Background
To induce consumers to purchase healthier foods and beverages, some policymakers have
suggested special taxes or labels on unhealthy products. The potential of such policies
is unknown.
Purpose
In a controlled field experiment, researchers tested whether consumers were more likely
to purchase healthy products under such policies.
Methods
From October to December 2011, researchers opened a store at a large hospital that
sold a variety of healthier and less-healthy foods and beverages. Purchases (N=3680)
were analyzed under five conditions: a baseline with no special labeling or taxation,
a 30% tax, highlighting the phrase “less healthy” on the price tag, and combinations
of taxation and labeling. Purchases were analyzed in January–July 2012, at the single-item
and transaction levels.
Results
There was no significant difference between the various taxation conditions. Consumers
were 11 percentage points more likely to purchase a healthier item under a 30% tax
(95% CI=7%, 16%, p<0.001) and 6 percentage points more likely under labeling (95% CI=0%, 12%, p=0.04). By product type, consumers switched away from the purchase of less-healthy
food under taxation (9 percentage point decrease, p<0.001) and into healthier beverages (6 percentage point increase, p=0.001); there were no effects for labeling. Conditions were associated with the purchase
of 11–14 fewer calories (9%–11% in relative terms) and 2 fewer grams of sugar. Results
remained significant controlling for all items purchased in a single transaction.
Conclusions
Taxation may induce consumers to purchase healthier foods and beverages. However,
it is unclear whether the 15%–20% tax rates proposed in public policy discussions
would be more effective than labeling products as less healthy.
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References
- Accelerating progress in obesity prevention: solving the weight of the nation.National Academies Press, Washington DC2012
- Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial.Int J Behav Nutr Phys Act. 2008; 5: 63
- Calorie labeling and food choices: a first look at the effects on low-income people in New York City.Health Aff. 2009; 28: w1110-w1121
- Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment.Int J Obes. 2011; 35: 493-500
- Consumer purchasing patterns in response to calorie labeling legislation in New York City.Int J Behav Nutr Phys Act. 2011; 8: 51
- Reducing childhood obesity through policy change: acting now to prevent obesity.Health Aff. 2010; 29: 357-363
- Cigarette tax increase and media campaign cost of reducing smoking-related deaths.Am J Prev Med. 2005; 29: 19-26
- Reducing prenatal smoking: the role of state policies.Am J Prev Med. 2012; 43: 34-40
- The impact of tobacco tax cuts on smoking initiation among Canadian young adults.Am J Prev Med. 2006; 30: 474-479
CDC. Reducing tobacco use: a report of the Surgeon General. Atlanta GA: DHHS, 2000.
- Ending the tobacco problem: a blueprint for the nation.National Academies Press, Washington DC2007
- The public health and economic benefits of taxing sugar-sweetened beverages.N Engl J Med. 2009; 361: 1599-1605
- Anti-obesity soda tax fails as lobbyists spend millions: retail.Bloomberg Businessweek. 2010; : 13
Yale Rudd Center for Food Policy & Obesity. Legislation trends: sugar-sweetened beverages/taxes. www.yaleruddcenter.org/legislation/legislation_trends.aspx.
- European nations launch tax attack on unhealthy foods.Can Med Assoc J. 2011; 183: E1229-E1230
- Taxing unhealthy food and drinks to improve health.BMJ. 2012; 344: E2931
French Republic, Ministry of Budget, Public Accounts and Reform of the State. Contributions of drinks and liquids for sugar-sweetened and artificially-sweetened drinks: indirect contributions. Circular 2012. Jan 24. NOR: BCRD 1202351C. . circulaire.legifrance.gouv.fr/pdf/2012/01/cir_34494.pdf
Nielsen ScanTrak Convenience Index. 100 kg Sale Volume. 2011 Jul 17 – 2012 Jul 15.
Pedersen TS, Jensen K, Rørvig M, Legarth M, Mikkelsen BB. Suggestions for a parliamentary resolution on the abolition of tax on saturated fat (the fat tax). www.ft.dk/samling/20121/beslutningsforslag/b3/index.htm.
