Jul 2 2012

Soda taxes and other measures designed to fight obesity

My once-a-month (first Sunday) Q and A column in the San Francisco Chronicle deals with recent city initiatives.

Q:Why do municipalities continue to try to tell us what to eat or drink through taxes (the 1-cent soda tax on the Richmond ballot in November) or outright bans (eliminating super-size soft drinks, proposed by Mayor Michael Bloomberg in New York)?  Richmond residents could just buy their sodas in neighboring towns, and 1 cent seems hardly enough to influence anyone. New Yorkers could just buy two drinks if they want more. Isn’t this all rather silly?

A: Silly? On the contrary. These are dead-serious attempts to address the health problems caused by obesity through “environmental” change – changing the context in which we make food choices.

By now, health officials are well aware that asking individuals to take responsibility for making their own healthy food choices hasn’t got a prayer of success in the face of a marketing environment that encourages people to eat everywhere, all day long, in very large portions and at relatively low cost.

This is the default food environment, where it’s useless to tell people they need to eat less and expect them to do it. They can’t. Instead, it makes sense to try to change the food environment to make healthy choices the easy choices.

Healthy by design?

Suppose, for example, that all kids’ meals at fast-food restaurants were healthy by design and automatically provided milk or water.

You could still order a soda for your kid, but you would have to ask for it – and pay extra. If you are like most people, you won’t bother. That’s why the default matters.

Cities are trying to change the default. One change may or may not make a difference – we don’t know that yet. But changing the default might well make healthy choices easier in schools, fast-food restaurants and other institutions.

Bloomberg’s proposal in New York, to ban sodas larger than 16 ounces, is one such step. From my standpoint, 16 ounces is generous. It’s two full servings and provides about 50 grams of sugars, 200 calories and 10 percent of daily calories for someone who consumes 2,000 calories a day.

Portion sizes used to be a lot smaller. Decades ago, Coca-Cola advertised 16-ounce bottles as “big” and enough to serve three over ice.

If we could recognize that larger portions have more calories – and act on this knowledge – we might have an easier time maintaining weight. But we can’t, at least not easily.

The Richmond soda tax proposal recognizes that more than half of Richmond schoolchildren are overweight or obese. This percentage is higher than in other areas of Contra Costa County.

Even more striking, city officials estimate that two-thirds of Richmond adolescents consume more than 400 calories a day from soft drinks.

Kids who habitually drink sugary sodas tend to have worse diets, to be fatter and to display more risk factors for chronic diseases than kids who don’t.

This makes sugar-sweetened beverages an obvious target for environmental approaches to obesity prevention. Sugary sodas have calories but no nutrients. They are consumed in large amounts. They are highly correlated with obesity and health risks. They are “liquid candy.”

Sugary drinks should be once-in-a-while treats, not daily fare.

Richmond officials hope that the tax will encourage healthier choices. They deliberately set the proposed tax small so it would not unduly burden low-income residents.

One penny per ounce – 16 cents on a 16-ounce soda – may not be enough to change behavior, but it sends a clear message: It’s less expensive to drink water, and it’s healthier to reduce soda intake.

Funding programs

The Richmond proposal has one other critically important feature. It specifies that soda tax revenue will be used to fund city programs to address and reduce childhood obesity, especially in low-income areas where obesity rates are high.

These experiments are worth national attention. They may well do some good for individuals, and I can’t see how they would cause harm in any way except, perhaps, to the economic interests of soda companies.

Soda companies are taking these initiatives seriously. They are pouring millions of dollars into lobbying and community campaigns against both proposals.

Both have elicited plenty of public discussion, much of it focused on the rights of individuals versus the public health interests of government.

What I like about these initiatives is that they do not infringe on individual rights – people can buy as much soda as they want. The proposals simply try to make the default food environment slightly more conducive to healthy choices.

I’m hoping both proposals go forward. I can’t wait to see how they play out.

  • http://www.FeedYourHeadDiet.com Ken Leebow

    Instead of soda taxes and shrinking sizes of soda, how about a great ad campaign that says: Drink Water.

    Maybe add a profound message from two well-known people.

    You wouldn’t think of watering a plant with soda. – Michelle Obama

    Do you want to spend the rest of your life selling sugar water to children, or do you want a chance to change the world? – Steve Jobs

    Remember the Got Milk message? It worked.

    Now …

    Drink Water

    Ken Leebow
    http://www.satietyandtaste.com

  • http://quipstravailsandbraisedoxtails.blogspot.com Michele Hays

    The major problem I have with this type of framing of the issue: people who buy soda are not really using free will. Soda and junk food companies spend billions of dollars on advertising and marketing campaigns designed specifically to manipulate consumers, using the best, most expensive, and most up-to-date psychological information.

    I think (and I wrote earlier) that all of these government efforts would be more palatable to the public if they were presented as an attempt to level the playing field so people are ABLE to make healthier choices. Back in 1950, when soda came in 6oz servings (see this blog, not mine: http://thesocietypages.org/socimages/2010/10/25/changing-soda-serving-sizes/) diet-related disease was less of an issue. In New York in particular, nobody is stopping any individual from purchasing two sodas, or refilling, or buying a 2-liter family size: they are limiting marketers’ ability to misrepresent what a single serving looks like.

    Consumers did not explicitly choose for serving sizes to get bigger, they merely were swept along in the wake of the decision by food companies to sell more and make more money.

  • Lauren

    I have to disagree with you–the rights of individuals trump the public health interests of government any day. What we have is a problem with our values-system–the internal driver of personal choices–and that is a much, much deeper issue. We have to get people to change their ways of thinking, not just coerce them into making better choices. Sure, the soda companies are in part to blame for obesity issues, but the bigger problem is with the consumer, who consistently chose to buy soda thereby funding the growth of the soda companies.

