Reading some of the recent articles in our favourite newspapers or listening to some of the debates on TV or radio, we could all be forgiven for thinking that a so-called “sugar tax on soft drinks” is the silver bullet and answer to so many questions that have eluded public health experts and policymakers for more than four decades. The reality, however, is that the debate and indeed the solutions are very complex, and no such panacea exists. Let’s look at some of the facts behind the fiction.
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For the last 15 years, sales in water-based beverages have been shifting away from regular sugar-sweetened varieties towards low and no sugar alternatives. During that same period, sugar contribution to the Australian diet from soft drinks has decreased by 26 per cent per capita. In 2018, three of the top four soft drinks sold in Australia contain no sugar at all. Walk into any supermarket drinks aisle, petrol station or convenience store, and the evidence to support this is stark. The truth is that Australians are consuming less sugar from cordial and soft drinks than they have in the past, all the while rates of obesity have increased. Yet many health advocates perceive soft drinks as a unique driver of obesity and indeed a soft target. This is little more than sickly misconception and we should not believe what is essentially thinly veiled propaganda.
The pro-tax lobbyists support a ludicrous proposition, that a tax will measurably reduce obesity, based on spectacularly weak ‘intervention logic’ which is as simple, as it is flawed. That is, a tax masquerading as a public health paladin will increase prices, which will decrease consumption, which will decrease daily kilojoule intake, which will cause people to lose weight, which will, in turn, cause population health to improve.
Unfortunately, this logic is weak, naive and, inevitably, flawed.
It’s weak because the evidence that implementing a tax improves population health is itself weak. A growing body of science including a recent New Zealand Institute of Economic Research report commissioned for the New Zealand Government’s Ministry of Health found exactly that: “evidence that sugar taxes improve health is weak”. Interestingly, this report looked at 47 studies. It’s naive because it assumes that the “links” between the chain are strong, when in fact they’re far anything but. An increase in price might decrease demand, but it might not. People could look to buy in bulk, buy cheaper alternatives such as private labels or buy substitutes to avoid the price hike, as is the case in Berkeley, California, a year after such a tax has been introduced. Interestingly in that market, research has shown the daily energy intake (calories) has increased because of the tax and not achieved the projected decrease.
Finally, it’s flawed because such a tax is regressive and discriminatory. It hits the poorest households the hardest, because they have the least to spend on treat foods or drinks. These households respond by simply adjusting their spending on other items to compensate, making it regressive. It’s discriminatory because it focuses on such a small and declining part of the diet – sugar from soft drinks. Government data analysed by the CSIRO shows the average child gets a whopping 42 per cent of their daily kilojoules from discretionary or treat foods and drinks. Soft drinks are ranked eighth in that list. Again, further research shows that for the last two decades, consumers have been shifting away from regular soft drinks in favour of low and no sugar varieties.
So why does our public health fraternity have such a blinkered focus on a sugar tax when there is no evidence from anywhere in the world that it will address the problem, and when both the government and opposition have ruled a tax off the table? Perhaps it’s because many pro-sugar tax lobbyists are still basking in the after-glow of a successful public health tobacco intervention, where indeed a tax hike did have an impact on smoking rates. Why? Because there is no substitute for tobacco in cigarettes, and there is no safe level of smoking. It’s embarrassing to the public’s intellect when tobacco and taxes are used as an example of why sugar and taxes will work in the same way. It’s also certainly a case of soft drinks being “low hanging fruit”, and slapping a tax on a can of cola is immeasurably easier than teaching all school kids about balanced diets. It’s perplexing and a little concerning that, in 2018, the best our public health advocates have to tackle a complex problem like obesity is to resort to an irrational tax without any global evidence and hope it will work. Today, society should expect more.
So what will work? To turn the tide on obesity, which we all agree is needed, all stakeholders, including government, public health, community groups and, yes, even industry, must develop an integrated framework of strategies to improve nutritional education, prevent generational misinformation on diet and promote activity from a young age. These constructive policies, including government initiatives like the Healthy Food Partnership and the Health Star Rating Scheme, combined with community projects to keep the young and the young at heart active, must be part of a fitter future. In the long term, we need to think about how our communities and the local environs in which we live, work and play in, can promote healthier, more active lifestyles.
The industry’s hope is that we will witness more tripartite collaboration to support individuals to adopt healthy lifestyles, and we encourage those health groups to direct some of their resources towards strategies designed to stimulate and support positive solutions to our obesity crisis, not to simply chase a tax down a public policy rabbit hole. Stigmatising sugar and more precisely sugar in soft drinks and promulgating a discriminatory and regressive tax as a band-aid solution to the nation’s burgeoning waistlines completely misses the point and is not doing anyone any good. The industry’s door remains open to any health group that wants to start those discussions.