Obesity is a growing problem around the world, especially
in the United States. The amount of obese people in our
nation has more than doubled since 1980 and this number is
steadily increasing at a rate of approximately 4-5%.4 A major
contributor to obesity, heart disease, and diabetes is soda.
Although there have been a plethora of proposals on ways
to reduce sugary drink consumption, an article in The New
England Journal of Medicine (NEJM) sparked a nationwide
debate when recommending a one-cent-per-ounce tax on
sugary beverages, roughly a 20% overall increase on the price
of most soda.1 The government involving itself in the regulation
of food through taxation, however, is not the answer. The
causes of the problem are people choosing to eat unhealthy
foods and the easy access of unhealthy foods in lower socioeconomic
environments. Taxes do not address this cause.
A sugar tax would not effectively combat obesity because it
attempts to use a legislative solution for a social and economic
problem. It ignores the social determinants of health-— the
environment and conditions in which people are born, grow,
live, work, and age, which are shaped by the distribution of
money, power and resources at the global, national and local
levels, according to the World Health Organization. It does
not directly address the various reasons why people choose to
drink soda or other sugary beverages, but rather assumes that
beverage choices are exclusively based on price. Two reactions
to an increase in price of unhealthy beverages could occur.
The desired effect would be the reduction of sugary beverage
consumption in favor of the healthier, cheaper options.
However, one must also consider the effect of choosing not
to buy the healthy drinks, like bottled water or natural juice,
in order to save for the better tasting unhealthy drinks, like
energy drinks and soda.
Although the revenue generated from this tax could be
helpful for funding further research related to obesity, the
cost of the tax would outweigh the benefits. People of lower
SES would be unfairly burdened by the tax, and will continue
to buy sugary drinks unless cheaper, healthier alternatives are
also made available. Kelly Brownell, director of Food Policy
and Obesity at Yale, coined the term “toxic food environment”
to describe the “ubiquitous availability of food at outlets
ranging from gas stations and drug stores to bank lobbies
and elementary schools; and the incessant advertising of highfat,
low-nutrition foods,” which has led to the rising obesity
rates.2 A tax is not going to change the “toxic food environment”
and the availability of unhealthy foods, and without
alternatives to unhealthy foods, the tax is not going to alter
consumer behavior either. A more effective solution would be
to subsidize healthier foods, restrict advertising of unhealthy
foods, and improve dietary practices in public schools.
One possible, yet controversial, intervention to reduce
the exorbitant quantity of soda consumed would be similar
to New York City Mayor Michael Bloomberg’s proposal of
eliminating the sale of large sugar-sweetened drinks in any
cup larger than 16 oz. Should a consumer want a 32-oz drink,
he need only buy two 16 oz drinks. No price raise. No taxes.
No elimination of freedom to consume as much as one wants.
Just clever psychology to discourage the ever so easy option of
choosing the extra large drink for a couple cents more.
A public health media campaign to raise awareness about
the health implications of drinks that have a high concentration
of sugar has the potential to change social norms and
behavior related to food choices, similar to the anti-tobacco
campaigns to reduce smoking. Cigarette smoking used to be
considered cool when the health risks were unknown. After
the Fairness Doctrine in 1966, in which the FCC mandated
that the media be used to serve the public interest and portray
both sides of an issue, education about the detrimental health
effects of smoking greatly increased. Through this education,
the public learned about the carcinogenic effects of cigarettes
and the causal link between smoking and lung cancer; the
consumption of cigarettes also greatly decreased as smoking
became considered a stigmatized behavior.3
The relationship between smoking and cancer, however,
is more apparent than that of sugary drinks and heart disease.
Despite the fact that heart disease is the leading cause of
death in America, the threat of cancer is a much scarier and
immediate one. The goal must then be to make Americans
realize the true dangers of consuming soda in large quantities
and to strive to create new social and behavioral norms.
Obesity is a growing problem in the United States. It is the
responsibility of the government to educate the public of the
detrimental health effects of the gluttonous consumption of
sugary drinks. It is not the responsibility of the government
to make an easy buck in the name of public health. Education
is the key to changing the social norms that dictate individual
behavior and consumer choice, not increased taxes. Unless
healthier options are available and there is a shift in the overall
“toxic food environment,” the tax will only hurt the people
it is intended to help.