1. Pomeranz JL, Teret SP, Sugarman SD, Rutkow L, Brownell KD. Innovative legal approaches to address obesity. Milbank Q. 2009;87(1):185–213.[PMC free article][PubMed]
2. US Dept of Agriculture. Agriculture Fact Book (2001–2002). Available at: http://www.usda.gov/factbook/2002factbook.pdf. Accessed February 1, 2013.
3. World Health Organization, Food and Agricultural Organization. Diet, nutrition and the prevention of chronic diseases. 2003. Available at: http://whqlibdoc.who.int/trs/WHO_TRS_916.pdf. Accessed February 1, 2013.
4. Drewnowski A, Darmon N. The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr. 2005;82(1 suppl):265S–273S.[PubMed]
5. Darmon N, Ferguson E, Briend A. Do economic constraints encourage the selection of energy dense diets? Appetite. 2003;41(3):315–322.[PubMed]
6. Powell LM, Chaloupka FJ. Food prices and obesity: evidence and policy implications for taxes and subsidies. Milbank Q. 2009;87(1):229–257.[PMC free article][PubMed]
7. Caraher M, Cowburn G. Taxing food: implications for public health nutrition. Public Health Nutr. 2005;8(8):1242–1249.[PubMed]
8. Kuchler F, Tegene A, Harris JM. Taxing snack foods: manipulating diet quality or financing information programs? Appl Econ Perspect Policy. 2005;27(1):4–20.
9. Mytton O, Gray A, Rayner M, Rutter H. Could targeted food taxes improve health? J Epidemiol Community Health. 2007;61(8):689–694.[PMC free article][PubMed]
10. Denmark introduces world’s first food fat tax. BBC News. October 1, 2011. Available at: http://www.bbc.co.uk/news/world-europe-15137948. Accessed January 29, 2013.
11. A fat chance: the Danish government rescinds its unwieldy fat tax. Economist. November 17, 2012. Available at: http://www.economist.com/news/europe/21566664-danish-government-rescinds-its-unwieldy-fat-tax-fat-chance. Accessed January 28, 2012.
12. Holt E. Hungary to introduce broad range of fat taxes. Lancet. 2011;378(9793):755.[PubMed]
13. Villanueva T. European nations launch tax attack on unhealthy foods. CMAJ. 2011;183(17):E1229–E1230.[PMC free article][PubMed]
14. Cheney C. Battling the couch potatoes: Hungary introduces “fat tax.” Spiegel Online. September 1, 2011. Available at: http://www.spiegel.de/international/europe/battling-the-couch-potatoes-hungary-introduces-fat-tax-a-783862.html. Accessed January 29, 2013.
15. Leicester A, Windmeijer F. The “fat tax”: economic incentives to reduce obesity. Institute for Fiscal Studies. 2004. Available at: http://eprints.ucl.ac.uk/14931/1/14931.pdf. Accessed January 15, 2012.
16. Brownell KD, Frieden TR. Ounces of prevention—the public policy case for taxes on sugared beverages. N Engl J Med. 2009;360(18):1805–1808.[PubMed]
17. Gearhardt AN, Bragg MA, Pearl RL, Schvey NA, Roberto CA, Brownell KD. Obesity and public policy. Annu Rev Clin Psychol. 2012;8:405–430.[PubMed]
18. Jou J, Techakehakij W. International application of sugar-sweetened beverage (SSB) taxation in obesity reduction: factors that may influence policy effectiveness in country-specific contexts. Health Policy. 2012;107(1):83–90.[PubMed]
19. American Lung Association. State cigarette excise tax. State of tobacco control. 2012. Available at: http://www.stateoftobaccocontrol.org/state-grades/methodology/state-cigarette-excise-tax.html. Accessed October 18, 2012.
20. Kim D, Kawachi I. Food taxation and pricing strategies to “thin out” the obesity epidemic. Am J Prev Med. 2006;30(5):430–437.[PubMed]
21. Jacobson MF, Brownell KD. Small taxes on soft drinks and snack foods to promote health. Am J Public Health. 2000;90(6):854–857.[PMC free article][PubMed]
22. Chouinard HH, Davis DE, LaFrance JT, Perloff JM. Fat taxes: big money for small change. Forum Health Econ Policy. 2007;10(2)
23. National Audit Office. Tackling obesity in England. 2001. Available at: http://www.nao.org.uk/publications/0001/tackling_obesity_in_england.aspx. Accessed February 1, 2013.
