Taxes on Soda Change Sales and People’s Perceptions

Remember when cigarettes were guilty pleasures featured in films and marketed to millions? It was all so glorious until taxes on cigarettes were raised by lawmakers and voters and lots of money went towards public education platforms about the harms of smoking.

Years of news coverage highlighted how cigarettes were dangerous and addictive while companies took huge steps to cover the risks and recruit more users. This resulted in making it less cool and acceptable to smoke and led to historic lows in cigarette use, particularly in minors.

According to new research from UC Berkeley, sugar-sweetened beverages may face a similar fate. Berkeley's first-in-the-nation tax on soda a decade ago, plus more recent Bay Area tax hikes on sugar-sweetened drinks, have led to reduced sales. In addition, the taxes are associated with significant changes in social norms and beliefs about the healthfulness of sweet drinks, said Kristine A. Madsen, a professor at UC Berkeley's School of Public Health and senior author of a paper published Nov. 25 in the journal BMC Public Health.

In just a few years, taxes along with heightened media attention significantly impacted the public's overall attitudes toward sugar-sweetened beverages, which include sodas, certain juices, and sports drinks. Madsen notes, “Such a shift in the informal rules surrounding how people think and act could have major implications for public health efforts more broadly.”

"Social norms are really powerful. The significant shift we saw in how people are thinking about sugary drinks demonstrates what else we could do," Madsen said. "We could reimagine a healthier food system. It starts with people thinking, 'Why drink so much soda?' But what if we also said, 'Why isn't most of the food in our grocery stores food that makes us healthy?'"

Surveys from 9,128 people living in lower-income neighborhoods in Berkeley, Oakland, San Francisco, and Richmond were evaluated by Madsen and colleagues from UC San Francisco and UC Davis. Using data from 2016 to 2019 and 2021, they examined annual trends in people's attitudes about sugar-sweetened beverages.

The goal was to understand how the Bay Area taxes might have impacted social norms when it came to sugary drinks. These included the unwritten and often unspoken rules that affect the food and drinks we purchase, the clothes we wear, and our habits at the dinner table. While social norms are invisible, they are very powerful forces on our actions and behaviors. This is evident when consumers buy something after an influencer promotes it on social platforms like TikTok or Instagram.

Questions about what people thought about their neighbors having soda, sports beverages, or fruity drinks were asked by the researchers. Subjects also ranked how healthy many drinks were, which indicated their own beliefs regarding the beverages.

The researchers discovered a 28% drop in the social acceptance of drinking sugar-sweetened beverages.

After the tax increase, positive thoughts of peers’ intake of sports drinks dropped in Oakland compared to other cities. In San Francisco, beliefs about the healthfulness of sugar-sweetened fruit beverages were also reduced.

If people thought their neighbors were drinking less sugar-sweetened drinks, this altered their interest in drinking soda, juices, and sports beverages.

"What it means when social norms change is that people say, 'Gosh, I guess we don't drink soda. That's just not what we do. Not as much. Not all the time,'" Madsen said. "And that's an amazing shift in mindsets."

This study is the newest from UC Berkeley that evaluates how intake patterns have changed in the decade since Berkeley enforced the nation's first soda tax. A study from 2016 showed a decline in soda consumption and increased intake of water while a 2019 study found a large drop in consumption of sugar-sweetened drinks. Previously in 2024, researchers from Berkeley discovered that sweetened beverage sales dramatically dropped, and continuously in five major US cities once taxes were introduced.

Madsen notes, “The penny-per-ounce tax on beverages, which is levied on distributors of sugary drinks -- who ultimately pass that cost of doing business on to consumers -- is an important means of communicating about health with the public”.

Researchers counted over 700 media stories about sugar-sweetened beverage taxes during the study period. That degree of messaging had a major impact on public awareness and norms. Madsen notes that taxes on sugary drinks worked similarly to public efforts to reduce cigarette smoking. These interventions can result in individual actions.

"If we change our behaviors, the environment follows," Madsen said. "While policy really matters and is incredibly important, we as individuals have to advocate for a healthier food system." 1

Here’s how you can encourage clients to kick the can:

·         Model good behavior. If you don’t want your family to drink soft drinks, don’t have them in the house or drink them in front of your kids. 2

·  Promote and provide nutrition education about the hazards of sugar-sweetened beverages to coaches, teachers, and other persons serving these drinks.

·         Water is free! Highlight the excessive cost of soda, sports drinks, and fruit beverages.

·         Discuss the environmental impact of canned and bottled drinks.

·         Remind clients about the health effects of soda consumption including obesity, diabetes, fatty liver disease, and certain types of cancer. 3, 4

·         Review the impact of soft drink consumption and mental health conditions such as depression. 5

·         Treat yourself to a reusable water bottle to reduce reliance on bottled drinks.

·         Swap sugar-sweetened beverages for unsweetened seltzer water if you like carbonation.

·         Suggest wedges of lemons, limes, or oranges to water for flavor.

·         Discourage the use of sports drinks for short-duration sports such as baseball, softball, or soccer in children. 6

Lisa Andrews, MEd, RD, LD

References:

1. Emily Altman, Dean Schillinger, Sofia Villas-Boas, Laura Schmidt, Jennifer Falbe, Kristine A. Madsen. De-normalizing sugar-sweetened beverage consumption: effects of tax measures on social norms and attitudes in the California Bay Area. BMC Public Health, 2024; 24 (1) DOI: 10.1186/s12889-024-20781-6

2. Mekonnen T, Papadopoulou E, Lien N, Andersen LF, Pinho MGM, Havdal HH, Andersen OK, Gebremariam MK. Mediators of parental educational differences in the intake of carbonated sugar-sweetened soft drinks among adolescents, and the moderating role of neighbourhood income. Nutr J. 2023 Sep 11;22(1):43. doi: 10.1186/s12937-023-00872-7. PMID: 37697383; PMCID: PMC10494387.

3. Ferretti F, Mariani M, Sarti E. Is the development of obesogenic food environments a self-reinforcing process? Evidence from soft drink consumption. Global Health. 2021 Aug 18;17(1):91. doi: 10.1186/s12992-021-00735-y. PMID: 34407853; PMCID: PMC8371432.

4. Peng X, Li J, Zhao H, Lai J, Lin J, Tang S. Lifestyle as well as metabolic syndrome and non-alcoholic fatty liver disease: an umbrella review of evidence from observational studies and randomized controlled trials. BMC Endocr Disord. 2022 Apr 10;22(1):95. doi: 10.1186/s12902-022-01015-5. PMID: 35399069; PMCID: PMC8996397.

5. Kim JM, Lee E. Association between Soft-Drink Intake and Obesity, Depression, and Subjective Health Status of Male and Female Adults. Int J Environ Res Public Health. 2021 Oct 3;18(19):10415. doi: 10.3390/ijerph181910415. PMID: 34639714; PMCID: PMC8507828.

6. Maloney EK, Bleakley A, Stevens R, Ellithorpe M, Jordan A. Urban Youth Perceptions of Sports and Energy Drinks: Insights for Health Promotion Messaging. Health Educ J. 2023 Apr;82(3):324-335. doi: 10.1177/00178969231157699. Epub 2023 Feb 28. PMID: 37223247; PMCID: PMC10205042.