drinks, introduced in 2020 to the United Arab Emirates, has in the long term on population health and consumption habits.
(1) Obesity Evidence Hub (2019), ‘Countries that have implemented taxes on sugar-sweetened taxes (SSBs)’. Available at: https://www.obesityevidencehub.org.au/collections/prevention/countries-that-have-implemented-taxes-on-sugar-sweetened-beverages-ssbs
(2) United Arab Emirates Government (2019), ‘Excise Tax’. Available at: https://government.ae/en/information-and-services/finance-and-investment/taxation/excise-tax
(3) Public Health England (2017), ‘Sugar reduction and wider reformulation programme: interim review’. Available at: https://www.gov.uk/government/publications/sugar-reduction-and-wider-reformulation-interim-review/sugar-reduction-and-wider-reformulation-programme-interim-review
(4) Ministry of Health Singapore (2019), The Singapore Health and Biochemical Congress 2019. Available at: https://www.moh.gov.sg/news-highlights/details/speech-by-mr-edwin-tong-senior-minister-of-state-ministry-of-law-ministry-of-health-at-the-opening-ceremony-of-the-singapore-health-biomedical-congress-2019-at-max-atria-@-singapore-expo
(5) World Health Organization (2018), ‘Obesity and Overweight – Key Facts’. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
(6) Alzaabi et al (2019), ‘Prevalence of diabetes and cardio-metabolic risk factors in young men in the United Arab Emirates: A cross-sectional national survey’ Endocrinology, Diabetes and Metabolism [online] 2(4). Available at: https://onlinelibrary.wiley.com/doi/abs/10.1002/edm2.81
(7) International Diabetes Federation (2019), Available at: https://www.idf.org/our-network/regions-members/middle-east-and-north-africa/members/49-united-arab-emirates.html
(9) Cabrera Escobar et al (2013), ‘Evidence that a tax on sugar sweetened beverages reduces the obesity rate: a meta-analysis’, BMC Public Health [online] 13(1037). Available at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1072
(10) Lee et al (2019), ‘Sugar-sweetened beverage consumption 3 years after the Berkeley, California, sugar-sweetened beverage tax’ American Journal of Public Health [online], 109(4) pp. 637-639
(11) Public Health England (2017), ‘Sugar reduction and wider reformulation programme: interim review’ Accessed at: https://www.gov.uk/government/publications/sugar-reduction-and-wider-reformulation-interim-review/sugar-reduction-and-wider-reformulation-programme-interim-review