24. Pomeranz JL. Advanced policy options to regulate sugar-sweetened beverages to support public health. J Public Health Policy. 2012;33(1):75–88.[PubMed]
25. Cutler DM, Glaeser EL, Shapiro JM. Why have Americans become more obese? National Bureau of Economic Research. 2003. Available at: http://www.cib.espol.edu.ec/Digipath/D_Papers/45741.pdf. Accessed July 13, 2011.
26. Chriqui JF, Eidson SS, Bates H, Kowalczyk S, Chaloupka FJ. State sales tax rates for soft drinks and snacks sold through grocery stores and vending machines, 2007. J Public Health Policy. 2008;29(2):226–249.[PubMed]
27. Guthrie JF, Frazão E, Andrews M. Improving food choices—can food stamps do more? Economic Research Service, US Dept of Agriculture. 2007. Available at: http://www.ers.usda.gov/AmberWaves/April07/PDF/Improving.pdf. Accessed January 13, 2012.
28. Qi Q, Chu AY, Kang JH et al. Sugar-sweetened beverages and genetic risk of obesity. N Engl J Med. 2012;367(15):1387–1396.[PMC free article][PubMed]
29. Andreyeva T, Chaloupka FJ, Brownell KD. Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue. Prev Med. 2011;52(6):413–416.[PubMed]
30. Fletcher JM, Frisvold D, Tefft N. Can soft drink taxes reduce population weight? Contemp Econ Policy. 2010;28(1):23–35.[PMC free article][PubMed]
31. Edwards R. Commentary: soda taxes, obesity, and the shifty behavior of consumers. Prev Med. 2011;52(6):417–418.[PubMed]
32. Andreyeva T, Long MW, Brownell KD. The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food. Am J Public Health. 2010;100(2):216–222.[PMC free article][PubMed]
33. Bowman SA. Diets of individuals based on energy intakes from added sugars. Fam Econ Nutr Rev. 1999;12(2):31–38.
34. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff (Millwood) 2009;28(5):w822–w831.[PubMed]
35. Jochelson K. Nanny or steward? The role of government in public health. Public Health. 2006;120(12):1149–1155.[PubMed]
36. Griffith R, O’Connell M. Public policy towards food consumption. Fisc Stud. 2010;31(4):481–507.
37. Steenhuis IHM, Waterlander WE, de Mul A. Consumer food choices: the role of price and pricing strategies. Public Health Nutr. 2011;14(12):2220–2226.[PubMed]
38. Volkow ND, Wise RA. How can drug addiction help us understand obesity? Nat Neurosci. 2005;8(5):555–560.[PubMed]
39. Wang GJ, Volkow ND, Logan J et al. Brain dopamine and obesity. Lancet. 2001;357(9253):354–357.[PubMed]
40. Yaniv G, Rosin O, Tobol Y. Junk-food, home cooking, physical activity and obesity: the effect of the fat tax and the thin subsidy. J Public Econ. 2009;93(5–6):823–830.
41. Epstein LH, Dearing KK, Paluch RA, Roemmich JN, Cho D. Price and maternal obesity influence purchasing of low- and high-energy-dense foods. Am J Clin Nutr. 2007;86(4):914–922.[PMC free article][PubMed]
42. Sturm R, Datar A. Food prices and weight gain during elementary school: 5-year update. Public Health. 2008;122(11):1140–1143.[PMC free article][PubMed]
43. Ross H, Blecher E, Yan L, Hyland A. Do cigarette prices motivate smokers to quit? New evidence from the ITC survey. Addiction. 2011;106(3):609–619.[PMC free article][PubMed]
44. Hu TW, Sung HY, Keeler TE. Reducing cigarette consumption in California: tobacco taxes vs an anti-smoking media campaign. Am J Public Health. 1995;85(9):1218–1222.[PMC free article][PubMed]
45. Rivard C, Smith D, McCann SE, Hyland A. Taxing sugar-sweetened beverages: a survey of knowledge, attitudes and behaviours. Public Health Nutr. 2012;15(8):1355–1361.[PMC free article][PubMed]
46. Gordon-Larsen P, Guilkey DK, Popkin BM. An economic analysis of community-level fast food prices and individual-level fast food intake: a longitudinal study. Health Place. 2011;17(6):1235–1241.[PMC free article][PubMed]
47. Mhurchu CN. Food costs and healthful diets the need for solution-oriented research and policies. Am J Clin Nutr. 2010;92(5):1007–1008.[PubMed]
48. Mytton OT, Clarke D, Rayner M. Taxing unhealthy food and drinks to improve health. BMJ. 2012;344 e2931. [PubMed]
Health and Mental Hygiene
Edward L. Glaeser is an economics professor at Harvard.
