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1.
PLoS One ; 19(5): e0302928, 2024.
Article in English | MEDLINE | ID: mdl-38713718

ABSTRACT

This paper analyzes how emigration impacts fiscal gap of population-exporting region in the long term. We construct a general equilibrium model of emigration and fiscal gap and make empirical verification using two-step system GMM model. Among the major lessons from this work, five general and striking results are worth highlighting: (1) the economic losses of emigration are the immediate cause of widening the fiscal gap. (2) in the short and long term, emigration can expand the fiscal revenue gap through the superimposed effect of tax rate and tax base. (3) the gap in fiscal expenditure is widened by the outflow of people in the short term. However, local governments would change the strategy to keep the spending gap from widening in the long run. (4) a positive impact of emigration on the fiscal gap. the more severe population emigration, the larger the fiscal gap. (5) when the trend of emigration becomes irreversible, the subsequent efforts of local governments to expand fiscal expenditure for attraction population would not only fail to revive the regional economy, but aggravate the expansion of fiscal gap. The contribution of research is twofold. On the one hand, it fills the theoretical gap between emigration and fiscal gap because previous studies have paid little attention to the fiscal problems of local government of population outflow. On the other hand, the selection of Northeast China that has been subject to long-term out-of-population migration is good evidence to verify this theory, which is tested very well using the 2S-GMM model. The comprehensive discussion on the relationship between emigration and fiscal gap is helpful to guide those continuous population-exporting regions that are facing a huge fiscal gap how to solve the fiscal gap and unsustainability from the perspective of fiscal revenue and expenditure.


Subject(s)
Emigration and Immigration , Humans , China , Population Dynamics , Taxes/economics
2.
PLoS One ; 19(5): e0303328, 2024.
Article in English | MEDLINE | ID: mdl-38771837

ABSTRACT

In recent decades, policy initiatives involving increases in the tobacco tax have increased pressure on budget allocations in poor households. In this study, we examine this issue in the context of the expansion of the social welfare state that has taken place over the last two decades in several emerging economies. This study explores the case of Colombia between 1997 and 2011. In this period, the budget share of the poorest expenditure quintile devoted to tobacco products of smokers' households doubled. We analyse the differences between the poorest and richest quintiles concerning the changes in budget shares, fixing a reference population over time to avoid demographic composition confounders. We find no evidence of crowding-out of education or healthcare expenditures. This is likely to be the result of free universal access to health insurance and basic education for the poor. For higher-income households, tobacco crowds out expenditures on entertainment, leisure activities, and luxury expenditures. This finding should reassure policymakers who are keen to impose tobacco taxes as an element of their public health policy.


Subject(s)
Health Expenditures , Tobacco Products , Colombia , Humans , Tobacco Products/economics , Health Expenditures/statistics & numerical data , Socioeconomic Factors , Taxes/economics , Family Characteristics , Male , Female , Income/statistics & numerical data
3.
Tob Control ; 33(Suppl 1): s27-s33, 2024 May 02.
Article in English | MEDLINE | ID: mdl-38697660

ABSTRACT

BACKGROUND: Across time, geographies and country income levels, smoking prevalence is highest among people with lower incomes. Smoking causes further impoverishment of those on the lower end of the income spectrum through expenditure on tobacco and greater risk of ill health. METHODS: This paper summarises the results of investment case equity analyses for 19 countries, presenting the effects of increased taxation on smoking prevalence, health and expenditures. We disaggregate the number of people who smoke, smoking-attributable mortality and cigarette expenditures using smoking prevalence data by income quintile. A uniform 30% increase in price was applied across countries. We estimated the effects of the price increase on smoking prevalence, mortality and cigarette expenditures. RESULTS: In all but one country (Bhutan), a one-time 30% increase in price would reduce smoking prevalence by the largest percent among the poorest 20% of the population. All income groups in all countries would spend more on cigarettes with a 30% increase in price. However, the poorest 20% would pay an average of 12% of the additional money spent. CONCLUSIONS: Our results confirm that health benefits from increases in price through taxation are pro-poor. Even in countries where smoking prevalence is higher among wealthier groups, increasing prices can still be pro-poor due to variable responsiveness to higher prices. The costs associated with higher smoking prevalence among the poor, together with often limited access to healthcare services and displaced spending on basic needs, result in health inequality and perpetuate the cycle of poverty.


