The results, now almost final, look like this:
And
Recall what this cost, and then some:
Next? Fingers crossed.
But at least this.
The World Health Organization took two actions yesterday to encourage people to cut down on consumption of sugar-sweetened beverages.
It issued a report urging national governments to consider taxes: “Taxes on sugary drinks: Why do it?
Governments can take a number of actions to improve availability and access to healthy foods and have a positive influence on the food people choose to consume. A major action for comprehensive programmes aimed at reducing consumption of sugars is taxation of sugary drinks. Just as taxing tobacco helps to reduce tobacco use, taxing sugary drinks can help reduce consumption of sugars.
It defines sugar drinks as products that contain added sugar, corn or fruit-juice concentrates and include carbonates, fruit drinks, sports drinks, energy and vitamin water drinks, sweetened iced tea, and lemonade.
It also took immediate action to remove sugary drinks from its Geneva headquarters
The agency explained this action:
The move signifies how seriously WHO is taking its leadership role in implementing policies to improve public health…By implementing this policy WHO is setting a positive example for Member States, other organizations and visitors…WHO vending machines, restaurants and coffee shops will continue to sell water, fizzy water, and unflavoured milks with different fat contents, teas and coffees, and beverages with non-sugar sweeteners (such as diet and zero calorie drinks). Sugar packets for use with tea and coffee will continue to be served.
These actions are getting plenty of attention.
The Guardian pointed out that:
Battle lines are being drawn in Colombia, where a consumer movement is pressing the case for a sugary drinks tax and the industry is fighting back…Last month, the Asociación Educar Consumidores – the consumer organisation which, like its Mexican equivalent, has backing from Bloomberg Philanthropies in the US – produced an educational video to be broadcast on television, warning that drinking too many sugary drinks can lead to diabetes and other diseases.
But after a complaint from Postobón, the Colombian beverage giant, the government’s regulatory agency charged with consumer protection banned any showing of the video on TV, saying it was inaccurate and could confuse the public.
Michael Bloomberg, now a global ambassador for WHO issued a statement.
A growing number of cities and countries – including Mexico – are showing that taxes on sugary drinks are effective at driving down consumption. The World Health Organization report released today can help these effective policies spread to more places around the world, and that will help save many lives.
The International Council of Beverages Associations (ICBA) issued a statement:
ICBA is disappointed that this technical committee’s report advocates the discriminatory taxation solely of certain beverages as a ‘solution’ to the very real and complex challenge of obesity. We strongly disagree with the committee’s recommendation to tax beverages, as it is an unproven idea that has not been shown to improve public health based on global experiences to date.
Healthy Food America says the soda industry has spent $30 million to fight soda taxes, just this year.
WHO has just given its blessing to soda taxes. Will countries respond? How much more is the soda industry willing to spend to stop taxes?
Stay tuned.
Other accounts:
Jennifer Falbe and other investigators from Kristin Madson’s group at UC Berkeley have just produced an analysis of the effects of the Berkeley soda tax on consumption patterns.
They surveyed people in low-income communities before and after the tax went into effect. The result: an overall 21% decline in reported soda consumption in low-income Berkeley neighborhoods versus a 4% increase in equivalent neighborhoods in Oakland and San Francisco.
The Los Angeles Times breaks out these figures: 
In Oakland and San Francisco, which have not yet passed a tax, sales of regular sodas went up by 10%.
Other findings, as reported by Healthy Food America:
Agricultural economist Parke Wilde at Tufts views this study as empirical evidence for the benefits of taxes. He writes on his US Food Policy blog that it’s time for his ag econ colleagues to take the benefits of taxes seriously:
There is a long tradition in my profession of doubting the potential impact of such taxes…Oklahoma State University economist Jayson Lusk, who also is president of the Agricultural and Applied Economics Association (AAEA), has blogged several times about soda taxes, agreeing with most of the Tamar Haspel column in the Washington Post, and concluding stridently: “I’m sorry, but if my choice is between nothing and a policy that is paternalistic, regressive, will create economic distortions and deadweight loss, and is unlikely to have any significant effects on public health, I choose nothing” (emphasis added).
Wilde points out that Lusk has now modified those comments in a blog post.
All that said, I’m more than willing to accept the finding that the Berkeley city soda tax caused soda consumption to fall. The much more difficult question is: are Berkeley residents better off?
Yes, they are.
The Berkeley study is good news and a cheery start to the week. Have a good one.
Addition
Politico adds up the “piles of cash” being spent on the soda tax votes in San Francisco, Oakland, and Alameda and analyzes the soda industry’s framing of the tax as a “grocery tax.”
My book, Soda Politics, came out not quite a year ago but so much has happened since then that it’s been hard to keep up with everything that’s happening in campaigns to discourage consumption of sugar-sweetened beverages.
