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, 17 (2), e1003025
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Impact of the Announcement and Implementation of the UK Soft Drinks Industry Levy on Sugar Content, Price, Product Size and Number of Available Soft Drinks in the UK, 2015-19: A Controlled Interrupted Time Series Analysis

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Impact of the Announcement and Implementation of the UK Soft Drinks Industry Levy on Sugar Content, Price, Product Size and Number of Available Soft Drinks in the UK, 2015-19: A Controlled Interrupted Time Series Analysis

Peter Scarborough et al. PLoS Med.

Abstract

Background: Dietary sugar, especially in liquid form, increases risk of dental caries, adiposity, and type 2 diabetes. The United Kingdom Soft Drinks Industry Levy (SDIL) was announced in March 2016 and implemented in April 2018 and charges manufacturers and importers at £0.24 per litre for drinks with over 8 g sugar per 100 mL (high levy category), £0.18 per litre for drinks with 5 to 8 g sugar per 100 mL (low levy category), and no charge for drinks with less than 5 g sugar per 100 mL (no levy category). Fruit juices and milk-based drinks are exempt. We measured the impact of the SDIL on price, product size, number of soft drinks on the marketplace, and the proportion of drinks over the lower levy threshold of 5 g sugar per 100 mL.

Methods and findings: We analysed data on a total of 209,637 observations of soft drinks over 85 time points between September 2015 and February 2019, collected from the websites of the leading supermarkets in the UK. The data set was structured as a repeat cross-sectional study. We used controlled interrupted time series to assess the impact of the SDIL on changes in level and slope for the 4 outcome variables. Equivalent models were run for potentially levy-eligible drink categories ('intervention' drinks) and levy-exempt fruit juices and milk-based drinks ('control' drinks). Observed results were compared with counterfactual scenarios based on extrapolation of pre-SDIL trends. We found that in February 2019, the proportion of intervention drinks over the lower levy sugar threshold had fallen by 33.8 percentage points (95% CI: 33.3-34.4, p < 0.001). The price of intervention drinks in the high levy category had risen by £0.075 (£0.037-0.115, p < 0.001) per litre-a 31% pass through rate-whilst prices of intervention drinks in the low levy category and no levy category had fallen and risen by smaller amounts, respectively. Whilst the product size of branded high levy and low levy drinks barely changed after implementation of the SDIL (-7 mL [-23 to 11 mL] and 16 mL [6-27ml], respectively), there were large changes to product size of own-brand drinks with an increase of 172 mL (133-214 mL) for high levy drinks and a decrease of 141 mL (111-170 mL) for low levy drinks. The number of available drinks that were in the high levy category when the SDIL was announced was reduced by 3 (-6 to 12) by the implementation of the SDIL. Equivalent models for control drinks provided little evidence of impact of the SDIL. These results are not sales weighted, so do not give an account of how sugar consumption from drinks may have changed over the time period.

Conclusions: The results suggest that the SDIL incentivised many manufacturers to reduce sugar in soft drinks. Some of the cost of the levy to manufacturers and importers was passed on to consumers as higher prices but not always on targeted drinks. These changes could reduce population exposure to liquid sugars and associated health risks.

Conflict of interest statement

We have read the journal's policy and the authors of this manuscript have the following competing interests: ADMB and MW are members of the Faculty of Public Health, which has a position statement supporting a soft drink tax. AMDB is also a former member of the UK Health Forum, which had a position statement supporting soft drink taxes. ADMB has written various peer-reviewed and commissioned papers on soft drink taxes. MR is chair of Sustain: the alliance for better food and farming, which has for more than eight years campaigned for a sugary drinks tax in the UK. MW receives salary as Director of NIHR's Public Health Research Progamme, outside the submitted work.

Figures

Fig 1
Fig 1. Data flowchart.
Fig 2
Fig 2. Proportion of soft drinks over the lower levy sugar threshold.
Fig 3
Fig 3. Change in price of (A) branded and (B) own-brand soft drinks by sugar content.

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Grant support

This work was funded by grants from the UK National Institute for Health Research Public Health Research programme (numbers 16/49/01 and 16/130/01) for an evaluation of the UK Soft Drink Industry Levy, and by the NIHR Oxford Biomedical Research Centre (IS-BRC-1215-20008). PS is supported by a British Heart Foundation fellowship (FS/15/34/31656). MR is supported by the University of Oxford. JA and MW are funded by the University of Cambridge and Centre for Diet and Activity Research (CEDAR). CEDAR is UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence. Funding for CEDAR from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UKCRC, is gratefully acknowledged. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health and Social Care, UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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