- Taxes on sugar-sweetened beverages: results from a 2011 national public opinion survey.Am J Prev Med. 2013; 44: 158-163
- Talking about sugar sweetened-beverage taxes: will actions speak louder than words?.Am J Prev Med. 2013; 44: 194-195
- The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food.Am J Public Health. 2010; 100: 216-222
- The influence of taxes and subsidies on energy purchased in an experimental purchasing study.Psychol Sci. 2010; 21: 406-414
- Experimental research on the relation between food price changes and food-purchasing patterns: a targeted review.Am J Clin Nutr. 2012; 95: 789-809
- The impact of price discounts and calorie messaging on beverage consumption: a multi-site field study.Prev Med. 2012; 55: 629-633
Smith T, Lin B, Lee J. Taxing caloric sweetened beverages: potential effects on beverage consumption, calorie intake, and obesity. U.S. Department of Agriculture, Economic Research Service. Economic Research Report No.: ERR–100.
- Soda taxes, soft drink consumption, and children’s body mass index.Health Aff. 2010; 29: 1052-1058
- Food prices and obesity: evidence and policy implications for taxes and subsidies.Milbank Q. 2009; 87: 229-257
- Food taxation and pricing strategies to “thin out” the obesity epidemic.Am J Prev Med. 2006; 30: 430-437
- Food pricing strategies, population diets, and non-communicable disease: a systematic review of simulation studies.PLoS Med. 2012; 9: e1001353
- Ounces of prevention—the public policy case for taxes on sugared beverages.N Engl J Med. 2009; 360: 1805-1808
- Impact of targeted beverage taxes on higher- and lower-income households.Arch Intern Med. 2010; 170: 2028-2034
- Intended and unintended consequences of a proposed national tax on sugar-sweetened beverages to combat the U.S. obesity problem.Health Econ. 2012; 21: 669-694
- A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes.Health Aff. 2012; 31: 199-207
- Exploring a fiscal food policy: the case of diet and ischaemic heart disease.BMJ. 2000; 320: 301-305
- Could targeted food taxes improve health?.J Epidemiol Community Health. 2007; 61: 689-694
- Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue.Prev Med. 2011; 52: 413-416
- Determining the impact of food price and income changes on body weight.J Health Econ. 2008; 27: 45-68
- Salience and taxation: theory and evidence.Am Econ Rev. 2009; 99: 1145-1177
- Youth smoking, cigarette prices, and anti-smoking sentiment.Health Econ. 2008; 17: 733-749
- Optimal defaults and active decisions.Q J Econ. 2009; 124: 1639-1674
Alabama State Board of Education. Alabama’s healthy snack standards for food and beverages at school. 2005. cnp.alsde.edu/NutritionPolicy/AlaHealthySnackStandards.pdf.
State of California. The Pupil Nutrition, Health, and Achievement Act of 2001. SB 19. Article 2.5. Section 49430.
- Pricing and availability intervention in vending machines at four bus garages.J Occup Environ Med. 2010; 52: S29-S33
- The New York City Health and Hospitals Corporation: transforming a public safety net delivery system to achieve higher performance. The Commonwealth Fund..Commission on a High Performance Health System. October 2008;
New York State Department of Health. New York State Minority Health Surveillance Report. 2007 Sep. www.health.ny.gov/statistics/community/minority/docs/surveillance_report_2007.pdf.
- Wartella E. Lichtenstein A. Yaktine A. Nathan R. National Academies Press, Washington DC2011
- Consumer estimation of recommended and actual calories at fast food restaurants.Obesity. 2011; 19: 1971-1978
- E-Z tax: tax salience and tax rates.Q J Econ. 2009; 124: 969-1010
- Obesity and socioeconomic status in adults: U.S. 2005-2008. NCHS data brief No. 50.National Center for Health Statistics, Hyattsville MD2010
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© 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
