Evaluating the 2014 sugar-sweetened beverage tax in Chile: An observational study in urban areas.
Evaluating the 2014 sugar-sweetened beverage tax in Chile: An observational study in urban areas.
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DOI：
10.1371/journal.pmed.1002596
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发表时间：
2018-07
期刊：
影响因子：
15.8
通讯作者：
Suhrcke M
中科院分区：
文献类型：
--
作者：
Nakamura R;Mirelman AJ;Cuadrado C;Silva-Illanes N;Dunstan J;Suhrcke M
2014年10月，智利对含糖饮料（SSB）实施了一项税收修改，称为Impuesto Adicional a las Bebidas Analcohólicas（IABA）。该税的设计是独特的，增加了对每100毫升添加糖超过6.25克的软饮料的税收，并降低了对低于这一门槛的软饮料的税收。这项研究评估了智利的SSB税，该税于2014年3月宣布，并于2014年10月实施。我们使用了2011年至2015年居住在代表智利城市人口的城市中的2，836个家庭的家庭层面杂货购买数据。我们采用了固定效应计量经济学方法，并估计了购买SSB的前后变化，控制了季节性，一般时间趋势，温度和经济波动以及时不变的家庭特征。结果显示，在统计学上首选的模型中，购买量发生了显着变化：虽然所有软饮料的数量几乎没有显着下降，但含糖软饮料的月购买量却大幅下降了21.6%。这种减少的方向对不同的经验建模方法是稳健的，但统计意义和变化的幅度差异很大。软饮料购买的减少在较高的社会经济群体和含糖软饮料的税前购买者中最为明显。在按家庭肥胖状况进行的估计中，没有系统的、稳健的模式。实施税收后，税率降低的软饮料的购买价格下降，但税率增加的含糖饮料的购买价格保持不变。然而，在政策宣布时，含糖软饮料的采购价格上涨。主要的局限性包括缺乏随机设计，限制了因果推断的可能性，以及关注购买数据而不是消费或健康结果。亚组分析的结果表明，该政策可能是部分有效的，但不一定是以可能减少饮食相关健康方面的社会经济不平等的方式。目前尚不清楚该政策是否对整个人口产生了重大影响。此外，由于本研究仅调查了购买软饮料1年的情况，因此在未来的研究中应进行长期评估，最好包括对消费和健康影响的评估。ClinicalTrials.gov 标识符：NCT 02926001 Ryota中村及其同事介绍了一项关于智利税收变化后含糖饮料购买情况的观察性研究结果。智利和世界其他国家正面临着一项重大挑战，即遏制肥胖率和与饮食有关的健康状况不佳，尤其是在社会经济地位较低的群体中。财政政策有可能影响消费模式，使之转向更健康的选择（并为增加福利目的增加政府收入），从而有助于预防慢性病，减少相关的经济成本。关于财政激励措施促进饮食相关健康的影响的大多数现有证据都依赖于小规模实验或假设模拟，这些实验或假设模拟使用从观察数据中估计的价格弹性，主要表明提高含糖饮料（SSB）等产品的价格将减少购买或消费。然而，缺乏对与饮食有关的实际财政干预措施的经验性评估，仍然不能确定这些措施是否能在“真实的世界”背景下有效地改善人口饮食和健康。本研究评估了智利适用于SSBs的税收政策。“Impuesto Adicional a las Bebidas Analcohólicas”（IABA;或“非酒精饮料附加税”），于2014年3月宣布，并于2014年10月实施。IABA的政策针对任何添加了着色剂、调味剂或甜味剂的非酒精饮料。对于添加糖浓度为6.25克/100毫升（或同等比例）或以上的饮料，税率从13%提高到18%，而对于低于这一门槛的饮料，税率从13%降低到10%，产生8%的税差。我们应用一系列计量经济学方法来评估税收政策的宣布和实施的效果，使用智利家庭层面的杂货购买数据，在税收实施前3年和实施后1年。我们发现，尽管税收优惠相对较小，但有迹象表明，在人口的高社会经济群体中，购买含糖量较高的SSB的数量已经减少。结果表明，智利的税收政策可能是部分有效的，但不一定是在可能减少饮食相关健康的社会经济不平等的方式。需要进行长期评估来分析长期购买SSB的影响以及对健康结果的影响。该评价不涉及随机设计，因此我们将结果解释为真正因果关系的程度将受到限制。
In October 2014, Chile implemented a tax modification on sugar-sweetened beverages (SSBs) called the Impuesto Adicional a las Bebidas Analcohólicas (IABA). The design of the tax was unique, increasing the tax on soft drinks above 6.25 grams of added sugar per 100 mL and decreasing the tax for those below this threshold. This study evaluates Chile’s SSB tax, which was announced in March 2014 and implemented in October 2014. We used household-level grocery-purchasing data from 2011 to 2015 for 2,836 households living in cities representative of the urban population of Chile. We employed a fixed-effects econometric approach and estimated the before–after change in purchasing of SSBs controlling for seasonality, general time trend, temperature, and economic fluctuations as well as time-invariant household characteristics. Results showed significant changes in purchasing for the statistically preferred model: while there was a barely significant decrease in the volume of all soft drinks, there was a highly significant decrease in the monthly purchased volume of the higher-taxed, sugary soft drinks by 21.6%. The direction of this reduction was robust to different empirical modelling approaches, but the statistical significance and the magnitude of the changes varied considerably. The reduction in soft drink purchasing was most evident amongst higher socioeconomic groups and higher pretax purchasers of sugary soft drinks. There was no systematic, robust pattern in the estimates by household obesity status. After tax implementation, the purchase prices of soft drinks decreased for the items for which the tax rate was reduced, but they remained unchanged for sugary items, for which the tax was increased. However, the purchase prices increased for sugary soft drinks at the time of the policy announcement. The main limitations include a lack of a randomised design, limiting the extent of causal inference