The Influence of Sugary Beverage Taxes on Fast Food Restaurant Purchases: An Evaluation Using National Sales Data

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PROJECT SUMMARY/ABSTRACT This project will examine the impact of taxes on sugar sweetened beverages (SSBs) utilizing detailed sales data from one of the largest fast food retailers in the U.S. Taxes on SSBs are one of the most promising solutions to reduce population-wide consumption of these unhealthful beverages and, consequently, their contribution to obesity and the health challenges of cardiovascular disease, diabetes and cancer. SSB taxes have reduced purchasing and consumption of SSBs in settings such as supermarkets and other food stores across the seven U.S. cities that have implemented them. However, fast food restaurants are also a key source of SSBs -- more than a third of U.S. adults consume fast food on any given day, often including an SSB, and a single beverage at a fast food restaurant contains more than the recommended daily allowance of calories from added sugars in just one serving – and have not been studied. The central hypothesis is that SSB taxes will reduce purchase of SSBs at fast food restaurants, with a greater impact in lower-income census tracts, despite less than complete “pass-through” of the tax to the consumer by the fast food restaurants. Using detailed sales data and appropriate comparison groups from multiple communities, the study estimates the influence of SSB tax policies in a detailed and causal way for several years after taxes are implemented. The model is a difference-in-difference approach, taking advantage of the fact that some locations implemented taxes and (most) others did not. The study will look at sales in localities that are similar at baseline (before taxes) and determine how they diverge after a tax is implemented. This is the first study to rigorously examine SSB taxes across the U.S. in a longitudinal manner, including thousands of retail locations for Taco Bell and hundreds of millions of purchases. The national scale of the data and multiple restaurants within each city that implemented a tax will allow estimation of whether effects of taxes differ by community income, critical to understanding health disparities and the regressive nature of SSB taxes. The specific aims are:  Aim 1: Determine the change in price paid in fast food restaurants as a result of SSB taxes (i.e., effective “pass-through”).  Aim 2: Determine the change in beverage calories purchased per customer order as a result of SSB taxes.  Aim 3: Determine how neighborhood characteristics, such as the income of the area in which a restaurant is located, influence both pass-through and beverage calories purchased in response to SSB taxes.