Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United Sates.
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United Sates; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United Sates.
Econ Hum Biol. 2022 Aug;46:101136. doi: 10.1016/j.ehb.2022.101136. Epub 2022 Mar 21.
Growing global concern about obesity and diet-related non-communicable diseases has raised interest in fiscal policy as a tool to reduce this disease burden and its social costs, especially excise taxes on sugar-sweetened beverages (SSBs). Of particular interest have been nutrient-based taxes to improve diet quality. These can incentivize producers to reformulate existing products and introduce healthier alternatives into their ranges. In 2018, South Africa adopted a sugar-based tax on SSBs, the Health Promotion Levy (HPL). Early findings suggest that purchases of higher-sugar taxable beverages fell and purchases of no- and lower-sugar beverages increased, alongside significant reductions in the sugar content of overall beverage purchases. However, underlying these changes are consumption shifts as well as product reformulation and changes in producers' product portfolios. Drawing on a household scanner dataset, this study employed a descriptive approach to decompose changes in the sugar content of households' non-alcoholic beverage purchases into producer factors (reformulation and product entry and exit) and consumer factors (product switching and volume changes as a result of price changes, changing preferences, or other factors). We look at these factors as the tax was announced and implemented across a sample of over 3000 South African households, and then by Living Standard Measures (LSM) groups (middle vs. high). The sugar content of beverage purchases fell by 4.9 g/capita/day overall, a 32% decrease. Taken in isolation, consumer switching and volume changes together led to a reduction equivalent to 71% of the total change, while reformulation accounted for a decrease equal to 34% of that change. Middle-LSM households experienced larger reductions than high-LSM households due to larger changes on the consumer side. For both LSM groups, reformulation-led reductions mostly occurred after implementation, and most changes came from taxable beverage purchases. As sugary drink tax designs evolve with broader implementation globally, understanding both supply- and demand-side factors will help to better assess the population and equity potential of these policies.
全球对肥胖和与饮食相关的非传染性疾病日益关注，这引起了人们对财政政策作为减少这一疾病负担及其社会成本的工具的兴趣，尤其是对含糖饮料（SSB）征收消费税。特别引起关注的是基于营养的税收来改善饮食质量。这些措施可以激励生产者对现有产品进行重新配方，并在其产品系列中引入更健康的替代品。2018 年，南非对 SSB 征收基于糖的税，即健康促进税（HPL）。早期的研究结果表明，高糖应税饮料的购买量下降，无糖和低糖饮料的购买量增加，同时饮料总购买量的含糖量也显著下降。然而，在这些变化的背后，既有消费转移，也有生产者的产品配方改革和产品组合的变化。本研究利用家庭扫描数据集，采用描述性方法，将家庭非酒精饮料购买中糖含量的变化分解为生产者因素（重新配方和产品进入与退出）和消费者因素（产品转换以及由于价格变化、偏好变化或其他因素导致的购买量变化）。我们在该税在 3000 多个南非家庭的样本中宣布和实施时以及按生活水平衡量（LSM）组别（中产阶级与高收入）来观察这些因素。总体而言，饮料购买的糖含量下降了 4.9 克/人/天，降幅为 32%。孤立地看，消费者转换和购买量变化共同导致了相当于总变化 71%的降幅，而重新配方则导致了相当于 34%的降幅。中产阶级 LSM 家庭的降幅大于高收入 LSM 家庭，因为消费者方面的变化更大。对于这两个 LSM 组，重新配方导致的降幅主要发生在实施之后，而且大多数变化都来自应税饮料的购买。随着全球更广泛地实施含糖饮料税设计，了解供求双方的因素将有助于更好地评估这些政策对人口和公平性的潜力。