Subject(s)
Commerce , Smoking , Taxes , Tobacco Products , Humans , Taxes/economics , Taxes/statistics & numerical data , Tobacco Products/economics , Prevalence , Commerce/statistics & numerical data , Commerce/economics , Smoking/epidemiology , Smoking/economics , World Health Organization , Income/statistics & numerical data , Health Expenditures/statistics & numerical data , Smoking Prevention/methods , Smoking Prevention/economics , Poverty/statistics & numerical data
4.
Health Policy ; 144: 105076, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38692186

ABSTRACT

INTRODUCTION: Economic evaluations of public health interventions like sugar-sweetened beverage (SSB) taxes face difficulties similar to those previously identified in other public health areas. This stems from challenges in accurately attributing effects, capturing outcomes and costs beyond health, and integrating equity effects. This review examines how these challenges were addressed in economic evaluations of SSB taxes. METHODS: A systematic review was conducted to identify economic evaluations of SSB taxes focused on addressing obesity in adults, published up to February 2021. The methodological challenges examined include measuring effects, valuing outcomes, assessing costs, and incorporating equity. RESULTS: Fourteen economic evaluations of SSB taxes were identified. Across these evaluations, estimating SSB tax effects was uncertain due to a reliance on indirect evidence that was less robust than evidence from randomised controlled trials. Health outcomes, like quality-adjusted life years, along with a healthcare system perspective for costs, dominated the evaluations of SSB taxes, with a limited focus on broader non-health consequences. Equity analyses were common but employed significantly different approaches and exhibited varying degrees of quality. CONCLUSION: Addressing the methodological challenges remains an issue for economic evaluations of public health interventions like SSB taxes, suggesting the need for increased attention on those issues in future studies. Dedicated methodological guidelines, in particular addressing the measurement of effect and incorporation of equity impacts, are warranted.


Subject(s)
Cost-Benefit Analysis , Obesity , Sugar-Sweetened Beverages , Taxes , Taxes/economics , Humans , Sugar-Sweetened Beverages/economics , Obesity/economics , Public Health/economics , Quality-Adjusted Life Years
5.
Health Policy Plan ; 39(5): 509-518, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38668636

ABSTRACT

This study determined the feasibility of investing revenues raised through Nigeria's sugar-sweetened beverage (SSB) tax of 10 Naira/l to support the implementation of the National, Surgical, Obstetrics, Anaesthesia and Nursing Plan, which aims to strengthen access to surgical care in the country. We conducted a mixed-methods political economy analysis. This included a modelling exercise to predict the revenues from Nigeria's SSB tax based on its current tax rate over a period of 5 years, and for several scenarios such as a 20% ad valorem tax recommended by the World Health Organization. We performed a gap analysis to explore the differences between fiscal space provided by the tax and the implementation cost of the surgical plan. We conducted qualitative interviews with key stakeholders and performed thematic analyses to identify opportunities and barriers for financing surgery through tax revenues. At its current rate, the SSB tax policy has the potential to generate 35 914 111 USD in year 1, and 189 992 739 USD over 5 years. Compared with the 5-year adjusted surgical plan cost of 20 billion USD, the tax accounts for ∼1% of the investment required. There is a substantial scope for further increases in the tax rate in Nigeria, yielding potential revenues of up to 107 663 315 USD, annually. Despite an existing momentum to improve surgical care, there is no impetus to earmark sugar tax revenues for surgery. Primary healthcare and the prevention and treatment of non-communicable diseases present as the most favoured investment areas. Consensus within the medical community on importance of primary healthcare, along the recent government transition in Nigeria, offers a policy window for promoting a higher SSB tax rate and an adoption of other sin taxes to generate earmarked funds for the healthcare system. Evidence-based advocacy is necessary to promote the benefits from investing into surgery.


