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Oral health hygiene: Would taxation curb consumption of sugary beverages?

Nov. 19, 2015
Oral health hygiene: Would taxation curb consumption of sugary beverages?

By Karen Davis, RDH, BSDH

Whether or not city and state governments should levy an extra tax on sugary drinks is a topic guaranteed to polarize people. Despite 30 city and state governments failing to raise taxes, soda tax seems to have gained some traction during the past year. Berkeley, California, was the first U.S. city to approve a $0.01 per ounce tax on sugary drinks despite the response from the beverage industry, which spent an estimated $1.7 million fighting its passage. Berkeley voters overwhelmingly passed the proposal in November of 2014. Proponents of the soda tax upheld the prevention of obesity and type II diabetes as the motivation for targeting sugary drinks, and the ordinance included the following sobering statistics:

  • From 1989 to 2008, the percentage of children consuming sugary drinks increased from 79% to 91%, and the percentage of total calories obtained from sugary drinks increased by 60% in children ages 6 to 11.
  • 40% of ninth graders in 2008-2009 were overweight or obese.
  • An African American resident of Berkeley is 14 times more likely than a white resident to be hospitalized for diabetes.

So, is it working to reduce soda consumption, and hopefully improve health outcomes? A study released August 17 from the National Bureau of Economic Research concludes that Berkeley's selective soda tax may have fallen flat. Only about 22% of the tax increase has been passed on to consumers in higher prices. One theory for the nominal increase passed on to consumers is that retailers fear people will shop outside of Berkeley to purchase tax-free sodas. Time will tell whether the lofty goal of improving health outcomes in Berkeley through increased taxes, and hopefully lower sugary drink consumption, will become a reality.

Interestingly, in January 2014, Mexico, which ranks fourth worldwide in soda purchases per capita, added a 10% tax per liter on sodas and sugary beverages. Additionally, the government added an 8% tax on unhealthy snacks such as potato chips and cookies. A six-month analysis of how their tax has impacted sales is quite different from the results reported in Berkeley. Preliminary results from a study by the Mexican National Institute of Public Health and the Carolina Center at the University of North Carolina, Chapel Hill, reveal household consumption in 53 Mexican cities dropped 12% by the end of 2014 compared to pretax consumption. Not only did people in Mexico drink fewer sodas with the added tax, but they also drank more water, according to this analysis.


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In April 2014, the Navajo Nation, which includes reservations in New Mexico, Utah, and Arizona, voted to add a 2% sales tax on sugary beverages and junk foods, while allowing fresh fruits and vegetables to be sold tax free. According to reports by the Indian Health Services, 10% of Navajo Nation residents have been diagnosed with diabetes, while another 30% are prediabetic, and obesity rates within the reservation ranges from 23% to 60%. Revenue generated from the additional taxes is earmarked for health and wellness programs on the reservation, such as gardening and nutrition education.

On July 1, 2015, a 6% sales tax on soft drinks went into effect in Vermont. Interestingly, their definition of soft drinks includes nonalcoholic beverages sweetened with natural or artificial sweeteners. That means a 12 oz. Coca Cola with 40.5 grams of sugar shares the same 6% tax as a 12 oz. Zevia with 0 grams of sugar that's sweetened with stevia, monk fruit, and erythritol. Exemptions to the soft drink law include soft drinks purchased with food stamps, items that contain milk, soy, rice, or other substitutes, and those that contain 50% vegetable or fruit juice by volume.

In San Francisco, voters did not successfully pass a tax on sugary drinks, but city officials recently unanimously approved the following warning label on advertisements for sugary drinks. "WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay. This is a message from the City and County of San Francisco."

The San Francisco ordinance includes any sugar-sweetened drink with more than 25 calories from sweeteners per 12 ounces. Diet drinks and other calorie-free beverages would not require the label.

Dental professionals should be guiding the way in conversations with patients to reduce or eliminate sugary beverages and offer suggestions for alternatives, including drinking more water. Low- or zero-calorie alternatives worth exploring are xyWater, Ocean Spray PACt cranberry extract water, Bai5 Antioxidant Infusions, and SweetLeaf Water Drops.

Whether or not more city or state governments pass a soda tax, just having the issue up for consideration brings the topic of this country's sugar overconsumption to the forefront. RDH

Karen Davis, RDH, BSDH, is the founder of Cutting Edge Concepts, an international continuing education company, and practices dental hygiene in Dallas, Texas. She is an independent consultant to the Philips Corp., Periosciences, and Hu-Friedy/EMS. She can be reached at [email protected].