Exploring attitudes toward taxation of sugar-sweetened beverages in rural Michigan

Abstract

Background While policies to address “obesity” have existed for decades, they have commonly focused on behavioral interventions. More recently, the taxation of sugar-sweetened beverages is gaining traction globally. This study sought to explore individuals’ attitudes and beliefs about sugar-sweetened beverages being taxed in a rural Michigan setting. Methods This qualitative study was conducted using critical policy analysis. Data were collected in 25 semi-structured, audio-recorded interviews with adult Michiganders. Following data collection, transcripts were coded into themes using NVivo software. Results Four themes emerged in participants’ perspectives regarding sugar-sweetened beverages being taxed: resistance, unfamiliarity, tax effects, and need for education. While some participants were unfamiliar with sugar-sweetened beverage taxes, many viewed taxation as a “slippery slope” of government intervention, which invoked feelings of mistrust. In addition, participants predicted a sugar-sweetened beverage tax would be ineffective at reducing intake, particularly among regular consumers, who were frequently perceived as mostly low income and/or of higher weight. Conclusions Further research is needed to explore perceptions of sugar-sweetened beverage taxes in different geographic areas in the USA to examine how perceptions vary. Policymakers should be aware of the potential implications of this health policy with respect to government trust and stigma towards lower income and higher-weight individuals.

An umbrella review of the acceptability of fiscal and pricing policies to reduce diet-related noncommunicable disease

“…Support for taxation among the public was often low, owing to concerns about its effectiveness, doubts about how equitable it might prove, 32 , 58 , 65 , 70 , 76 , 77 , 82 and mistrust in the government’s use of revenues or transparency in the implementation process. 32 , 65 , 70 , 76 Beliefs about the benefit of and support for taxation tended to be lower among those with high consumption of SSBs, those who were overweight, and those who were less educated. 32 , 76 , 77 In the case of Eykelenboom et al (2021), these 3 factors were independently associated with acceptability of an SSB tax in the Netherlands.…”

“… 32 , 65 , 70 , 76 Beliefs about the benefit of and support for taxation tended to be lower among those with high consumption of SSBs, those who were overweight, and those who were less educated. 32 , 76 , 77 In the case of Eykelenboom et al (2021), these 3 factors were independently associated with acceptability of an SSB tax in the Netherlands. 32 Key facilitators in the implementation process related to how diet-related taxes were framed (as revenue-raising 28 , 29 , 31 , 73 or as health-improving 34 , 35 , 63 , 69 ) or related to the allocation of revenues towards social programs (eg, early-childhood education) and health initiatives (eg, healthy food subsidization).…”

“…These results support those of the umbrella review, finding that: (1) the majority of studies (>90%) focus on SSB taxation; (2) the policy-making process is inhibited by industry influence and narratives around the negative economic impacts of diet-related tax implementation, 28 , 31 , 34 , 35 , 62 , 63 , 67 , 80 , 82 even though the 2 studies using RWE to examine this found no significant impact of an SSB tax on employment 74 , 78 ; (3) the policy-making process is facilitated when diet-related taxes are framed as revenue-raising 28 , 29 , 31 , 73 and when revenues are allocated towards social programs (eg, early-childhood education) and health initiatives (eg, healthy food subsidization). 28 , 32 , 59 , 69 , 72 , 81 , 82 Additionally, support was found for SSB taxation being lower among less-educated individuals, and among those who are overweight or who have high SSB consumption, 32 , 76 , 77 and for the policy-making process being influenced by media campaigns and facilitated by strong advocacy and networks among pro-tax stakeholders. 28 , 29 , 35 , 59 , 61–63 , 66 , 80–82 …”

“…The umbrella review highlighted mistrust in governments’ use of revenues, or lack of transparency in the implementation or revenue allocation process, as barriers. 32 , 33 , 65 , 70 , 76 While taxes may reduce consumption of harmful products/nutrients, they also restrict autonomy and will inevitably be met with opposition from some members of the public. Public support for taxation in general is low but increases when funds are earmarked for health initiatives.…”

Sugar Tax or What? The Perspective and Preferences of Consumers

“…The same to increase public acceptance of the new tax was suggested by Eykelenboom et al [22], whose research results show that in general, 40% of the Dutch population (n = 500) support SBB taxation (51% of Poles participated in this study). In contrast, according to the studies conducted by Bombak et al, inhabitants of Michigan (USA) suggested that a sugar-sweetened beverage tax would be unsuccessful and would not change the shopping habits of regular consumers of SSB [36].…”