The equitable impact of sugary drink taxation structures on sugary drink consumption among Canadians: a modelling study using the 2015 Canadian Community Health Survey-Nutrition

Abstract

Objective: Estimate the impact of 20% flat-rate and tiered sugary drink tax structures on the consumption of sugary drinks, sugar-sweetened beverages, and 100% juice by age, sex, and socioeconomic position. Design: We modelled the impact of price changes –for each tax structure– on the demand for sugary drinks by applying own- and cross-price elasticities to self-report sugary drink consumption measured using single day 24-hour dietary recalls from the cross-sectional, nationally-representative 2015 Canadian Community Health Survey-Nutrition. For both 20% flat-rate and tiered sugary drink tax scenarios, we used linear regression to estimate differences in mean energy intake and proportion of energy intake from sugary drinks by age, sex, education, food security and income. Setting: Canada. Participants: 19,742 respondents aged 2 and over. Results: In the 20% flat-rate scenario, we estimated mean energy intake and proportion of daily energy intake from sugary drinks on a given day would be reduced by 29 kcal/day (95%UI: 18, 41) and 1.3% (95%UI: 0.8, 1.8), respectively. Similarly, in the tiered tax scenario, additional small, but meaningful reductions were estimated in mean energy intake (40 kcal/day, 95%UI: 24, 55) and proportion of daily energy intake (1.8%, 95%UI: 1.1, 2.5). Both tax structures reduced, but did not eliminate, inequities in mean energy intake from sugary drinks despite larger consumption reductions in children/adolescents, males and individuals with lower education, food security and income. Conclusions: Sugary drink taxation, including an additional benefit of taxing 100% juice, could reduce overall and inequities in mean energy intake from sugary drinks in Canada.