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英国家庭购买的软饮料变化与英国软饮料行业征税有关:对照中断时间序列分析。

Changes in soft drinks purchased by British households associated with the UK soft drinks industry levy: controlled interrupted time series analysis.

机构信息

Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK.

Faculty of Health, School of Kinesiology and Health Science, Toronto, Canada.

出版信息

BMJ. 2021 Mar 10;372:n254. doi: 10.1136/bmj.n254.

Abstract

OBJECTIVE

To determine changes in household purchases of drinks and confectionery one year after implementation of the UK soft drinks industry levy (SDIL).

DESIGN

Controlled interrupted time series analysis.

PARTICIPANTS

Members of a panel of households reporting their purchasing on a weekly basis to a market research company (average weekly number of participants n=22 183), March 2014 to March 2019.

INTERVENTION

A two tiered tax levied on manufacturers of soft drinks, announced in March 2016 and implemented in April 2018. Drinks with ≥8 g sugar/100 mL (high tier) are taxed at £0.24/L and drinks with ≥5 to <8 g sugar/100 mL (low tier) are taxed at £0.18/L. Drinks with <5 g sugar/100 mL (no levy) are not taxed.

MAIN OUTCOME MEASURES

Absolute and relative differences in the volume of, and amount of sugar in, soft drinks categories, all soft drinks combined, alcohol, and confectionery purchased per household per week one year after implementation of the SDIL compared with trends before the announcement of the SDIL.

RESULTS

In March 2019, compared with the counterfactual estimated from pre-announcement trends, purchased volume of drinks in the high levy tier decreased by 155 mL (95% confidence interval 240.5 to 69.5 mL) per household per week, equivalent to 44.3% (95% confidence interval 59.9% to 28.7%), and sugar purchased in these drinks decreased by 18.0 g (95% confidence interval 32.3 to 3.6 g), or 45.9% (68.8% to 22.9%). Purchases of low tier drinks decreased by 177.3 mL (225.3 to 129.3 mL) per household per week, or 85.9% (95.1% to 76.7%), with a 12.5 g (15.4 to 9.5 g) reduction in sugar in these drinks, equivalent to 86.2% (94.2% to 78.1%). Despite no overall change in volume of no levy drinks purchased, there was an increase in sugar purchased of 15.3 g (12.6 to 17.9 g) per household per week, equivalent to 166.4% (94.2% to 238.5%). When all soft drinks were combined, the volume of drinks purchased did not change, but sugar decreased by 29.5 g (55.8 to 3.1 g), or 9.8% (17.9% to 1.8%). Purchases of confectionery and alcoholic drinks did not change.

CONCLUSIONS

Compared with trends before the SDIL was announced, one year after implementation, the volume of soft drinks purchased did not change. The amount of sugar in those drinks was 30 g, or 10%, lower per household per week-equivalent to one 250 mL serving of a low tier drink per person per week. The SDIL might benefit public health without harming industry.

TRIAL REGISTRATION

ISRCTN18042742.

摘要

目的

在英国软饮料行业征税(SDIL)实施一年后,确定家庭购买饮料和糖果的变化。

设计

对照中断时间序列分析。

参与者

向市场研究公司每周报告购买情况的家庭小组的成员(平均每周参与者人数 n=22183),2014 年 3 月至 2019 年 3 月。

干预措施

对软饮料制造商征收两级税,于 2016 年 3 月宣布,并于 2018 年 4 月实施。含糖量≥8g/100mL(高等级)的饮料每升征收 0.24 英镑的税,含糖量≥5g但<8g/100mL(低等级)的饮料每升征收 0.18 英镑的税,含糖量<5g/100mL(无征税)的饮料不征税。

主要观察指标

与 SDIL 宣布前的趋势相比,实施 SDIL 一年后,家庭每周购买的软饮料类别、所有软饮料、酒精和糖果的绝对和相对差异,以及每家庭每周购买的软饮料中的糖量。

结果

2019 年 3 月,与从预公告趋势估计的反事实相比,每个家庭每周购买的高征税等级饮料量减少了 155 毫升(95%置信区间为 240.5 至 69.5 毫升),相当于 44.3%(95%置信区间为 59.9%至 28.7%),且这些饮料中购买的糖减少了 18.0 克(95%置信区间为 32.3 至 3.6 克),相当于 45.9%(68.8%至 22.9%)。低征税等级饮料的购买量每周减少 177.3 毫升(225.3 至 129.3 毫升),相当于 85.9%(95.1%至 76.7%),其中糖的摄入量减少了 12.5 克(15.4 至 9.5 克),相当于 86.2%(94.2%至 78.1%)。尽管购买无征税饮料的总量没有变化,但每个家庭每周购买的糖量增加了 15.3 克(12.6 至 17.9 克),相当于 166.4%(94.2%至 238.5%)。当所有软饮料合并时,饮料购买量没有变化,但糖的含量减少了 29.5 克(55.8 至 3.1 克),或 9.8%(17.9%至 1.8%)。糖果和酒精饮料的购买量没有变化。

结论

与 SDIL 宣布前的趋势相比,实施一年后,家庭购买软饮料的数量没有变化。这些饮料中的含糖量减少了 30 克,或 10%,相当于每人每周少喝一份低等级饮料(每份 250 毫升)。SDIL 可能在不损害行业的情况下有益于公众健康。

试验注册

ISRCTN86545338。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c68a/7944367/5c0f6a853bac/peld062092.f1.jpg

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