A health impact assessment of the UK soft drinks industry levy: a comparative risk assessment modelling study
Lancet Public Health
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Briggs, A., Mytton, O., Kehlbacher, A., Tiffin, R., Elhussein, A., Rayner, M., Jebb, S., et al. (2017). A health impact assessment of the UK soft drinks industry levy: a comparative risk assessment modelling study. Lancet Public Health, 2 (1), e15-e22. https://doi.org/10.1016/S2468-2667(16)30037-8
Background In March, 2016, the UK government proposed a tiered levy on sugar-sweetened beverages (SSBs; high, moderate, and no tax for drinks with >8g, 5g to 8g, and <5g sugar per 100ml). We estimate the effect of possible industry responses to the levy on obesity, diabetes, and dental caries. Methods We modelled three possible industry responses: (1) reformulation to reduce sugar concentration, (2) increasing product price, and (3) changing the market share of high-, mid-, and low-sugar drinks. For each response, we defined a better and worse case health scenario. We developed a comparative risk assessment model to estimate the UK health impact of each scenario. Findings The best modelled scenario for health is SSB reformulation, resulting in 144,000 (95% uncertainty interval: 5,100 to 306,700) fewer adults and children with obesity in the UK, 19,000 (6,900 to 32,700) fewer incident cases of diabetes per year, and 269,000 (82,200 to 470,900) fewer decayed, missing, or filled teeth annually. Increasing the price of SSBs and changes to market share to increase the proportion of low-sugar drinks sold would also result in population health benefits, but to a lesser extent. The greatest benefit for obesity and oral health would be among individuals under 18 years, with people over 65 years experiencing the largest absolute decreases in diabetes incidence. Interpretation The health impact of the soft drink levy is dependent on its implementation by industry. There is uncertainty as to how industry will react and in the estimation of health outcomes. Health gains could be maximised by significant product reformulation with additional benefits possible if the levy is passed onto purchasers through raising the price of high- and mid-sugar drinks, and through activities to increase the market share of low-sugar products.
RT and AK have previously done work on sugar-sweetened beverage taxes funded by the Union of European Soft Drinks Associations. MR is chair of Sustain and the Children's Food Campaign, which have campaigned for sugar drink taxes in the UK. MR is funded by the British Heart Foundation, grant number 006/PSS/CORE/2016/OXFORD. ADMB and OTM are members of the Faculty of Public Health, which has a position statement supporting sugary drink taxes. ADMB is funded by the Wellcome Trust, grant number 102730/Z/13/Z. OTM is a member of the UK Health Forum, which has also supported a UK sugar drinks tax. OTM is supported by a Wellcome Trust Clinical Doctoral Fellowship. SAJ was the independent Chair of the Department of Health Public Health Responsibility Deal Food Network from 2010 to 2015. SAJ is funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Oxford. The views expressed are those of the authors and not necessarily those of the National Health Service, National Institute for Health Research, or the Department of Health. PS is funded by the British Heart Foundation, grant number FS/15/34/31656. TB is funded the Health Research Council of New Zealand (16/443). AE declares no competing interests.
Wellcome Trust (103394/Z/13/Z)
Wellcome Trust (087636/Z/08/Z)
Cambridge University Hospitals NHS Foundation Trust (CUH) (BRC 2012-2017)
External DOI: https://doi.org/10.1016/S2468-2667(16)30037-8
This record's URL: https://www.repository.cam.ac.uk/handle/1810/261366
Attribution 4.0 International, Attribution 4.0 International, Attribution 4.0 International, Attribution 4.0 International