Taxing Soda for Public Health (eBook)

Yann Le Bodo, M.Sc., is a PhD student in community health at Laval University in the Faculties of Medicine and Nursing. Since 2012, he has been a project manager at the Evaluation Platform on Obesity Prevention (EPOP) set up by Laval University and the Québec Heart and Lung Institute in Québec City, Canada. Le Bodo is in charge of research projects on healthy eating and physical activity policies. An important part of his research has focused on sugar-sweetened beverage taxation in Canada. Le Bodo is co-author of several peer‐reviewed publications, as well as co-editor and co-author of the books Preventing Childhood Obesity: EPODE European Network Recommendations and L'Experience quebecoise en promotion des saines habitudes de vie et prevention de l'obesite: comment faire mieux?   Marie-Claude Paquette, Dt.P., Ph.D., is an expert and researcher at the Public Health Institute of Québec (Institut national de santé publique du Québec) in Canada. She is a registered dietician at Université de Montréal in Québec. Dr. Paquette has worked for the past 10 years at the Institut national de santé publique du Québec in a multidisciplinary team focusing on environmental and policy approaches for the promotion of healthy lifestyle habits and the prevention of weight-related problems. Her expertise lies mainly in the food environment and the sociocultural environment. Dr. Paquette has been involved in characterizing the school food environment and more recently in developing indicators using supermarket food purchases. Over the last few years, she has developed expertise in sugar-sweetened beverages following a governmental mandate on this topic. Dr. Paquette is the author of many government publications on topics associated with nutrition and the sociocultural dimensions of eating. Finally, she also is an associate professor at the Département de nutrition, Faculty of Medicine, of Université de Montréal.Philippe De Wals, M.D., Ph.D., is professor in the Department of Social and Preventive Medicine, Faculty of Medicine, at Laval University, and scientific director at the Evaluation Platform on Obesity Prevention (EPOP) in Québec City, Canada. His research interests include the epidemiology of infectious diseases, birth defects and chronic conditions including obesity, as well as the evaluation of public health programs. Professor De Wals is the author of over 150 published articles in scientific journals and has contributed several chapters to textbooks. Currently, he is a medical advisor to the 'Institut national de santé publique du Québec' and to several national and international organizations. In 1990, Professor De Wals was awarded the Jean Van Beneden Prize in recognition of his excellent work in the public health field, and in 2005, he was elected to the Royal Academy of Medicine of Belgium.

Summary1. Introduction2. Methods2.1 Theoretical basis2.2 A 'realist' review of evidence2.3 Data collection2.4 Data analysis3. Why - Rationale3.1 Reasons for targeting specifically SSB (sugar sweetened beverages)     3.1.1 SSB and health risks     3.1.2 SSB consumption and marketing trends     3.1.3 Considerations on some other non-alcoholic beverages     3.1.4 Concluding comments3.2 Merits of SSB taxation as a public health policy instrument     3.2.1 Price, a key determinant of food habits     3.2.2 Taxing SSB as part of a comprehensive strategy     3.2.3 Learning from tobacco taxation     3.2.4 Taxation, a highly cost-effective option     3.2.5 Concluding comments3.3 Economic rationale for taxation and ethical concerns     3.3.1 Economic debates about the normative justification of SSB taxation     3.3.2 Ethical concerns surrounding freedom of choice and autonomy     3.3.3 Concluding comments3.4 Clarifying SSB taxation logics4. What - Impact4.1 Tax effects on SSB prices     4.1.1 Factors that may impair SSB tax shift onto prices     4.1.2 Empirical evidence     4.1.3 Additional proposals to secure the pass-through     4.1.4 Concluding comments4.2 Tax effects on SSB demand     4.2.1 Findings from experimental studies     4.2.2 Factors that may impair tax effects on demand in the 'real world'     4.2.3 'Real-world' price-elasticity of SSB demand     4.2.4 Preliminary evidence from taxes implemented across the world     4.2.5 May we miss our core target?     4.2.6 Concluding comments4.3 Tax effects on energy intakes and population health     4.3.1 Overview of substitution concerns     4.3.2 Results from public health modeling studies     4.3.3 Results from economics modeling studies     4.3.4 Preliminary evidence from taxes implemented across the world     4.3.5 Concluding comments4.4 Potential inequities related to SSB taxation     4.4.1 Distribution of changes in SSB intakes     4.4.2 Distribution of the financial contribution to tax revenues     4.4.3 Distribution of effects according to SSB consumption levels     4.4.4 Equity concerns and acceptability of SSB taxation     4.4.5 Concluding comments4.5 Potential undesirable effects related to SSB taxation     4.5.1 Tax-related administration costs for industries     4.5.2 Tax impact on profitability     4.5.3 Tax impact on employment     4.5.4 Tax impact on investments     4.5.5 Tax impact on competitiveness     4.5.6 Tax impact on cross-border trade     4.5.7 Concluding comments4.6 Raising fiscal revenues from SSB taxation     4.6.1 Confidence and estimations     4.6.2 Justification for targeting SSB specifically     4.6.3 Pursuing both fiscal and behavioural logics may be paradoxical     4.6.4 The importance of earmarking tax revenues to health promotion     4.6.5 Concluding comments4.7 Potential 'signal' effects from SSB taxation     4.7.1 An 'alarm-signal' to the population     4.7.2 A 'coercive signal' to manufacturers     4.7.3 Arguments for a comprehensive 'de-normalization' strategy     4.7.4 The complex evaluation of signal effects     4.7.5 Concluding comments5. How - Applicability5.1 Legal and administrative feasibility     5.1.1 The complexity of sweetener inputs' taxation     5.1.2 Excise taxes commonly preferred to sales taxes     5.1.3 How feasible is it to rely on sales and/or excise SSB taxes in Canada?     5.1.4 Concerns on the scope of the tax and its rate     5.1.5 Concluding comments5.2 Social and political acceptability     5.2.1 International perspective     5.2.2 Canadian experts     5.2.3 Canadian civil society     5.2.4 Canadian elected representatives     5.2.5 Canadian public opinion     5.2.6 Importance of a constructive dialogue     5.2.7 Concluding comments5.3 Evaluability     5.3.1 Importance of SSB taxation evaluation     5.3.2 Evaluation of a price-induced behavioural logic     5.3.3 Evaluation of a fiscal logic     5.3.4 Evaluation of a signal-induced de-normalization logic     5.3.5 The challenge of robust economic evaluations     5.3.6 Concluding comments6. Discussion6.1 Proposal of a multi-dimensional evidence-based framework6.2 Conclusion7. Bibliography