Fortunately, Healthy Food America’s Casey Hinds puts out a daily roundup of sugar and soda news (you can sign up for it and HFA’s other materials here).
A few recent items of particular interest:
USA Today’s editorial, “soda taxes fall flat“
More effective ways already are being used to change people’s diets. The best use of government authority is to empower people with the information they need to make healthier choices.
The editorial comes with a poll, still up. You can vote on it here. At this moment only 183 votes have come in, 51% strongly in favor of the editorial opinion.
Jim Krieger of Healthy Food America did a counterpoint
The time has come to tax sugary drinks like we tax tobacco. The analogy is powerful: As with tobacco, rock-solid evidence shows habitual use harms health. Sugary drinks are a prime culprit in rampant health problems — diabetes, obesity, and heart, dental and liver disease – that cut lives short and drive up health care costs. Tobacco taxes have reduced smoking, while raising money to make lives better. Taxing sugary drinks would do the same
This too has a poll on which you can still vote. Only 92 votes have come in, and only 38% strongly agree.
Americans don’t like taxes. Even so, either this issue doesn’t generate much interest or it’s just August and too hot to think about such things.
The beverage industry spent $10.6 million to oppose Philadelphia’s soda tax initiative
The soft drink industry does not like taxes and seems willing to put fortunes into opposing them.
The Philadelphia City Council passed the tax anyway. I keep thinking of all the good things nearly $11 million could do for public health.
Melbourne’s The Alfred Hospital reduces sugary drink consumption
The hospital did an experiment to see if they could shift the mix of drinks purchased from sugary to less sugary. They did this by increasing the price of sugary drinks and hiding them under counters. Sales of sugar-sweetened beverages sales fell by 36,500 drinks in a year.
I don’t get it. Why not just stop selling them altogether?
That’s it for this August Monday. Stay cool. More to come.
Addition, August 23
A reader from New Zealand writes to say that “all of its hospitals no longer sell sugary sodas and some are also beginning to remove juice and artificially sweetened beverages due to their acidic nature and detrimental impact on oral health.”
Two items in the case against excessive consumption of sugary beverages:
More ties to Coca-Cola at CDC
Carey Gillam, the research director for U.S. Right to Know, has been busy delving through e-mails between officials at the Centers for Disease Control and Prevention (CDC) and Coca-Cola.
Her previous story was followed by that official’s retirement.
This one identifies another CDC official with “a history of promoting and helping lead research funded by Coca-Cola.”
I’m quoted in the article:
Officials of public health agencies run the risk of cooptation, capture, or conflict of interest when they have close professional ties with companies whose job it is to sell food products, regardless of the effects of those products on health.
Calls for warning labels
Dean Schillinger, a doctor at UCSF and CSPI’s Michael Jacobson have co-authored an article in JAMA calling for warning labels on advertisements for sugary drinks—something that is being tried in San Francisco, albeit in the face of legal challenges.
So far, the courts have upheld the warning labels. The authors conclude:
Implementing such policies could benefit all US residents, but could especially benefit socioeconomically vulnerable populations, including children, some of whom are exposed to a disproportionate volume of SSB advertising and often purchase these products at high rates and experience the greatest risk of chronic diseases. The decision in American Beverage Association (ABA) et al v City & County of San Francisco, if upheld by the appellate court, provides a pivotal legal precedent that could influence public health policy at local, state, and national levels related to communicating the health risks inherent to SSBs and other products.
I’m at the Summer Academy in Global Food Law and Policy in Getxo, Spain speaking about Soda Politics and was happy to see Healthy Food America’s analyses of how Philadelphia passed a soda tax.
Jim Krieger starts out with a reminder that all cities are different and all politics is local, but in this case Philadelphia did an outstanding job on the
All of these are essential elements in any advocacy campaign.
Casey Hinds, also of Healthy Food America, focuses on why Mayor Kenney’s messaging was so effective. She quotes from his
This last interview is particularly inspiring. He knew what he was doing, and why.
KENNEY: It never was a grocery tax. From my perspective and my opinion, their miscalculation is that they thought the people were stupid and that they would totally eat the idea of a grocery tax. In the end, diet [beverages] became part of it because it was part of the negotiation to get us the nine votes or the 13 votes we needed. It was always about sugar-sweetened beverages. It was never about anything else. I think people recognize that this was a way to generate significant revenue without raising their real estate taxes, without raising their wage taxes, without raising business taxes, because those are all the taxes that we’ve always [used] to fund education.
…BOTTEMILLER EVICH: So when the other cities, states, call you, what are you going to tell local officials about going down this road?