Subject(s)
Taxes , Taxes/economics , Nigeria , Humans , Sugar-Sweetened Beverages/economics , Health Policy , Politics , Surgical Procedures, Operative/economics
6.
Int J Drug Policy ; 127: 104408, 2024 May.
Article in English | MEDLINE | ID: mdl-38631249

ABSTRACT

INTRODUCTION: While cigarette taxes are a vital tobacco control tool, their impact on cigarette tax revenue has been largely understudied in the extant literature. This study examines how the level of cigarette taxes affects the revenue generated from cigarettes in the United States over a thirty-year period. METHODS: We obtained the Tax Burden Data from the Centers for Disease Control and Prevention (1989-2019). Our dependent variables were gross cigarette tax revenue and per capita gross cigarette tax revenue, and our independent variable was state tax per pack. We used two-way fixed effects to estimate the relationship between state cigarette tax revenue and cigarette taxes, adjusting for state-level sociodemographic characteristics, state-fixed effects, and time trends. RESULTS: The study reveals that raising cigarette state tax by 10 % led to a 7.2 % to 7.5 % increase in cigarette tax revenue. We also found state and regional variation in taxes and revenue, with the Northeast region having the highest taxes per pack and tax revenues. In 2019, most states had low or moderate taxes per pack and tax revenues per capita, while a few states had high taxes per pack and tax revenues per capita. CONCLUSIONS: Our research demonstrates the positive impact of increased cigarette taxes on state tax revenue over three decades. Not only do higher taxes aid in tobacco control, but they also enhance state revenues that can be reinvested in state initiatives. Some states could potentially optimize their tax rates.


Subject(s)
Taxes , Tobacco Products , Taxes/economics , Tobacco Products/economics , Tobacco Products/legislation & jurisprudence , Humans , United States , Commerce/economics , Commerce/statistics & numerical data , Commerce/legislation & jurisprudence , Commerce/trends , State Government , Public Policy , Smoking/economics , Smoking/epidemiology
7.
Public Health ; 231: 116-123, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38677098

ABSTRACT

OBJECTIVES: Evidence suggests that cigarette costs significantly impact tobacco use, yet the effect of state-level cost variations on cigarette sales per capita in the US remains uncertain. This study investigates how state-level cigarette costs affect pack sales per capita consumption. STUDY DESIGN: This was an observational study of cigarette-pack sales per capita consumption in the United States. METHODS: We used the tobacco tax burden data (1989-2019) and a two-way fixed-effects model to analyse how cigarette costs affect consumption. Our predictor variables were average cost per pack, state tax per pack, and combined federal and state tax as a percentage of the retail price. Additionally, we compared the percentage change in state cigarette taxes per pack for each state in five-year intervals, adjusting for inflation. RESULTS: Regression analysis revealed that a 10% increase in the average cost per pack was related to a 9.59% decrease in per capita cigarette consumption (ß_average cost = -0.959, P < 0.001). Similarly, a rise in state tax per pack and a higher tax as a proportion of the retail price per pack were related to a decline in consumption (ß_ state tax = -0.176, P < 0.001), (ß_retail price = -0.323, P < 0.001). States that raised cigarette taxes beyond the rate of inflation had a higher reduction in cigarette per capita sales than those maintaining stable tax rates. CONCLUSIONS: Some states have not raised their cigarette taxes sufficiently to account for inflation. It appears that cigarette costs have significantly reduced cigarette consumption in the US.


Subject(s)
Commerce , Taxes , Tobacco Products , United States , Tobacco Products/economics , Tobacco Products/statistics & numerical data , Humans , Taxes/statistics & numerical data , Taxes/economics , Commerce/statistics & numerical data , Commerce/economics , Smoking/epidemiology , Smoking/economics
9.
Nat Hum Behav ; 8(4): 657-667, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38374443

ABSTRACT

The COVID-19 pandemic put families in the United States under financial stress. The federal government's largest response in 2021 was the American Rescue Plan Act, which temporarily expanded the Child Tax Credit (CTC) into a large, unconditional child allowance providing monthly payments to families with children. This study investigates consumption responses to the CTC expansion using anonymized mobile-location data and debit/credit card data that track visits and spending at 1.3 million establishments across US counties. For identification, we exploit variation in the size of households' income gains due to the CTC across counties in a difference-in-differences framework spanning January 2021 to May 2022. Counties benefiting most from the CTC expansion experienced larger increases in visits to childcare centres and health- and personal-care establishments, and increased visits to and spending per transaction at grocery and general stores. These findings suggest that the CTC expansion increased household consumption and spending on children.


