Public acceptability of the UK Soft Drinks Industry Levy: repeat cross-sectional analysis of the International Food Policy Study (2017–2019)

Abstract

ObjectivesTo determine whether public acceptability, in terms of both support for and perceived effectiveness of, the UK Soft Drinks Industry Levy (SDIL) changed between 4 months prior to, and 8 and 20 months after, implementation.DesignRepeat cross-sectional online survey.SettingThe UK.ParticipantsUK respondents to the International Food Policy Study aged 18–64 years who provided information on all variables of interest in November–December 2017 (4 months prior to SDIL implementation), 2018 (8 months after) or 2019 (20 months after; n=10 284).Outcome measuresSelf-reported support for, and perceived effectiveness of, the SDIL.ResultsThe adjusted logistic regression model predicted that 70% (95% CI: 68% to 72%) of participants supported the SDIL in 2017, 68% (95% CI: 67% to 70%) in 2018 and 68% (95% CI: 66% to 70%) in 2019. There was no evidence of a difference in support in 2018 vs 2017 (OR: 0.93; 95% CI: 0.81 to 1.05); or in 2019 vs 2017 (OR: 0.90; 95% CI: 0.78 to 1.03). The adjusted logistic regression model predicted that 72% (95% CI: 70% to 74%) of participants perceived the SDIL to be effective in 2017, 67% (95% CI: 65% to 69%) in 2018 and 67% (95% CI: 64% to 69%) in 2019. There was evidence that perceived effectiveness decreased a small amount in 2018 vs 2017 (OR: 0.78; 95% CI: 0.69 to 0.88). The difference in 2019 vs 2017 was similar.ConclusionsWe found high support for the SDIL among UK adults and this did not change between 4 months before implementation and 8 or 20 months after. While perceived effectiveness remained high, there was evidence that this decreased slightly after implementation in 2018, but no further in 2019. Greater understanding of influences on public acceptability of effective structural public health interventions is required.

Contextual Factors That May Impact on the Development and Implementation of the Sugary Drinks Policy; Comment on "Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019"

“…This could be explained by both the reformulation of drinks from the lower levy to no-levy tier with removal of some but not all sugar, and changes in consumer attitudes and beliefs. A previous survey 8 on the public acceptability of SDIL found a high support among UK adults although this decreased slightly after its implementation in 2018. A previous review suggested that commitments to hypothecation (earmarking the revenue from health taxes for specific purposes, such as funding health system improvement or obesity prevention), can increase public and political support for taxes.…”

Exploring views of members of the public and policymakers on the acceptability of population level dietary and active-travel policies: a qualitative study

“…We asked participants for their views on acceptability of a wide range of population-level dietary and active-travel policies, some of which exist nationally in England, e.g., Soft Drinks Industry Levy (SDIL), some exist locally in England, e.g., congestion charges and some are not yet implemented in England, e.g., plain packaging of convenience food. This allowed us to capture views on already existing policies, but also new policies with which people would be less familiar, since the stage of policy implementation can influence policy acceptability [ 29 , 36 ]. These included policies that varied in their scope and focus, i.e., economic, town and city planning, guiding choice, and inform and educate policies ( Fig.…”

“…Existing research has shown that the public are more supportive of higher-agency policies, as these are generally considered to maintain more freedom of choice compared to lower-agency policies [ 29 – 33 ]. Public support is also higher for policies perceived to be more effective [ 34 , 35 ] ) or for policies that have already been implemented [ 29 , 36 ]. Engagement with the targeted behaviour and embracing pro-health norms are also predictors of acceptability [ 29 , 37 ].…”

“…Existing studies on policy support have primarily used quantitative methods to explore public support for dietary, and to a lesser extent active-travel policies [ 30 , 32 , 33 , 36 , 37 , 43 , 44 ]. Qualitative studies have mainly focused on specific policies or levels of agency required to engage with the policy, e.g., taxes [ 45 ] or financial incentives [ 40 ], specific settings, e.g., schools [ 46 ] or supermarkets [ 47 ], specific outcomes, e.g., low-calorie foods [ 48 ] or less-healthy foods [ 47 ], and have mainly been conducted outside the UK [ 41 , 42 , 45 , 49 , 50 ].…”

Adolescents’ perspectives on soft drinks after the introduction of the UK Soft Drinks Industry Levy: A focus group study using reflexive thematic analysis

“…These perceptions, in particular public acceptability, can influence the likelihood of policy success (Diepeveen, Ling, Suhrcke, Roland, & Marteau, 2013;Sharp, Bellis, Hughes, Ford, & Lemma, 2020). In 2017, 2018 and 2019, 70%, 68% and 68% respectively of UK adults expressed support for the SDIL, with no evidence of a difference in acceptability of the SDIL over time (Adams et al, 2021). This is greater than support for SSB taxation in other countries where support amongst adults and children ranges from 39 to 66%, with a pooled proportion in one systematic review and meta-analysis of 42% (95% CI 38-47%) (Eykelenboom et al, 2019).…”