Last April, I wrote my final submission on my War on Sugar blog series to make room for other meaningful health topics in our CCS Medical blog section. I feel we would be remiss if we didn’t revisit this critical issue to examine recent developments in what we hope will become a national fight against added sugars.
First, a brief recap for those who are new to this issue:
- Added sugars are the #1 cause of type 2 diabetes in the United States, despite government authorities that have pointed the finger at obesity and lack of exercise as the main culprits.
- Type 2 diabetes is reaching EPIDEMIC PROPORTIONS with 29 million Americans – 10% of the population – that are currently diagnosed; 86 million more with prediabetes– and most are not aware of their condition; and GLOBAL projections showing a 54% increase in adults with diabetes by the year 2040.
- If even 1/3 of prediabetics developed type 2, we would have 20% of the American population with type 2 diabetes!
- Given the current polarizing debates on affordable health care, imagine what the increasing health care costs will be if these trends continue unchecked.
- Added sugars are prevalent in the American/Western diet – even in the “healthiest” of packaged foods & beverages. Thanks to an influential sugar industry that is subsidized with our tax dollars, there is little hope of reversing trends in favor of “real health” options at the supermarket without a mass appeal to consumers to vote with their wallets.
A New Hope! New “Sin Taxes” on added sugar beverages have decreased consumption significantly in some US cities.
As a rule I am no fan of any kind of taxes, particularly “sin” taxes for three very straight-forward reasons:
- They are usually not high enough to change behavior, with the notable exception of tobacco. The sin taxes we see on alcohol are relatively minor and has not curbed consumption in any meaningful way.
- They are a regressive tax; thereby disproportionately hurting the poorest in our society.
- Most importantly taxes typically take from highly productive private enterprises or individuals and are then given to wildly unproductive government agencies.
However, when a particular product is having a significantly harmful impact on our society as a whole; where the cost of caring for people who consume these products is burdened by everyone, then there is a greater good that we need to address.
The good news is that a small number of US cities have joined the fight against added sugars in recent years. In 2016, four cities – Boulder, Colorado and San Francisco, Oakland and Albany, California have voted to add excise taxes, ranging from 1-2 cents per ounce on distributors of sugary drinks like soda pop, sports drinks and sweetened ice tea.
It is heartening to see that in all four of these referendums, voters supported the new “sin tax” with more than 70% of the vote in Albany, 62% in San Francisco, almost 61% in Oakland, and 54% in Boulder. In each of these campaigns, the amount of money spent by advocacy groups on both sides of the issue were comparable to many U.S. Senate races.[i]
A similar measure adopted in Philadelphia has resulted in a 50% drop in the consumption of sweet drinks since the tax went into effect last January 1st.[ii] The greatest impact of this tax has come from the size of the drink people are now consuming. Big Gulps and other 64 oz. cups of sugar are now being substituted for more appropriate sized 16 oz. cups. While the response from major brand owners in the soda category has been major layoffs, the city reports an increase of over $5 million in revenues, which has been earmarked for the creation of approximately 250 teaching and support staff positions focused on healthy nutrition.[iii]
The one exception of sin taxes curbing behavior has been in cigarette consumption. Thirty years ago the average smoker would consume over a pack per day. Today, the average smoker consumes a pack every 2 days thanks to sin taxes that raised the cost from $0.45 per pack to a national median price of $6.94/pack, and a high of over $12/pack in states like New York.[vi]
This begs the question – is a 1-2 cent per ounce increase on sugar sweetened beverages enough to curb consumption habits nationally? With regards to the “Philadelphia Story,” one could argue that the huge decrease in consumption is due to the higher rate of lower income populations compared to other communities nationally. The upside to this scenario is that diabetes impacts lower income Americans more profoundly than the rest of us, but I believe that raising the excise tax to 20 cents per ounce would give us the substantial decreases across the board akin to what we have seen with cigarette consumption.
We need to do more to win the war on added sugars by taxing all consumables and the manufacturers themselves.
The sin tax notwithstanding, the most effective anti-smoking element has been the social pressures which has led to laws forbidding smokers from partaking inside public places anymore. The same pressure needs to happen in the fight against added sugars.
While sugar-sweetened beverages are the largest contributor to the American diet – accounting for about 48% of added sugars in the average dietary regime[iv] – there is a plethora of other consumables like doughnuts, candy, cakes, desserts, ice cream snacks, etc. that can satisfy the national addiction to sugar (and yes, there really is an addictive element of sugar). Recognizing and promoting the addictive power of sugar should compel movements to impose excise taxes on all consumer packaged goods utilizing added sugars at the local, state and federal levels.
Therefore, shouldn’t the manufacturers themselves bear a tax on their products knowing full well that their performance in the market depends on the levels of added sugars in their recipes? Maybe they would think twice about adding sugar or sugar substitutes to pizza, bread, yogurt, and a million other everyday items that are now loaded with these flavor sweeteners, if they incurred the wrath of sin taxes comparable to what the tobacco industry has had to endure.
The most alarming statistics are all about consumption. Adult consumption of added sugars has increased by more than 30% over the past 30 years, with the top 20% of adult consumers eating 721 calories from added sugar per day, and the top 20% of child consumers eating an average 673 calories per day from added sugar![v]
It is encouraging to see the developments in the aforementioned cities, and it is a promising start. We still have a long way to go to curb behaviors nationally and to bring significant social pressure throughout more local municipalities, as well as at the state and federal levels, if we are to prevent this pandemic from exploding.