Chatelan Angeline, Rouche Manon, Kelly Colette, Fismen Anne-Siri, Pedroni Camille, Desbouys Lucille, Castetbon Katia
School of Public Health, Université libre de Bruxelles, Brussels, Belgium; Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.
School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
Am J Clin Nutr. 2023 Mar;117(3):576-585. doi: 10.1016/j.ajcnut.2023.01.011. Epub 2023 Jan 13.
The WHO recommends soda taxes to reduce sugar consumption, but the effect across socioeconomic groups is unclear.
We assessed 16-y trends in daily soda consumption among adolescents in 4 European countries with a soda tax and 5 comparison countries, by family affluence.
Five rounds of the international "Health Behaviour in School-Aged Children" school-based survey were used (school years 2001/2002 to 2017/2018, repeated cross-sectional design). Finland, France, Belgium, and Portugal introduced or updated a soda tax during this period. For comparison, we selected 5 neighboring countries without such a tax. Nationally representative samples of adolescents aged 13 and 15 y (n = 165,521; 51.2% girls) completed a standardized questionnaire, including a question on soda consumption frequency. Using the family affluence scale (FAS), we categorized adolescents into lower-, middle- or higher-affluent groups. Changes in daily soda consumption were assessed in each country independently.
Before taxation, daily soda consumption was more likely among lower-affluent adolescents in France and Belgium (P < 0.001, socioeconomic inequalities) and was similar across FAS groups in Finland and Portugal (no inequalities). After the tax, daily soda consumption was reduced across all FAS groups in Finland, Belgium, and Portugal (P ≥ 0.33). In France, a posttax decrease was observed only among lower-affluent adolescents (OR, 0.76; 95% CI: 0.60, 0.96; reduced inequalities). During the same periods, socioeconomic patterns remained stable in 3 comparison countries (P ≥ 0.38), and larger reductions in daily soda consumption were observed among middle- or higher-affluent adolescents compared with lower-affluent adolescents in the remaining 2 comparison countries (P ≤ 0.08, increased inequalities).
Socioeconomic patterns did not change after the tax implementation in 3 out of 4 countries, and socioeconomic inequalities were reduced in France. Taxing sodas might be an effective measure to attenuate, or at least not exacerbate, socioeconomic inequalities in adolescent daily soda consumption. Am J Clin Nutr 20XX;xx:xx-xx.
世界卫生组织建议征收汽水税以减少糖分摄入，但该措施对不同社会经济群体的影响尚不清楚。
我们按家庭富裕程度评估了4个征收汽水税的欧洲国家和5个对照国家青少年每日汽水消费量的16年趋势。
采用国际“学龄儿童健康行为”基于学校的调查的五轮数据（2001/2002学年至2017/2018学年，重复横断面设计）。在此期间，芬兰、法国、比利时和葡萄牙引入或更新了汽水税。作为对照，我们选择了5个没有此类税收的邻国。13岁和15岁青少年的全国代表性样本（n = 165,521；51.2%为女孩）完成了一份标准化问卷，包括一个关于汽水消费频率的问题。使用家庭富裕量表（FAS），我们将青少年分为低、中或高富裕组。每个国家独立评估每日汽水消费量的变化。
征税前，法国和比利时低富裕青少年的每日汽水消费量更高（P < 0.001，社会经济不平等），而芬兰和葡萄牙各FAS组的情况相似（无不平等）。征税后，芬兰、比利时和葡萄牙所有FAS组的每日汽水消费量均有所下降（P ≥ 0.33）。在法国，仅低富裕青少年的汽水消费量在征税后有所下降（比值比，0.76；95%置信区间：0.60，0.96；不平等减少）。在同一时期，3个对照国家的社会经济模式保持稳定（P ≥ 0.38），在其余2个对照国家中，中或高富裕青少年的每日汽水消费量降幅大于低富裕青少年（P ≤ 0.08，不平等增加）。
4个国家中有3个在实施汽水税后社会经济模式没有改变，法国的社会经济不平等有所减少。对汽水征税可能是减轻或至少不加剧青少年每日汽水消费中社会经济不平等的有效措施。《美国临床营养学杂志》20XX年；xx：xx - xx。
