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Assessing the impact of the Barbados sugar-sweetened beverage tax on beverage sales: an observational study.
Int J Behav Nutr Phys Act. 2019 01 30; 16(1):13.IJ

Abstract

BACKGROUND

The World Health Organization has advocated for sugar-sweetened beverage (SSB) taxes as part of a broader non-communicable disease prevention strategy, and these taxes have been recently introduced in a wide range of settings. However, much is still unknown about how SSB taxes operate in various contexts and as a result of different tax designs. In 2015, the Government of Barbados implemented a 10% ad valorem (value-based) tax on SSBs. It has been hypothesized that this tax structure may inadvertently encourage consumers to switch to cheaper sugary drinks. We aimed to assess whether and to what extent there has been a change in sales of SSBs following implementation of the SSB tax.

METHODS

We used electronic point of sale data from a major grocery store chain and applied an interrupted time series (ITS) design to assess grocery store SSB and non-SSB sales from January 2013 to October 2016. We controlled for the underlying time trend, seasonality, inflation, tourism and holidays. We conducted sensitivity analyses using a cross-country control (Trinidad and Tobago) and a within-country control (vinegar). We included a post-hoc stratification by price tertile to assess the extent to which consumers may switch to cheaper sugary drinks.

RESULTS

We found that average weekly sales of SSBs decreased by 4.3% (95%CI 3.6 to 4.9%) compared to expected sales without a tax, primarily driven by a decrease in carbonated SSBs sales of 3.6% (95%CI 2.9 to 4.4%). Sales of non-SSBs increased by 5.2% (95%CI 4.5 to 5.9%), with bottled water sales increasing by an average of 7.5% (95%CI 6.5 to 8.3%). The sensitivity analyses were consistent with the uncontrolled results. After stratifying by price, we found evidence of substitution to cheaper SSBs.

CONCLUSIONS

This study suggests that the Barbados SSB tax was associated with decreased sales of SSBs in a major grocery store chain after controlling for underlying trends. This finding was robust to sensitivity analyses. We found evidence to suggest that consumers may have changed their behaviour in response to the tax by purchasing cheaper sugary drinks, in addition to substituting to untaxed products. This has important implications for the design of future SSB taxes.

Links

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Authors+Show Affiliations

Alvarado M
Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. mra47@cam.ac.uk.
Unwin N
Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Sharp SJ
Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Hambleton I
George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Bridgetown, Barbados.
Murphy MM
Faculty of Medical Sciences, Cave Hill Campus, University of the West Indies, Bridgetown, Barbados.
Samuels TA
George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Bridgetown, Barbados.
Suhrcke M
Centre for Health Economics, University of York, York, UK.
Adams J
Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.

MeSH

AdultBarbadosBeveragesCommerceConsumer BehaviorDietDietary SugarsFood PreferencesHumansSugarsSweetening AgentsTaxes

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30700311

Citation

Alvarado, Miriam, et al. "Assessing the Impact of the Barbados Sugar-sweetened Beverage Tax On Beverage Sales: an Observational Study." The International Journal of Behavioral Nutrition and Physical Activity, vol. 16, no. 1, 2019, p. 13.
Alvarado M, Unwin N, Sharp SJ, et al. Assessing the impact of the Barbados sugar-sweetened beverage tax on beverage sales: an observational study. Int J Behav Nutr Phys Act. 2019;16(1):13.
Alvarado, M., Unwin, N., Sharp, S. J., Hambleton, I., Murphy, M. M., Samuels, T. A., Suhrcke, M., & Adams, J. (2019). Assessing the impact of the Barbados sugar-sweetened beverage tax on beverage sales: an observational study. The International Journal of Behavioral Nutrition and Physical Activity, 16(1), 13. https://doi.org/10.1186/s12966-019-0776-7
Alvarado M, et al. Assessing the Impact of the Barbados Sugar-sweetened Beverage Tax On Beverage Sales: an Observational Study. Int J Behav Nutr Phys Act. 2019 01 30;16(1):13. PubMed PMID: 30700311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessing the impact of the Barbados sugar-sweetened beverage tax on beverage sales: an observational study. AU - Alvarado,Miriam, AU - Unwin,Nigel, AU - Sharp,Stephen J, AU - Hambleton,Ian, AU - Murphy,Madhuvanti M, AU - Samuels,T Alafia, AU - Suhrcke,Marc, AU - Adams,Jean, Y1 - 2019/01/30/ PY - 2018/10/08/received PY - 2019/01/22/accepted PY - 2019/2/1/entrez PY - 2019/2/1/pubmed PY - 2019/8/6/medline KW - Diabetes prevention KW - Evaluation KW - Fiscal policy KW - Obesity prevention KW - Sugar-sweetened beverages SP - 13 EP - 13 JF - The international journal of behavioral nutrition and physical activity JO - Int J Behav Nutr Phys Act VL - 16 IS - 1 N2 - BACKGROUND: The World Health Organization has advocated for sugar-sweetened beverage (SSB) taxes as part of a broader non-communicable disease prevention strategy, and these taxes have been recently introduced in a wide range of settings. However, much is still unknown about how SSB taxes operate in various contexts and as a result of different tax designs. In 2015, the Government of Barbados implemented a 10% ad valorem (value-based) tax on SSBs. It has been hypothesized that this tax structure may inadvertently encourage consumers to switch to cheaper sugary drinks. We aimed to assess whether and to what extent there has been a change in sales of SSBs following implementation of the SSB tax. METHODS: We used electronic point of sale data from a major grocery store chain and applied an interrupted time series (ITS) design to assess grocery store SSB and non-SSB sales from January 2013 to October 2016. We controlled for the underlying time trend, seasonality, inflation, tourism and holidays. We conducted sensitivity analyses using a cross-country control (Trinidad and Tobago) and a within-country control (vinegar). We included a post-hoc stratification by price tertile to assess the extent to which consumers may switch to cheaper sugary drinks. RESULTS: We found that average weekly sales of SSBs decreased by 4.3% (95%CI 3.6 to 4.9%) compared to expected sales without a tax, primarily driven by a decrease in carbonated SSBs sales of 3.6% (95%CI 2.9 to 4.4%). Sales of non-SSBs increased by 5.2% (95%CI 4.5 to 5.9%), with bottled water sales increasing by an average of 7.5% (95%CI 6.5 to 8.3%). The sensitivity analyses were consistent with the uncontrolled results. After stratifying by price, we found evidence of substitution to cheaper SSBs. CONCLUSIONS: This study suggests that the Barbados SSB tax was associated with decreased sales of SSBs in a major grocery store chain after controlling for underlying trends. This finding was robust to sensitivity analyses. We found evidence to suggest that consumers may have changed their behaviour in response to the tax by purchasing cheaper sugary drinks, in addition to substituting to untaxed products. This has important implications for the design of future SSB taxes. SN - 1479-5868 UR - https://www.unboundmedicine.com/medline/citation/30700311/Assessing_the_impact_of_the_Barbados_sugar_sweetened_beverage_tax_on_beverage_sales:_an_observational_study_ DB - PRIME DP - Unbound Medicine ER -