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Sugar: a taxing problem?
Editorial
On Oct 22, 2015, Public Health England published its long-awaited report on the evidence for taking action on sugar reduction. Current sugar intake exceeds recommendations in all population groups in the UK. Consumption of excessive amounts of food and drink containing high levels of sugar can lead to weight gain, and the report states that 10% of 4–5 year olds, 19% of 10–11 year olds, and almost 25% of adults in England are obese; a substantial proportion of all age groups are overweight. The health effects of being overweight or obese are well-documented—eg, heart disease, diabetes, stroke, and cancers—indeed, one in 20 cancers in the UK are related to being overweight. The report offers a number of recommendations to help cut sugar intake: special promotions in shops should be reduced, and advertising of food and drink to children and adults across all media substantially decreased. Clear definitions of high sugar foods are called for, as is the introduction of a programme of gradual reduction in sugar levels in everyday food and drink products, together with reductions in portion size. The introduction of government buying standards for food and catering across the public sector is proposed, as is ensuring that individuals with the opportunity to influence food choices in the catering, fitness, and leisure sectors have appropriate training in diet and health. Continued efforts to raise awareness about dietary sugar levels, together with the provision of practical steps for individuals to take to reduce consumption, are also suggested. Perhaps the report’s most controversial recommendation is the introduction of a tax or levy of a minimum of 10–20% on high sugar products such as full sugar soft drinks. Evidence suggests that price increases for high sugar foods and non-alcoholic drinks are likely to reduce the sales of these products, at least in the short term. Similar schemes are already in place in other countries, such as Norway, Finland, Hungary, France, and Mexico. And indeed, following the introduction of a peso-per-litre tax on sugar sweetened drinks in Mexico in October, 2013—akin to a 10% increase in price—preliminary data suggest that there was a reduction of 6% in purchasing of such products in 2014, with larger reductions noted in more socioeconomically deprived households. www.thelancet.com/oncology Vol 16 December 2015
Nevertheless, anecdotal evidence suggests that the scheme has done little to curb actual consumption, instead driving consumers to turn to cheaper bargain brands. And perhaps under pressure from the drinks industry, the Mexican congress voted on Oct 20, 2015, to cut the tax in half for drinks with less than 5 mg sugar per 100 mL. Indeed, whether taxation of unhealthy foods actually works is contentious—for instance, Denmark’s “fat tax”, introduced to wide acclaim in October, 2011, was abandoned after just 15 months as a result of negative economic effects, little evidence of a reduction in consumption, and the lack of popularity among the public. In addition to objections from business owners and trade unions, the tax was widely criticised for making the poor poorer, a situation that could also arise with a sugar tax. Furthermore, one could foresee a situation in which the food and drinks industry could absorb any potential increase in price in the large and excessive profit margins for their products. Thus, taxing the consumer is a blunt weapon and might not be the panacea to tackling sugar consumption on its own. The past 30–40 years have seen unprecedented changes in the way we interact with food, both in terms of the foods available and in how they are produced, marketed, and advertised. We have become complacent, disconnected with the realities of food production, and the forces of capitalism have allowed the food industry to shirk their ethical responsibility in the pursuit of profit. Public Health England’s report recognises the need for cultural change and an acknowledgment of our individual responsibilities, and proposes the introduction of a plan to gradually reduce sugar levels in everyday food and drink products. However, a recent report from the Institute for Alcohol Studies shows that a voluntary “responsibility deal” between the UK Government and the alcohol industry has failed to implement any meaningful change. Clearly, commercial organisations cannot be left to regulate themselves; a more aggressive stance with the food and drinks industry is needed. Direct, punitive taxes for the companies that have had key roles in driving the current landscape might well force a long-overdue rethink of the situation. ■ The Lancet Oncology
Kevin Curtis/Science Photo Library
Sugar: a taxing problem?
