Stacey, Nicholas, Edoka, Ijeoma, Hofman, Karen, Swart, Elizabeth C, Popkin, Barry and Ng, Shu Wen (2021) Changes in beverage purchases following the announcement and implementation of South Africa's Health Promotion Levy: an observational study. The Lancet Planetary Health, 5 (4). e200 - e208. ISSN 2542-5196
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Abstract
BACKGROUND: In 2016, South Africa announced an intention to levy a tax on sugar-sweetened beverages (SSBs). In 2018, the country implemented an SSB tax of approximately 10%, known as the Health Promotion Levy (HPL). We aimed to assess changes in the purchases of beverages before and after the HPL announcement and implementation. METHODS: We used Kantar Europanel data on monthly household purchases between January, 2014, and March, 2019, among a sample of South African households (n=113 653 household-month observations) from all nine provinces to obtain per-capita sugar, calories, and volume from taxable and non-taxable beverages purchased before and after the HPL announcement and implementation. We describe survey-weighted means for each period, and regression-controlled predictions of outcomes and counterfactuals based on pre-HPL announcement trends, with bootstrapped 95% CIs, and stratify results by socioeconomic status. FINDINGS: Mean sugar from taxable beverage purchases fell from 16·25 g/capita per day (95% CI 15·80-16·70) to 14·26 (13·85-14·67) from the pre-HPL announcement to post-announcement period, and then to 10·63 g/capita per day (10·22-11·04) in the year after implementation. Mean volumes of taxable beverage purchases fell from 518·99 mL/capita per day (506·90-531·08) to 492·16 (481·28-503·04) from pre-announcement to post announcement, and then to 443·39 mL/capita per day (430·10-456·56) after implementation. Across these time periods, there was a small increase in the purchases of non-taxable beverages, from 283·45 mL/capita per day (273·34-293·56) pre-announcement to 312·94 (296·29-329·29) post implementation. When compared with pre-announcement counterfactual trends, reductions in taxable beverage purchase outcomes were significantly larger than the unadjusted survey-weighted observed reductions. Households with lower socioeconomic status purchased larger amounts of taxable beverages in the pre-announcement period than did households with higher socioeconomic status, but demonstrated bigger reductions after the tax was implemented. INTERPRETATION: The announcement and introduction of South Africa's HPL were followed by reductions in the sugar, calories, and volume of beverage purchases. FUNDING: Bloomberg Philanthropies, International Development Research Centre, South African Medical Research Council, and the US National Institutes of Health.
Item Type: | Article |
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Official URL: | https://www.thelancet.com/journals/lanplh/home |
Additional Information: | © 2021 The Authors |
Divisions: | Health Policy |
Subjects: | R Medicine > RA Public aspects of medicine H Social Sciences > HC Economic History and Conditions H Social Sciences > HJ Public Finance |
Date Deposited: | 15 Apr 2021 13:27 |
Last Modified: | 09 Aug 2024 20:18 |
URI: | http://eprints.lse.ac.uk/id/eprint/109878 |
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