Cost Effectiveness Of A Sugar-Sweetened Beverage Excise Tax In The Us printable pdf download

Cost Effectiveness of a Sugar-Sweetened

Beverage Excise Tax in the U.S.

Michael W. Long, ScD, Steven L. Gortmaker, PhD, Zachary J. Ward, MPH, Stephen C. Resch, PhD,

Marj L. Moodie, DrPH, Gary Sacks, PhD, Boyd A. Swinburn, MD, Rob C. Carter, PhD,

Y. Claire Wang, MD, ScD

Introduction:

Reducing sugar-sweetened beverage consumption through taxation is a promising

public health response to the obesity epidemic in the U.S. This study quantiﬁes the expected health

and economic beneﬁts of a national sugar-sweetened beverage excise tax of $0.01/ounce over

10 years.

Methods:

A cohort model was used to simulate the impact of the tax on BMI. Assuming ongoing

implementation and effect maintenance, quality-adjusted life-years gained and disability-adjusted

life-years and healthcare costs averted were estimated over the 2015–2025 period for the 2015 U.S.

population. Costs and health gains were discounted at 3% annually. Data were analyzed in 2014.

Implementing the tax nationally would cost $51 million in the ﬁrst year. The tax would

Results:

reduce sugar-sweetened beverage consumption by 20% and mean BMI by 0.16 (95% uncertainty

interval [UI]¼0.06, 0.37) units among youth and 0.08 (95% UI¼0.03, 0.20) units among adults in

the second year for a cost of $3.16 (95% UI¼$1.24, $8.14) per BMI unit reduced. From 2015 to 2025,

the policy would avert 101,000 disability-adjusted life-years (95% UI¼34,800, 249,000); gain 871,000

quality-adjusted life-years (95% UI¼342,000, 2,030,000); and result in $23.6 billion (95% UI¼$9.33

billion, $54.9 billion) in healthcare cost savings. The tax would generate $12.5 billion in annual

revenue (95% UI¼$8.92, billion, $14.1 billion).

Conclusions:

The proposed tax could substantially reduce BMI and healthcare expenditures and

increase healthy life expectancy. Concerns regarding the potentially regressive tax may be addressed

by reduced obesity disparities and progressive earmarking of tax revenue for health promotion.

(Am J Prev Med 2015;49(1):112–123) & 2015 American Journal of Preventive Medicine

1–4

Introduction

beverages (SSBs) compared to 30 years ago.

Observa-

tional studies and RCTs have linked SSB consumption to

lthough consumption has declined in recent

excess weight gain, diabetes, and cardiovascular disease.

years, children and adults in the U.S. consume

Consumption of SSBs increases the risk of chronic

twice as many calories from sugar-sweetened

diseases through its impact on BMI and other mecha-

5,6

nisms.

The Dietary Guidelines for Americans, 2010

recommend that individuals reduce intake of SSBs in

From the Department of Social and Behavioral Sciences (Long, Gort-

order to manage their body weight.

maker), Center for Health Decision Science (Ward, Resch), Harvard T.H.

Drawing on the success of tobacco taxation and

Chan School of Public Health, Boston, Massachusetts; Department of

Health Policy and Management (Wang), Mailman School of Public Health,

8–10

decades of economic research,

public health experts

Columbia University, New York, New York; Deakin Health Economics

have called for higher taxes on unhealthy food and

(Moodie, Carter), WHO Collaborating Centre for Obesity Prevention

9,11

beverages.

In 2009, the IOM recommended that local

(Sacks, Swinburn), Deakin University, Melbourne, Victoria, Australia; and

Section of Epidemiology and Biostatistics, the School of Population Health

governments implement tax strategies to reduce con-

(Swinburn), University of Auckland, New Zealand

sumption of “calorie-dense, nutrient-poor foods,”

Address correspondence to: Michael W. Long, ScD, Department of

emphasizing SSBs as an appropriate target for taxation.

Social and Behavioral Sciences, Harvard T.H. Chan School of Public

Health, 677 Huntington Ave., Bldg 3, Fl 7, Boston MA 02115. E-mail:

As of January 2014, a total of 34 states applied a sales tax

michael.long@mail.harvard.edu.

on carbonated beverages, with an average tax rate of

0749-3797/$36.00

5.2%.

In 2013, one city and 12 states considered

& 2015 American Journal of Preventive Medicine

112 Am J Prev Med 2015;49(1):112–123

Published by Elsevier Inc.

Cost Effectiveness Of A Sugar-Sweetened Beverage Excise Tax In The Us

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