COST: Tobacco Tax. Soda Next?

The average American consumes about 50 gallons of soda annually. (Note, that number excludes the countless other sugary beverages we drink.) Evidence shows that sugar-sweetened beverages are a big element in the mounting obesity crisis in the United States.

Fifty gallons (that's about 100 two liter bottles or 533 cans of soda) is a lot.

Public health advocates hope to curtail soda consumption and have suggested “taxes, warning labels and a massive public health marketing campaign,” reports Mark Bittman, cookbook author and food blogger, in a weekend piece for the New York Times. Sound familiar?

In an opinion piece for the New England Journal of Medicine last spring, Dr. Kelly D. Brownell, director of Yale’s Rudd Center for Food Policy and Obesity, and Dr. Thomas R. Frieden, then-New York City health commissioner, now head of the CDC, reflected on the success of the tobacco tax and suggested a soda tax could be as effective:

Taxes on tobacco products have been highly effective in reducing consumption, and data indicate that higher prices also reduce soda consumption. A review conducted by Yale University's Rudd Center for Food Policy and Obesity suggested that for every 10 percent increase in price, consumption decreases by 7.8 percent. An industry trade publication reported even larger reductions: as prices of carbonated soft drinks increased by 6.8 percent, sales dropped by 7.8 percent, and as Coca-Cola prices increased by 12 percent, sales dropped by 14.6 percent.

Sugary beverages account for about seven percent of the average person’s daily caloric intake, and about ten percent for children and teenagers. And, as Bittman notes, “these calories … are worse than useless -- they’re empty, and contribute to a daily total that is already too high.”

While “food taxes” are controversial in the policy-making circle, the problems associated with obesity (and the mushrooming deficit) are not slimming in size. The revenues collected from a soda tax “could be used to subsidize fruits and vegetables, fund obesity prevention programs for children and home economic classes in schools, and more,” Dr. Brownell suggested.

Dr. Brownell and Dr. Frieden estimated, for example, that a penny-per-ounce soda tax in New York State alone would raise $1.2 billion in just one year.

“What you want,” explains Brownell, “is to reverse the fact that healthy food is too expensive and unhealthy food is too cheap, and the soda tax is a start. Unless food marketing changes, it’s hard to believe that anything else can work.”

As Bittman notes, many states have already introduced small excise taxes on soda or soft drinks. Arkansas, Tennessee, Virginia, Washington and West Virginia have small excise taxes on soda, and Chicago has a three percent retail tax on soft drinks. Several other states are considering similar legislation.

Beverage companies have expressed opposition, arguing that there isn’t evidence demonstrating a direct link between obesity and soda consumption. “If you’re trying to manage people being overweight you need a variety of behavior changes to achieve energy balance -- it can’t be done by eliminating one food from the diet,” reasons Susan Neely, president of the American Beverage Association. Nevertheless, the beverage industry has agreed to help out -- up to a point -- and in a gesture of support for Michelle Obama's Let's Move program, have agreed to remove "full-calorie soft drinks from schools across the country and ... will place the full calories for our products on the front of our containers."

A soda tax isn't going to change Americans diet and exercise patterns overnight. That is going to require big changes in public attitudes and social norms -- as happened with smoking -- along with changes in policy. A sugary drinks tax was considered, and dropped, as a revenue-raiser for health reform. But we don't think we've heard the last of this idea -- there will be other legislation directed at healthy foods and obesity in the coming years (and other legislation aimed at raising revenue and reducing the deficit). We expect this is a policy idea that will stay in the mix. A calorie free mix, perhaps, with a twist of lemon.