Subject(s)
COVID-19 , Humans , United States , COVID-19/epidemiology , COVID-19/economics , Child , Income/statistics & numerical data , Taxes/economics , Family Characteristics , Child, Preschool , Financial Stress
10.
Int J Drug Policy ; 126: 104372, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38422713

ABSTRACT

BACKGROUND: While a growing number of studies examined the effect of e-cigarette (EC) excise taxes on tobacco use behaviors using cross-sectional surveys or sales data, there are currently no studies that evaluate the impact of EC taxes on smoking and vaping transitions. METHODS: Using data from the US arm of the 2016-2020 International Tobacco Control Four Country Smoking and Vaping Survey (ITC 4CV), we employed a multinomial logit model with two-way fixed effects to simultaneously estimate the impacts of cigarette/EC taxes on the change in smoking and vaping frequencies. RESULTS: Our benchmark model suggests that a 10 % increase in cigarette taxes led to an 11 % reduction in smoking frequencies (p < 0.01), while EC taxes did not have a significant effect on smoking frequencies. CONCLUSION: Our findings suggest that increasing cigarette taxes may serve as an effective means of encouraging people who smoke to cut back on smoking or quit smoking. The impact of increasing EC taxes on smoking transitions is less certain at this time.


Subject(s)
Electronic Nicotine Delivery Systems , Taxes , Vaping , Humans , Taxes/economics , Vaping/epidemiology , Vaping/economics , United States , Electronic Nicotine Delivery Systems/economics , Electronic Nicotine Delivery Systems/statistics & numerical data , Adult , Male , Cross-Sectional Studies , Female , Smoking/epidemiology , Smoking/economics , Tobacco Products/economics , Surveys and Questionnaires , Young Adult , Adolescent , Middle Aged , Smoking Cessation/economics , Smoking Cessation/statistics & numerical data , Cigarette Smoking/economics , Cigarette Smoking/epidemiology
11.
PLoS One ; 18(10): e0293117, 2023.
Article in English | MEDLINE | ID: mdl-37878645

ABSTRACT

Financial subsidies and tax incentives play essential roles in the innovation efficiency of enterprises. This paper selects Chinese listed NEV enterprises from 2010 to 2022 as a research sample and investigates various impacts under various circumstances. We find that both financial subsidies and tax incentives can promote the innovation efficiency of NEV enterprises. Compared to financial subsidies, tax incentives are more effective; the interaction between financial subsidies and tax incentives has a weaker impact on the innovation efficiency of NEV enterprises. Both financial subsidies and tax incentives have more potent innovation effects on enterprises with higher financing constraints. In addition, financial subsidies and tax incentives have a stronger innovation efficiency effect on private enterprises than state-owned enterprises. Further research shows that marketization and market distortion affect the innovation efficiency of NEV enterprises. This study provides a new perspective for understanding the effects of financial subsidies, tax incentives, and innovation efficiency of NEV enterprises, and the conclusions and suggestions are relevant references for the government to improve the quality of policy-making.


Subject(s)
Financing, Government , Motor Vehicles , Organizational Innovation , Taxes , China , Government , Motivation , Financing, Government/economics , Taxes/economics , Organizational Innovation/economics , Energy-Generating Resources/economics
12.
Environ Sci Pollut Res Int ; 30(40): 92568-92580, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37491497

ABSTRACT

Green innovation is a strategic choice for Chinese enterprises to achieve in balancing economic performance and environmental benefits. Environmental protection tax (EPT) is the first green tax in China. How to fully leverage the institutional dividends of environmental tax reform to achieve green innovation in enterprises is of great significance for the high-quality development of China's current economy. This study takes the levy of environmental protection taxes as the quasi-natural experiment and uses DID, DDD, PSM-DID and so on to verify the impact of EPT on green innovation. The results show that EPT can improve green innovation through the path of legitimacy pressure and legitimacy management. Notably, the effects are more obvious in enterprises with non-state-owned, low-financing constraints and located in the eastern region. Furthermore, green innovations under the push of environmental protection tax can improve long-term performance, while it has a negative effect on short-term performance. The levy of EPT has the dual dividend effect of economy and environment. Moreover, this study explores the source of the legitimacy pressure and the strategic response of enterprises and provides guidance for government's precise implementation of policies to optimize the role of EPT in green innovation.


