The world's leading health experts want countries to start taxing soda

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City Considering Tax on Soda

Sweet tooths, we come to you with some very bitter news today: The world's top health experts want to put a tax on your favorite sugary drinks, from your morning coffee to your afternoon cola to that bottle of fruit juice you swig right before your workout. A report released Thursday by the World Health Organization from a commission charged with finding ways to end childhood obesity around the world recommended that sugar-sweetened beverages get taxed around the world.

Here's the WHO, from that report:

It is well established that the consumption of sugar-sweetened beverages is associated with an increased risk of obesity. Consumption patterns may vary in different settings and more detail is needed about the patterns of intake in children in different settings. Low-income consumers and their children have the greatest risk of obesity in many societies and are most influenced by price. Fiscal policies may encourage this group of consumers to make healthier choices (provided healthier alternatives are made available) as well as providing an indirect educational and public health signal to the whole population.

Sugar has long attracted the ire of health experts, who've called the stuff everything from toxic to being "like cocaine" to the root of a public-health crisis. Worldwide, estimates suggest that 184,000 people die annually from slurping on sugar-sweetened beverages. On the face of it, it seems like sugar taxes and the like should work. After all, people generally aren't exactly delighted to cough up extra cash for taxes. And when you're getting taxed on a treat — the so-called "sin taxes" are designed to change "sinful" behavior, focusing on gambling, alcohol, tobacco, and now your afternoon hankering for the latest sugar-drenched coffee concoction — it should curb your bad habits, right?

See images of the warning labels of soda in San Francisco:

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Soda warning labels, San Francisco, California
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The world's leading health experts want countries to start taxing soda
A shelf of soft drinks are shown in a refrigerator at K & D Market in San Francisco, Wednesday, Oct. 1, 2014. A tax on sodas and other sugar-laden drinks that voters and courts in other parts of the country have rejected is on the November ballots in San Francisco and Berkeley, two cities that have been open to such social-engineering initiatives in the past. (AP Photo/Jeff Chiu)
SAN FRANCISCO, CA - JULY 22: Health advocates hold signs during a rally in favor of a soda tax at San Francisco City Hall on July 22, 2014 in San Francisco, California. The San Francisco Board of Supervisors will vote on Tuesday to place a measure on the November ballot for a 2-cents-per-ounce soda tax. If the measure passes in the November election, tax proceeds would help finance nutrition, health, disease prevention and recreation programs. (Photo by Justin Sullivan/Getty Images)
A woman shops down an aisle for frozen foods, sodas and other sugary drinks at a supermarket in Monterey Park, California on June 18, 2014, a day after a bill in California that would require soft drinks to have health warning labels failed to clear a key committee. Under the measure, sugary drinks sold in the most populous US state would have had to carry a label with a warning that sugar contributes to obesity, diabetes and tooth decay and the legislation, which would have been the first of its kind in the United States, passed the state Senate in May, but on it failed to win enough votes in the health commission of the California State Assembly on June 17, the Los Angeles Times reported. AFP PHOTO/Frederic J. BROWN (Photo credit should read FREDERIC J. BROWN/AFP/Getty Images)
SAN FRANCISCO, CA - JULY 22: Health advocates hold signs during a rally in favor of a soda tax at San Francisco City Hall on July 22, 2014 in San Francisco, California. The San Francisco Board of Supervisors will vote on Tuesday to place a measure on the November ballot for a 2-cents-per-ounce soda tax. If the measure passes in the November election, tax proceeds would help finance nutrition, health, disease prevention and recreation programs. (Photo by Justin Sullivan/Getty Images)
SAN FRANCISCO, CA - JULY 22: Bottles of Pepsi are displayed in a food truck's cooler on July 22, 2014 in San Francisco, California. The San Francisco Board of Supervisors will vote on Tuesday to place a measure on the November ballot for a 2-cents-per-ounce soda tax. If the measure passes in the November election, tax proceeds would help finance nutrition, health, disease prevention and recreation programs. (Photo by Justin Sullivan/Getty Images)
A woman shops for food items near a display of bottes of soda at a superrmarket in Rosemead, California on June 18, 2014, a day after a bill in California that would require soft drinks to have health warning labels failed to clear a key committee. Under the measure, sugary drinks sold in the most populous US state would have had to carry a label with a warning that sugar contributes to obesity, diabetes and tooth decay and the legislation, which would have been the first of its kind in the United States, passed the state Senate in May, but on it failed to win enough votes in the health commission of the California State Assembly on June 17, the Los Angeles Times reported. AFP PHOTO/Frederic J. BROWN (Photo credit should read FREDERIC J. BROWN/AFP/Getty Images)
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But it's not that simple. Studies have wavered back and forth on whether such taxes actually work. Recent research has tested the basic idea here — that is, a punishment mechanism of costing you your hard-earned cash every time you indulge in something not good for you. A February 2010 Psychological Sciencestudy, for instance, showed that a general "junk-food tax" made consumers in an experiment more likely to purchase healthier options.