possible, and the focus on purchasing data rather than consumption or health outcomes. The results of subgroup analyses suggest that the policy may have been partially effective, though not necessarily in ways that are likely to reduce socioeconomic inequalities in diet-related health. It remains unclear whether the policy has had a major, overall population-level impact. Additionally, because the present study examined purchasing of soft drinks for only 1 year, a longer-term evaluation—ideally including an assessment of consumption and health impacts—should be conducted in future research. ClinicalTrials.gov Identifier: NCT02926001 Ryota Nakamura and colleagues present findings from an observational study of sugar-sweetened beverage purchases in Chile after a tax change. Chile and other countries in the world are facing a major challenge to curb rising rates of obesity and diet-related ill health, often particularly among lower socioeconomic groups. Fiscal policy has the potential to influence consumption patterns towards healthier options (and raise government revenue for welfare-enhancing purposes), thereby contributing to the prevention of chronic diseases and to the reduction of the associated economic costs. Most existing evidence on the effects of fiscal incentives to promote diet-related health relies on small-scale experiments or hypothetical simulations using price elasticity estimated from observational data, largely suggesting that increasing the price of products such as sugar-sweetened beverages (SSBs) would reduce purchasing or consumption. There is, however, a scarcity of empirical evaluations of actual diet-related fiscal interventions, and it is still uncertain whether these can be effective in improving population diet and health in a ‘real world’ context. This study evaluates the tax policy applied to SSBs in Chile. The ‘Impuesto Adicional a las Bebidas Analcohólicas’ (IABA; or ‘additional tax on nonalcoholic drinks’), which was announced in March 2014 and implemented in October 2014. The IABA policy targeted any nonalcoholic beverages to which colorants, flavourings, or sweeteners have been added. For beverages with an added sugar concentration of 6.25 grams per 100 mL (or equivalent proportion) or more, the tax was increased from 13% to 18%, while for those below this threshold, the tax was decreased from 13% to 10%, producing an 8% tax difference. We applied a series of econometric approaches to evaluate the effects of the announcement and implementation of the tax policy, using household-level grocery-purchasing data from Chile for 3 years pre- and 1 year post-tax implementation. We find that, despite the fact that the tax incentive is comparatively small, there are signs that purchasing of SSBs with higher sugar content has been reduced among high socioeconomic groups of the population. The results suggest that the Chilean tax policy may have been partially effective, though not necessarily in ways that are likely to reduce socioeconomic inequalities in diet-related health. Longer-term evaluations are needed to analyse the effect on SSB purchasing in the long run as well as on health outcomes. The evaluation did not involve a randomised design, therefore the degree to which we can interpret the results as truly causal will be limited.
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影响因子：
3.5
作者：
Finkelstein, Eric A.;Zhen, Chen;Todd, Jessica E.
通讯作者：
Todd, Jessica E.
影响因子：
4.8
作者：
Han, Euna;Powell, Lisa M.
通讯作者：
Powell, Lisa M.
DOI：
10.4067/s0034-98872015000500007
发表时间：
2015-05-01
期刊：
Revista médica de Chile
影响因子：
--
作者：
Azar, Ariel;Franetovic, Gonzalo;Santos, Humberto
通讯作者：
Santos, Humberto
影响因子：
6.3
作者：
Blakely, Tony;Mhurchu, Cliona Ni;Rodgers, Anthony
通讯作者：
Rodgers, Anthony
DOI：
10.1016/s0140-6736(15)00128-2
发表时间：
2015-12-05
期刊：
Lancet (London, England)
影响因子：
--
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通讯作者：
Murray CJ