Subject(s)
Conservation of Natural Resources , Sustainable Development , Taxes , China , Conservation of Natural Resources/economics , Conservation of Natural Resources/legislation & jurisprudence , Taxes/economics , Taxes/legislation & jurisprudence , Sustainable Development/economics , Sustainable Development/legislation & jurisprudence
14.
Environ Sci Pollut Res Int ; 30(34): 82760-82769, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37335508

ABSTRACT

The idea that energy taxes and innovation may contribute to lowering greenhouse gas emissions and fostering the development of a more sustainable energy future is gaining popularity. Therefore, the study's main goal is to explore the asymmetric impact of energy taxes and innovation on CO2 emissions in China by employing linear and nonlinear ARDL econometric methods. The outcomes of the linear model demonstrate that long-term increases in energy taxes, energy technological innovation, and financial development cause CO2 emissions to reduce, while increases in economic development cause CO2 emissions to climb. Similarly, energy taxes and energy technological innovation cause CO2 emissions to fall in the short run, while financial development promotes CO2 emissions. On the other hand, in the nonlinear model, the positive energy changes, positive energy innovation changes, financial development, and human capital help reduce the long-run CO2 emissions, and economic development increase the CO2 emissions. In the short run, the positive energy and innovation changes are negatively and significantly connected to CO2 emissions, while financial development is positively linked to CO2 emissions. The negative energy innovation changes are insignificant in both the short and long run. Therefore, Chinese policymakers should try to promote energy taxes and innovations as tools to achieve green sustainability.


Subject(s)
Carbon Dioxide , Economic Development , Renewable Energy , Sustainable Development , Taxes , Carbon Dioxide/analysis , China , Renewable Energy/economics , Taxes/economics , Sustainable Development/economics
15.
PLoS One ; 16(12): e0261342, 2021.
Article in English | MEDLINE | ID: mdl-34914798

ABSTRACT

In 2016, China implemented an environmental protection tax (EPTL2016) to promote the transformation and upgrading of heavily polluting industries through tax leverage. Using panel data of China's listed companies, this study assesses the treatment effects of the EPTL2016 on the transformation and upgrading of heavily polluting firms by incorporating the intermediary role of the financial market. The empirical findings show that the EPTL2016 significantly reduced the innovation investment and productivity of heavily polluting firms but had no significant effect on fixed-asset investment. Additionally, EPTL2016 reduced the supply of bank loans to heavily polluting firms and increased the value of growth options for private enterprises and the efficiency of the supply of long-term loans to heavily polluting firms. Although the environmental policy of EPTL2016 benefits the transformation and upgrading of heavily polluting industries in many aspects, it generally hinders the industrial upgrading because of the reduction of bank loans.


Subject(s)
Environmental Policy/economics , Environmental Pollution/prevention & control , Taxes/economics , China , Commerce/legislation & jurisprudence , Conservation of Natural Resources/economics , Conservation of Natural Resources/methods , Environmental Policy/trends , Environmental Pollutants/economics , Environmental Pollution/economics , Metallurgy/legislation & jurisprudence , Private Sector/legislation & jurisprudence , Taxes/trends
16.
JAMA Netw Open ; 4(11): e2132271, 2021 11 01.
Article in English | MEDLINE | ID: mdl-34739061

