Sugar-Sweetened Beverage Taxes are Associated with Decreases in Soda Consumption Among High School Students: Difference-in-Difference Estimates from Four Large US Cities

Abstract

Sugar-sweetened beverage consumption (SSB) among children is a main risk factor for childhood obesity and subsequent onset of chronic diseases including type-2 diabetes and cardiovascular disease. Introducing a tax on SSBs could potentially curb SSB consumption. We aimed to assess the effect of an SSB tax on consumption among youth. We used quasi-natural experiment and difference-in-difference (DID) analytical framework of pre- and post-tax SSB consumption among youth. The treatment groups consisted of Philadelphia, PA; Seattle, WA; Oakland, CA; and Chicago, IL where sweetened beverage taxes were implemented, and other thirty cities without an SSB tax as controls. 9 th to 12 th high school students were included. We evaluated the effect of an SSB tax on the probability and quantity of soda, milk, and 100% fruit juice consumption. We found the introduction of an SSB tax was associated with a significant decline in soda consumption among high-school students in terms of probability (2.3 percentage points, [CI, - 3.5 to -0.1], p<0.01) and quantity (0.48 of a can, equivalent to 5.76 ounces [CI, -0.60 to -0.37], p < 0.01) of consumption. The decreased soda consumption was compensated by an increase in weekly milk consumption (0.55 glasses/ 4.4 ounces, [CI, -0.44 to -0.66], p<0.01), whereas the consumption of 100% juice remained unchanged. The tax effects were more pronounced among normal weight, female, and racially Black/African American or White high school students compared to their counterparts. In conclusion, SSB taxes are an efficacious fiscal policy tool to curb SSB consumption among US youth.

Note:

Funding Information: None to declare.

Declaration of Interests: All authors reported no conflict of interests.

Ethics Approval Statement: Written consent was obtained from survey participants. This study was exempted from institutional review broad approval; per the US Department of Health and Human Services guidelines.

Keywords: Childhood obesity, Sugar-sweetened beverage taxes, Policy evaluation, Quasi-natural experiment, Beverage consumption