An examination of sugar-sweetened beverage tax regulations in six jurisdictions: applying a social justice perspective to beverage taxation and exemptions
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University of Manitoba, Canada
Athabasca University, Canada
University of New Brunswick, Canada
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1656
Background and Objective: Taxes, legislation, and politics are social determinants of health, which impact health through multiple pathways. Globally, sugar-sweetened beverages (SSB) are increasingly taxed as a public health measure, despite criticism that excise taxes are regressive. The purpose of this study was to review laws and regulations regarding taxation of SSB, and describe how various jurisdictions determine applicable taxes to meet their respective legislative objectives. Methods: We reviewed SSB taxation schemes from Berkeley, Mexico, Philadelphia, San Francisco, South Africa, and the United Kingdom. A comparative review of supplementary government documents and academic publications helped differentiate rationales for taxation, exemption or zero-rating of beverages. Beverage categories selected reflect availability of similar beverages in Canada and the US. Results: Several beverage types fell clearly into typically taxed or exempt/zero-rated categories across all six jurisdictions (e.g. pop/soda as taxed and water as zero-rated). However, no two sets of regulations were the same, regardless of having similar legislative objectives – to reduce consumption of SSB. Exemptions and ambiguities within the six jurisdictions can generally be grouped lacking clarity regarding the meaning and use of milk; the meaning of ‘medical purposes’ and ‘supplemental’; the point at which a beverage is ‘prepared’; the form of concentrate (i.e. liquid/frozen/powder) or medium used (e.g. water, coffee); and the location of preparation (e.g. pre-prepared or point-of-sale) or business size of retailer. Conclusions: SSB tax regimes are complex, unclear, vary across jurisdiction, and unexplainably omit from taxation several added-sugar beverage types, potentially risking legal challenge. In addition, other research suggests tax complexity is associated with tax avoidance, diminished perceptions of equity and fairness, and increased regressive tax administrative and compliance costs, potentially amplifying negative impacts of SSB taxation on social determinants of health. Lastly, tax exemptions generally reflect and perpetuate existing, already inequitable, political dynamics within the food system.