ABSTRACT

Importance: Adults and children routinely exceed recommended intake amounts of added sugars established by dietary guidelines. Taxes are used as a policy tool to reduce demand for sugar-sweetened beverages (SSBs) given consumption-related adverse health outcomes but may induce substitution to other sources of added sugars. Objective: To examine the extent to which changes in grams of sugar sold from taxed beverages may be offset by changes in grams of sugar sold from untaxed beverages, sweets, and stand-alone sugar after the implementation of the Seattle, Washington, Sweetened Beverage Tax (SBT) on January 1, 2018. Design, Setting, and Participants: This study used difference-in-differences analyses to examine changes in grams of sugar sold from taxed and untaxed products in Seattle compared with Portland, Oregon, at year 1 and year 2 post tax. This study used Nielsen scanner data from supermarkets and mass merchandise as well as grocery, drug, convenience, and dollar stores on unit sales and measurements for beverage and food product universal product codes (UPCs) for each site for the pretax period (January 8-December 30, 2017) and the corresponding weeks in year 1 post tax (2018) and in year 2 post tax (2019). Nutritional analyses assessed grams of sugar for each UPC. The analytical balanced sample included 1326 taxed beverage UPCs, 239 untaxed beverage UPCs, 2054 sweets UPCs, and 81 stand-alone sugar UPCs. Statistical analysis was performed from January to August 2021. Exposures: Implementation of the Seattle SBT. Main Outcomes and Measures: Changes in grams of sugar sold from taxed beverages, untaxed beverages, sweets, and stand-alone sugar. Results: At both year 1 and year 2 post tax in Seattle compared with Portland, grams of sugar sold from taxed beverages decreased 23% (year 2 posttax ratio of incidence rate ratios [RIRR] = 0.77; 95% CI, 0.73-0.80). Sugar sold from untaxed beverages increased at year 1 post tax by 4% (RIRR = 1.04; 95% CI, 1.00-1.07) with no change at year 2 post tax. Sugar sold from sweets increased by 4% at both year 1 and year 2 post tax (year 2 posttax RIRR = 1.04; 95% CI, 1.03-1.06). There were no changes in stand-alone sugar sold. Conclusions and Relevance: This study using difference-in-differences analysis found a net 19% reduction in grams of sugar sold from taxed SSBs at year 2 post tax after accounting for changes in sugar sold from untaxed beverages, sweets, and stand-alone sugar. These results suggest that SSB taxes may effectively yield permanent reductions in added sugars sold from SSBs in food stores.


Subject(s)
Sugar-Sweetened Beverages/economics , Sugars/economics , Taxes/economics , Taxes/statistics & numerical data , Beverages , Commerce , Humans , Washington
17.
PLoS One ; 16(11): e0259210, 2021.
Article in English | MEDLINE | ID: mdl-34739507

ABSTRACT

BACKGROUND: Tobacco consumption is one of the leading causes of preventable death. In this study, we analyze whether someone's genetic predisposition to smoking moderates the response to tobacco excise taxes. METHODS: We interact polygenic scores for smoking behavior with state-level tobacco excise taxes in longitudinal data (1992-2016) from the US Health and Retirement Study (N = 12,058). RESULTS: Someone's genetic propensity to smoking moderates the effect of tobacco excise taxes on smoking behavior along the extensive margin (smoking vs. not smoking) and the intensive margin (the amount of tobacco consumed). In our analysis sample, we do not find a significant gene-environment interaction effect on smoking cessation. CONCLUSIONS: When tobacco excise taxes are relatively high, those with a high genetic predisposition to smoking are less likely (i) to smoke, and (ii) to smoke heavily. While tobacco excise taxes have been effective in reducing smoking, the gene-environment interaction effects we observe in our sample suggest that policy makers could benefit from taking into account the moderating role of genes in the design of future tobacco control policies.


Subject(s)
Smoking Cessation/psychology , Smoking Prevention/methods , Smoking/genetics , Databases, Factual , Genetic Predisposition to Disease , Humans , Nicotine/adverse effects , Nicotine/economics , Public Policy/economics , Smoking/economics , Smoking/psychology , Smoking Cessation/economics , Smoking Prevention/economics , Taxes/economics , Taxes/trends , Nicotiana/adverse effects , Tobacco Industry/trends , Tobacco Products , Tobacco Smoking/psychology , Tobacco Use/economics , United States
18.
JAMA Pediatr ; 175(12): 1261-1268, 2021 12 01.
Article in English | MEDLINE | ID: mdl-34661612