For Public Health England’s report see https://www.gov.uk/ government/publications/sugarreduction-from-evidence-intoaction For the Institute for Alcohol Studies report see http://www. ias.org.uk/What-we-do/IASreports.aspx
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On Oct 22, 2015, Public Health England published its long-awaited report on the evidence for taking action on sugar reduction. Current sugar intake exceeds recommendations in all population groups in the UK. Consumption of excessive amounts of food and drink containing high levels of sugar can lead to weight gain, and the report states that 10% of 4–5 year olds, 19% of 10–11 year olds, and almost 25% of adults in England are obese; a substantial proportion of all age groups are overweight. The health effects of being overweight or obese are well-documented—eg, heart disease, diabetes, stroke, and cancers—indeed, one in 20 cancers in the UK are related to being overweight. The report offers a number of recommendations to help cut sugar intake: special promotions in shops should be reduced, and advertising of food and drink to children and adults across all media substantially decreased. Clear definitions of high sugar foods are called for, as is the introduction of a programme of gradual reduction in sugar levels in everyday food and drink products, together with reductions in portion size. The introduction of government buying standards for food and catering across the public sector is proposed, as is ensuring that individuals with the opportunity to influence food choices in the catering, fitness, and leisure sectors have appropriate training in diet and health. Continued efforts to raise awareness about dietary sugar levels, together with the provision of practical steps for individuals to take to reduce consumption, are also suggested. Perhaps the report’s most controversial recommendation is the introduction of a tax or levy of a minimum of 10–20% on high sugar products such as full sugar soft drinks. Evidence suggests that price increases for high sugar foods and non-alcoholic drinks are likely to reduce the sales of these products, at least in the short term. Similar schemes are already in place in other countries, such as Norway, Finland, Hungary, France, and Mexico. And indeed, following the introduction of a peso-per-litre tax on sugar sweetened drinks in Mexico in October, 2013—akin to a 10% increase in price—preliminary data suggest that there was a reduction of 6% in purchasing of such products in 2014, with larger reductions noted in more socioeconomically deprived households. www.thelancet.com/oncology Vol 16 December 2015
Nevertheless, anecdotal evidence suggests that the scheme has done little to curb actual consumption, instead driving consumers to turn to cheaper bargain brands. And perhaps under pressure from the drinks industry, the Mexican congress voted on Oct 20, 2015, to cut the tax in half for drinks with less than 5 mg sugar per 100 mL. Indeed, whether taxation of unhealthy foods actually works is contentious—for instance, Denmark’s “fat tax”, introduced to wide acclaim in October, 2011, was abandoned after just 15 months as a result of negative economic effects, little evidence of a reduction in consumption, and the lack of popularity among the public. In addition to objections from business owners and trade unions, the tax was widely criticised for making the poor poorer, a situation that could also arise with a sugar tax. Furthermore, one could foresee a situation in which the food and drinks industry could absorb any potential increase in price in the large and excessive profit margins for their products. Thus, taxing the consumer is a blunt weapon and might not be the panacea to tackling sugar consumption on its own. The past 30–40 years have seen unprecedented changes in the way we interact with food, both in terms of the foods available and in how they are produced, marketed, and advertised. We have become complacent, disconnected with the realities of food production, and the forces of capitalism have allowed the food industry to shirk their ethical responsibility in the pursuit of profit. Public Health England’s report recognises the need for cultural change and an acknowledgment of our individual responsibilities, and proposes the introduction of a plan to gradually reduce sugar levels in everyday food and drink products. However, a recent report from the Institute for Alcohol Studies shows that a voluntary “responsibility deal” between the UK Government and the alcohol industry has failed to implement any meaningful change. Clearly, commercial organisations cannot be left to regulate themselves; a more aggressive stance with the food and drinks industry is needed. Direct, punitive taxes for the companies that have had key roles in driving the current landscape might well force a long-overdue rethink of the situation. ■ The Lancet Oncology
Kevin Curtis/Science Photo Library
Sugar: a taxing problem?
For Public Health England’s report see https://www.gov.uk/ government/publications/sugarreduction-from-evidence-intoaction For the Institute for Alcohol Studies report see http://www. ias.org.uk/What-we-do/IASreports.aspx
1569