Over the past 30 years, Americans have gotten a lot heavier thanks primarily to technological progress in the food industry, which has provided an abundance of tasty, caloric treats. The champions of public health are now fighting fat with the same tools that helped turn the smoky city of the “Mad Men” era into the clean-aired boroughs of Bloomberg.
New York City is runninganti-soda ads where a brown liquid streaming out of a bottle turns into fat in a glass. The New York Times editorial page wants sterner stuff. It suggests that these ads are distinctly inferior to “the best move when it comes to soft drinks — a tax on sodas and other sugary beverages.”
Many public interventions can be readily dismissed because they are costly and ineffective. Yet the battle against cigarettes has taught us that taxes and advertising together can dramatically reduce an unhealthy habit. The public sector could indeed dramatically drive down the consumption of sugary sodas, but should it? Is public paternalism appropriate? If the state wants to champion health, should it use stomach-churning public service messages or sin taxes?
The economist’s perspective differs from the perspective of the public health advocate.
Public health advocates champion health. Economists don’t exactly champion illness, but they don’t usually think that health trumps all. For die-hard cola lovers, the pleasure of sugary soda may just be more important than the health consequences of a few extra calories. That perspective, combined with a respect for individual decision-making, leads many economists to question the merits of public paternalism.
Cola taxes and unpleasant ads are appropriate only if soda sippers are making bad decisions and drinking when they shouldn’t. One reason why consumers might err is that they ignore the impact of their behavior on others. Advocates of a penny-per-ounce soda tax argue that “because of the contribution of the consumption of sugar-sweetened beverages to obesity, as well as the health consequences that are independent of weight, the consumption of sugar-sweetened beverages generates excess health care costs.”
But if soda is to be taxed because of the costs that obesity and diabetes impose on taxpayers, then the tax’s supporters should document that those costs are near a penny for each ounce of soda.
An alternative justification for paternalism is that out of ignorance or an absence of self-control, people don’t make decisions that are in their own best interests. Every cola can has so much dietary information that it is hard to imagine that anyone thinks that soda is slimming. Public information campaigns can provide knowledge without repulsive images. And if self-control is the problem, then soda drinkers themselves should be leading the campaign for a soda tax. I haven’t seen much of that.
But if we are indeed convinced that soda consumption needs to fall, then should the government use taxes or psychologically savvy advertisements?
Both approaches try to reduce soda consumption by making it less pleasant to drink soda. One approach hits you in the wallet; the other hits you in the stomach.
Some fans of limited government think that public service advertisements represent a more modest, and hence preferable, intervention, but that rationale doesn’t seem right to me. A tiny tax actually can be far less intrusive than a constant barrage of disgusting ads. If these ads lead to warning pictures showing globules of fat on every can of Coke, then the intervention will have become enormously intrusive and probably effective as well.
The big difference between ads and taxes is not intrusiveness or effectiveness, but that taxes raise revenue and ads don’t.
Both interventions make it more costly to drink a glass of Coke, but in one case (the tax) this cost is transferred to the government. In the other case (the ad), the cost is just pure loss. An effective ad that makes drinking soda less psychologically pleasant is essentially a tax without revenue.
The case for taxes and against ads is that if we are going to impose costs on cola drinkers, it is better to get some revenue back. Of course, the problem with that revenue is that it creates an incentive for the tax-hungry government to make taxes higher than they should be. Just as an inefficient Medicare system could make expanding public health care less politically appealing, an inefficient means of taxing soda makes it less appealing to raise the tax excessively.
Obesity is a serious problem and high-calorie sodas contribute to that problem. But that doesn’t make the case for giving soda the same treatment that was earlier given to cigarettes. All soda drinkers, even the rail-thin ones, suffer when soda consumption is either taxed or vilified. The costs imposed on them need to be weighed against the benefits of reducing obesity.