ABSTRACT

Importance: Sweetened beverage taxes are one policy approach to reduce intake of added sugars. Soda is the leading source of added sugars in the US diet, but few studies have examined how such taxes influence sweetened beverage intake in youth. Objective: To estimate the association between the Philadelphia, Pennsylvania, beverage tax and adolescent soda intake. Design, Setting, and Participants: This economic evaluation of school district-level Youth Risk Behavior Surveillance System data from September 2013 to December 2019 compared weekly soda intake in high school students in Philadelphia, a city with a sweetened beverage tax, with that in 7 comparison cities without beverage taxes. Difference-in-differences regression modeling was used to estimate change in soda intake in Philadelphia compared with control cities. Secondary analyses compared 100% juice and milk intake to explore potential substitution associations. Subgroup analyses evaluated differences by race and ethnicity and weight status (obesity and overweight or obesity). Analyses were performed between August 20 and October 20, 2020. School districts that had weighted data and a survey question on weekly soda intake from 2013 to 2019 were included. The study included high school students, grades 9 to 12, in school districts participating in the Youth Risk Behavior Surveillance System from 2013 to 2019. Exposures: Implementation of a sweetened beverage tax in Philadelphia, Pennsylvania, in January 2017. Main Outcomes and Measures: Reported weekly servings of soda, 100% juice, and milk. Results: A total of 86 928 participants (weighted mean [SD] age, 15.8 [1.3] years; 49% female) from 8 US cities (including Philadelphia) were included. Before the tax, adolescents in the 7 comparison cities had a mean intake of 4 servings of soda per week compared with 5.4 servings per week in Philadelphia. Philadelphia's tax was associated with a reduction of 0.81 servings of soda per week (95% CI, -1.48 to -0.14 servings; P = .02) 2 years after tax implementation. There was no significant difference in 100% juice or milk intake, although Philadelphia adolescents consumed more juice than those in nontaxed cities. In subgroup analyses, the tax was associated with a reduction of 1.13 servings per week in Hispanic/Latinx adolescents (95% CI, -2.04 to -0.23 servings; P = .01) and 1.2 servings per week in adolescents with obesity (95% CI, -2.33 to -0.13 servings; P = .03). Conclusions and Relevance: This economic evaluation found that a sweetened beverage tax was associated with a reduction in soda intake among adolescents, providing evidence that such taxes can improve dietary behaviors.


Subject(s)
Drinking , Students , Sugar-Sweetened Beverages/economics , Taxes/economics , Adolescent , Female , Humans , Male , Philadelphia , Schools , Sugar-Sweetened Beverages/statistics & numerical data
20.
Am J Public Health ; 111(11): 1986-1996, 2021 11.
Article in English | MEDLINE | ID: mdl-34678053

ABSTRACT

Objectives. To assess the effect of a 2017 excise tax on sugar and artificially sweetened beverages in Philadelphia, Pennsylvania, on the shopping patterns of low-income populations using Supplemental Nutrition Assistance Program (SNAP) data. Methods. I used a synthetic controls approach to estimate the effect of the tax on Philadelphia and neighboring Pennsylvania counties (Bucks, Delaware, and Montgomery) as measured by total SNAP sales ("SNAP redemption") and SNAP redemption per SNAP participant. I assembled biannual data (2005-2019) from all US counties for SNAP redemption and relevant predictors. I performed placebo tests to estimate statistically significant effects and conducted robustness checks. Results. Detectable increases in SNAP spending occurred in all 3 Philadelphia neighboring counties. Per-participant SNAP spending increased in 2 of the neighboring counties and decreased in Philadelphia. These effects were robust across multiple specifications and placebo tests. Conclusions. The tax contributed to increased SNAP shopping in Philadelphia's neighboring counties across both outcome measures, and decreased spending in Philadelphia (at least by 1 measure). This raises questions about retailer behavior, the effectiveness of the tax's public health aim of reducing sugar-sweetened beverage consumption, and policy aims of investing in low-income communities. (Am J Public Health. 2021;111(11):1986-1996. https://doi.org/10.2105/AJPH.2021.306464).


Subject(s)
Artificially Sweetened Beverages/economics , Commerce/economics , Food Assistance/economics , Sugar-Sweetened Beverages/economics , Taxes/economics , Humans , Philadelphia , Poverty
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