Division of Health Policy and Administration, University of Illinois Chicago School of Public Health, Chicago.
Institute for Health Research and Policy, University of Illinois Chicago, Chicago.
JAMA Netw Open. 2021 Nov 1;4(11):e2132271. doi: 10.1001/jamanetworkopen.2021.32271.
Adults and children routinely exceed recommended intake amounts of added sugars established by dietary guidelines. Taxes are used as a policy tool to reduce demand for sugar-sweetened beverages (SSBs) given consumption-related adverse health outcomes but may induce substitution to other sources of added sugars.
To examine the extent to which changes in grams of sugar sold from taxed beverages may be offset by changes in grams of sugar sold from untaxed beverages, sweets, and stand-alone sugar after the implementation of the Seattle, Washington, Sweetened Beverage Tax (SBT) on January 1, 2018.
DESIGN, SETTING, AND PARTICIPANTS: This study used difference-in-differences analyses to examine changes in grams of sugar sold from taxed and untaxed products in Seattle compared with Portland, Oregon, at year 1 and year 2 post tax. This study used Nielsen scanner data from supermarkets and mass merchandise as well as grocery, drug, convenience, and dollar stores on unit sales and measurements for beverage and food product universal product codes (UPCs) for each site for the pretax period (January 8-December 30, 2017) and the corresponding weeks in year 1 post tax (2018) and in year 2 post tax (2019). Nutritional analyses assessed grams of sugar for each UPC. The analytical balanced sample included 1326 taxed beverage UPCs, 239 untaxed beverage UPCs, 2054 sweets UPCs, and 81 stand-alone sugar UPCs. Statistical analysis was performed from January to August 2021.
Implementation of the Seattle SBT.
Changes in grams of sugar sold from taxed beverages, untaxed beverages, sweets, and stand-alone sugar.
At both year 1 and year 2 post tax in Seattle compared with Portland, grams of sugar sold from taxed beverages decreased 23% (year 2 posttax ratio of incidence rate ratios [RIRR] = 0.77; 95% CI, 0.73-0.80). Sugar sold from untaxed beverages increased at year 1 post tax by 4% (RIRR = 1.04; 95% CI, 1.00-1.07) with no change at year 2 post tax. Sugar sold from sweets increased by 4% at both year 1 and year 2 post tax (year 2 posttax RIRR = 1.04; 95% CI, 1.03-1.06). There were no changes in stand-alone sugar sold.
This study using difference-in-differences analysis found a net 19% reduction in grams of sugar sold from taxed SSBs at year 2 post tax after accounting for changes in sugar sold from untaxed beverages, sweets, and stand-alone sugar. These results suggest that SSB taxes may effectively yield permanent reductions in added sugars sold from SSBs in food stores.
成年人和儿童经常超过膳食指南建议的添加糖摄入量。鉴于与消费相关的不良健康后果，税收被用作减少含糖饮料（SSB）需求的政策工具，但可能会促使人们转而购买其他添加糖源的产品。
在 2018 年 1 月 1 日西雅图华盛顿州甜味饮料税（SBT）实施后，评估从征税饮料中销售的糖量变化与从未征税饮料、甜食和独立糖中销售的糖量变化之间的关系。
设计、地点和参与者：本研究采用差异分析方法，比较了西雅图和俄勒冈州波特兰在税收前后一年的征税和未征税产品中糖的销售量变化。本研究使用了来自超市和大众商品以及杂货店、药店、便利店和一元店的尼尔森扫描数据，以获得每个地点征税前（2017 年 1 月 8 日至 12 月 30 日）和税收后一年（2018 年）和税收后两年（2019 年）的饮料和食品产品通用产品代码（UPC）的单位销售和测量值。营养分析评估了每个 UPC 的糖含量。分析的平衡样本包括 1326 个征税饮料 UPC、239 个未征税饮料 UPC、2054 个甜食 UPC 和 81 个独立糖 UPC。统计分析于 2021 年 1 月至 8 月进行。
西雅图 SBT 的实施。
征税饮料、未征税饮料、甜食和独立糖的销售量变化。
与波特兰相比，税收后一年和两年，征税饮料中糖的销售量分别下降了 23%（税收后两年的发病率比[RIRR]为 0.77；95%CI，0.73-0.80）。未征税饮料的销售量在税收后一年增加了 4%（RIRR 为 1.04；95%CI，1.00-1.07），税收后两年没有变化。甜食的销售量在税收后一年和两年都增加了 4%（税收后两年的 RIRR 为 1.04；95%CI，1.03-1.06）。独立糖的销售量没有变化。
本研究采用差异分析发现，在考虑到未征税饮料、甜食和独立糖销售量变化后，税收后两年征税 SSB 的糖销售量净减少 19%。这些结果表明，SSB 税可能会有效地减少食品店中 SSB 销售的添加糖。