In November, the Washington Post suggested a national sugar tax should be implemented, citing Mexico City's seemingly successful reduction of sugar consumption on average by 6 percent after a 10 percent hike in taxes (poorer families, who are most at risk for childhood obesity and tend to be heavy consumers of soda, reduced consumption by about 9 percent). The Tax Policy Center, however, argues that taxing soda to combat obesity isn't fair, punishing poor people up to four times more relative to their wealth than wealthier people, for whom soda taxes aren't as painful. Plus, taxes often target sugar across the board, making drinks with a touch of sugar equally "evil" as ones that contain 30-plus grams of sugar.

The WHO also rightly points out that most sugary beverages are actually consumed by poor families, who have the double trouble of being at the highest risk for obesity. Sugary beverages, after all, tend to be cheap, filling, and taste delicious. But will making the poor pay more for a can of soda make it less appealing for kids and create an alternate, more healthy hankering for, say, a bag of carrots and celery? That same Psychological Science study that showed people buying healthier food when taxes were in place also showed that when subsidies for healthier food were established instead, savings were often transferred to buying — surprise, surprise — junk food.

It's not like there aren't other options. In economics, it's the classic example of the substitution effect: Prices go up for something you want/need, so you replace it with something else that is palatable. A 2010 JAMA Internal Medicine study suggests that if a kid can't get their hands on soda, they might turn to other sweetened beverages to get the same kick, nullifying any benefit of a soda tax. Or kids might turn to unhealthy junk foods — equally cheap, equally filling, and equally sinfully delicious — for their fix.

And here's the kicker: Research shows that soda taxes actually don't help obese people lose weight, since most obese people are glugging diet soda, not the sugar-infused kind. Granted, the study was limited to American adults, but it's representative of the complex behavior behind implementing a tax.

This isn't to say that taxing soda isn't a beneficial step toward getting kids to eat healthier. Just last week, the medical journal The Lancet published an op-ed acknowledging that childhood obesity is a grave, growing issue, and that sugar taxes are a first step toward addressing this health concern. But simply slapping a tax on a bottle of soda isn't going to single-handedly solve childhood obesity, The Lancet argues: It's a multifaceted issue that requires all aspects of civic life to offer incentives, both economic and behavioral, to get families — not just kids — away from unhealthy habits:

[A]lthough national obesity strategies are welcome and much needed, they need to be comprehensive by involving all relevant government departments and also covering both prevention and treatment. In addition to the health sector, the education sector is a vital role model, empowering children and adolescents with the relevant knowledge about food and nutrition and the opportunity to do physical activity beyond competitive sport. Transport and urban planning departments need to ensure that cities and environments support easy and preferred access to healthy food and physical activity. Economic, business, and enterprise departments need to be held accountable for the health effects of their policies.

Addressing obesity in both children and adults is difficult. Treatment strategies are multifaceted, and begin with the need to recognise overweight and obesity and their consequences, and range from nutritional information and advice to bariatric surgery. Interventions for childhood obesity only work if the whole family is engaged. Any national strategy should have clear guidance on treatment of established overweight and obesity.

The soda-tax debate is far from over, and in the coming days more research and voices will muddle the debate. What's clear is this: It's a first, small step. But it's going to take a lot more incentives to get kids off the sugary track and a lifetime of health issues than some cents tacked onto a soda purchase.


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