KENNEY: Tie it to initiatives that the public wants. Build a coalition around those initiatives. And just continue to grow the coalition and don’t worry about the big money. It’s clear now that the big money isn’t all it’s cracked up to be.
We need more politicians like this.
The Philadelphia city council votes sometime today on whether to pass a soda tax, with most—but not all—of the revenues targeted to pre-kindergarten education. I’m getting on an airplane pretty soon and will miss the vote, but it is widely assumed to pass.
The decision is up to the city council. Although the soda industry spent more than $4 million on public relations to urge the council to vote no, and promised to fund the first year of pre-K, its efforts don’t seem to be working.
To put this in context: Sodas are an easy target for public health measures. Nobody needs them, they are candy in liquid form, and they have no nutritional value. But it seems as though their makers are willing to spare no expense to stop any city that attempts to tax them. The total in Philly is $4.9 million by the latest rumors.
Americans are highly likely to support taxes that are earmarked for social purposes, as the Philly tax mostly is.
Every other city council can see that Berkeley gets more than a million a year for discretionary child health programs. Philadelphia is a bigger city and will get more, but is using it to fill budget holes as well as Pre-K. I’m guessing lots of places will figure out that they can do this too.
At the very least, the soda industry will be willing to donate huge amounts of money to get city councils to delay or block measure, as it did in Philadelphia.
This vote is worth watching closely (you can do that here). I’m sorry to be missing it but will try to catch up with it later.
References
In January this year, JAMA Internal Medicine published my Viewpoint on corporate funding of nutrition research: science or marketing.
Richard Kahn, former chief scientist and medical officer of the American Diabetes Association, wrote a letter in reply (see below for more about him**). The journal published his letter, along with my response, in its current issue. Here’s what I said.
In Reply Dr Kahn requests evidence that nutrition research funded by food companies is of lesser quality than studies funded by independent agencies or performed by investigators with nonfinancial conflicts of interest. Concerns about such issues are relatively recent; few published studies address them directly. Instead, concerns about industry sponsorship of nutrition research derive from comparisons with the results of studies of funding by tobacco, chemical, drug, or medical device companies. This research typically finds industry-sponsored studies to report results more favorable to the products of the sponsor than studies not funded by industry. It identifies subtle rather than substantive differences in the quality of this research; industry-funded studies are more likely to underreport unfavorable results and interpret neutral results more positively.1 When results are negative, they are less likely to be published.2
Between March 2015 and March 2016, I identified 166 industry-funded nutrition research studies and posted and discussed them on my blog.3 Of these, 154 reported results favorable to the interest of the sponsor; only 12 reported contrary results. The few studies systematically examining the influence of industry funding on nutrition research tend to confirm results obtained from other industries. For example, a systematic review comparing industry-funded and nonindustry-funded trials of probiotics in infant formula reported no association of funding source with research quality. Industry-funded studies, however, seemed more likely to report favorable conclusions unsupported by the data.4
Dr Kahn states that sponsored studies often specify that the funder had no role in the study. Only recently have some journals required such statements, and I am unaware of research on the extent of this practice or authors’ adherence to it. Among the 166 industry-funded studies that I reviewed, few disclosed involvement of a sponsor.
Dr Kahn asks whether industry funding is any more biasing than career self-interest or intellectual passion. Unlike industry funding, self-interest and passions are intrinsic to every scientist who conducts research, are a matter of public record, cannot be eliminated, and have not been shown to consistently bias research results in the same ways as industry funding.5 Fortunately, nutrition societies and research institutions are developing policies to manage financial relationships with industry.6 Such policies hold promise for preventing financial conflicts of research in nutrition research.
1. Lundh A, Sismondo S, Lexchin J, Busuioc OA, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2012;12:MR000033. PubMed
2. Rising K, Bacchetti P, Bero L. Reporting bias in drug trials submitted to the Food and Drug Administration: review of publication and presentation. PLoS Med. 2008;5(11):e217. PubMed | Link to Article
3. Nestle M. Food Politics Blog. https://foodpolitics.com/. Accessed March 2, 2016.
4. Mugambi MN, Musekiwa A, Lombard M, Young T, Blaauw R. Association between funding source, methodological quality and research outcomes in randomized controlled trials of synbiotics, probiotics and prebiotics added to infant formula: a systematic review. BMC Med Res Methodol. 2013;13:137. PubMed | Link to Article
5. Bero L. What is in a name? Nonfinancial influences on the outcomes of systematic reviews and guidelines. J Clin Epidemiol. 2014;67(11):1239-1241. PubMed | Link to Article6. Charles Perkins Centre. Engagement with Industry Guidelines 2015. University of Sydney, 2015. https://intranet.sydney.edu.au/perkins/research-support/engaging-with-industry.html. Accessed March 2, 2016.