    Bloomberg’s proposal is misguided and fails to acknowledge the root issue. A better step toward reducing public consumption of soda would be to invest in an ad campaign, much like Ken suggests above. Change their hearts first, and their actions will follow suit.

  • Joel

    Comic Sans? Seriously?

  • Lauren

    Amen, Joel. Amen.

  • FarmerJane

    Have a glass of fresh wholesome milk instead of soda! We grew up lean and strong drinking milk with our meals. Soda was only a treat. We never dreamed of spending money on bottled water. Milk’s a beverage produced from the working countryside here in the Northeast, millions and millions of acres of grasslands just north of New York City. The dairy farmers of the northeast are proud of the contributions that we make to our local rural economies and the food that we produce for our beloved Big Apple.

  • Steve

    ‘Silly? On the contrary. These are dead-serious attempts to address the health problems caused by obesity through “environmental” change – changing the context in which we make food choices.’

    Dead-serious? More like brain dead. If government wishes to reduce the consumption of sugared beverages then government should quit caving to the sugar industry and put out an honest campaign pointing out how deadly sugar, in all of its forms, is for your health.

    Yes, continue to point the finger of blame in the direction of the voting public, its a heck of a lot easier then pointing the finger in the direction of the politicos who’s voting records show support their support of the sugar industry comes well before that of their constituents health.

    These taxes and laws will accomplish NOTHING when it comes to our health. They will however make for a very nice story to tell on their next campaign trail!

  • Anthro

    I like Ken’s idea! I would say to add it to the mix. We need taxes on soda, and massive counter-advertising. Adding the tax is cheaper–who pays for all the public-interest advertising? The taxes, perhaps?

    @FarmerJane

    Milk is fine and I grew up with it as well. Also, I live in Wisconsin, so I support the dairy industry, but sadly, milk for too many kids means chocolate (heavily sweetened) milk. Wholesome milk has been just as co-opted by food and beverage marketers as soda. Many gas-station type quick marts only have chocolate milk in individual serving sizes. Also, the calories can add up if you drink milk at meals and as a “snack” (where did that word come from?), so water should be the default away from home anyway.

    There are nifty water bottles available everywhere now, so no need to buy water in plastic bottles. I always have a thermos bottle of Lake Michigan’s finest in my car!

  • Margaret

    I agree that soda over-consumption is a serious nutritional problem and, that because soda is over-consumed on a national (and burgeoning global) level, serious steps need to be taken to address it.
    Testing small-scale programs like these sounds like a good idea, then we’ll be better able to judge what could happen and what will work in addressing this health issue as it continues to grow.
    I think that if consumers were to see just how much political maneuvering is involved in the production and marketing of soda, it would be clear that the purchase of soda is already (in many ways) governmentally regulated.

  • Joe

    I must reveal that I have a soft spot in my heart for an idealistic mind. The answer posted here is rooted in such idealism which cannot be discounted on face. However there is almost always a considerable distance between idealism and reality and such is the case here.

    Were it the case that by simply passing a law at the local, state or federal level of government a problem could be solved then there would be few problems. But the reality is that laws even those passed with warm fuzzy intent cannot solve problems unless there is the consent of those governed.

    For the big things like murder, theft and assault most of the governed seem to consent to live by those laws. But when it comes to legislating behaviors such as how much soda an individual can purchase and how much salt they can use or some such law how can anyone really assume that because it is a law or a tax that type of behavior will drastically change to the point the health trajectory of a nation will be altered?

    In truth nothing will change as a result of intrusive “health” laws but far be it from me to share such a truth and burst the idealistic echo chamber.

  • brad

    I’m skeptical that a “Drink Water” campaign would work, because faced with the choice between plain water and soda most people will still choose soda. Soda provides immediate taste rewards.

    In many ways this is a harder nut to crack than other unhealthy behaviors such as smoking. With smoking, either you smoke or you don’t; there’s no healthier thing to smoke. But with soda, it’s not like you can just stop drinking anything. You still have to drink something, but it has to be something other than soda. And that something, for most people, tastes boring in comparison.

    I don’t think there’s any way water can compete with soda on a large scale. I successfully weaned myself off soda years ago (I think the last time I drank a Coke was in 2005), but that was because I had cut down on my sugar intake in general and soda started tasting too sickly-sweet for me. Education alone isn’t going to change behavior; we need to appeal to people’s emotions.

    But even that’s not very effective. Look at all the people who continue to smoke despite the horrifying photos on cigarette packages and anti-smoking advertisements. I think you have to approach it from both angles: effective messaging to encourage people to move away from sodas, and taxes on sodas to discourage their consumption.

    To be effective, a soda tax has to be big enough to have a disuasive effect. If you had to pay $20 for a small bottle of soda you’d see behavior change very quickly, in the same way that people would quickly start driving less and begin buying fuel-efficient cars if gasoline were priced at $25/gallon. The key is figuring out the price point at which behavior starts to change, and then shooting for something higher than that, knowing that the political negotiation process will invariable settle on a lower value.

  • David

    I think a penny per ounce of soda would be a reasonable tax. Here in Michigan we have a .10 bottle deposit on all carbonated beverages. So a 24 pack Pepsi cube would have a $2.40 deposit. Sure you get your money back when you return your empty containers back to the store but that is too cumbersome for me. A 24 pack has 288oz and if you times that by 1 cent per oz that would be a $2.88 cent soda tax. I would be for this. The revenue generatated could go to a number of things as many states are hurting.