We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Outcomes Following Taxation of Sugar-Sweetened Beverages: A Systematic Review and Meta-analysis.
- Authors
Andreyeva, Tatiana; Marple, Keith; Marinello, Samantha; Moore, Timothy E.; Powell, Lisa M.
- Abstract
Key Points: Question: What are the outcomes of implemented sugar-sweetened beverage (SSB) taxes around the world? Findings: In this systematic review of 86 studies and a meta-analysis of 62 studies, implemented SSB taxes were associated with higher prices of targeted beverages (tax pass-through of 82%) and 15% lower SSB sales, with a price elasticity of demand of −1.59. No negative changes in employment were identified. Meaning: These findings suggest that SSB taxes may work as intended in reducing demand for SSBs through higher prices, yet further research is needed to understand their associations with diet and health outcomes and heterogeneity of consumer responses. This systematic review and meta-analysis assesses the associations of implemented SSB taxes with prices, sales, consumption, diet, body weight, product changes, unintended consequences, health, and pregnancy outcomes. Importance: More than 45 countries and several local jurisdictions have implemented sugar-sweetened beverage (SSB) taxes to improve nutrition and population health, and evidence on their outcomes to date is essential to inform policy discussions. Responding to this need, the World Health Organization commissioned a systematic literature review on the outcomes of fiscal policies, including SSB taxes. Objective: To assess the associations of implemented SSB taxes with prices, sales, consumption, diet, body weight, product changes, unintended consequences, health, and pregnancy outcomes. Data Sources: Searches of 8 bibliographic databases (Business Source Complete, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, EconLit, PsycINFO, PubMed, and Scopus) were performed from database inception through June 1, 2020, with no language or setting restrictions. Grey literature was assessed using 14 sources and government websites. Study Selection: The review included primary studies of implemented SSB taxes. Data Extraction and Synthesis: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. For prices, sales and consumption, results were meta-analyzed using a 3-level random-effects model. Study quality was assessed at the outcome level. Main Outcomes and Measures: Tax pass-through rate for prices, percentage reduction in SSB demand, and price elasticity of demand for sales and consumption. Heterogeneity was assessed using τ2 and the I2 statistic. Results: A total of 86 articles were eligible, with 62 studies contributing to the meta-analysis. The overall tax pass-through rate was 82% (95% CI, 66% to 98%; P <.001, I2 = 99%), suggesting tax undershifting. The demand for SSBs was highly sensitive to tax-induced price increases, with the price elasticity of demand of −1.59 (95% CI, −2.11 to −1.08; P <.001; I2 = 100%) and a mean reduction in SSB sales of 15% (95% CI, −20% to −9%; P <.001; I2 = 100%). There was no evidence of substitution to untaxed beverages, and changes in SSB consumption were not significant. The narrative synthesis found reformulation and reduced sugar content of taxed beverages for tiered taxes, cross-border shopping in most studies of local-level taxes, and no negative changes in employment. Data on the heterogeneity of SSB tax outcomes across subpopulations were limited. Conclusions and Relevance: In this systematic review and meta-analysis of implemented SSB taxes worldwide, SSB taxes were associated with higher prices and lower sales of taxed beverages.
- Subjects
RATING of sales personnel; TAXATION; MEDICAL databases; PSYCHOLOGY information storage &; retrieval systems; ONLINE information services; BEVERAGES; BODY weight; META-analysis; DRINKING (Physiology); SYSTEMATIC reviews; EFFECT sizes (Statistics); AGE distribution; DIET; HEALTH status indicators; PREGNANCY outcomes; COST analysis; COMMERCIAL product evaluation; EMPLOYMENT; SHOPPING; RESEARCH funding; DESCRIPTIVE statistics; HEALTH impact assessment; MEDLINE; NUTRITION policy
- Publication
JAMA Network Open, 2022, Vol 5, Issue 6, pe2215276
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2022.15276