When considering taxing sugar-sweetened beverages in Canada, policy-makers should look at lessons learned from tobacco taxation, especially how taxation could increase inequalities and stigma, argues an analysis in CMAJ (Canadian Medical Association Journal)
"Proponents of a tax on sugar-sweetened beverages are quick to emphasize positive aspects of a tobacco tax; however, a thorough comparison analysis reveals other lessons about exacerbation of inequity and stigma, including racial stigma, in already-marginalized populations," writes Natalie Riediger, University of Manitoba, Winnipeg, Manitoba, with Andrea Bombak, Central Michigan University, Mount Pleasant, Michigan.
The authors look at the issues around taxation of sugar-sweetened beverages through a social justice lens.
"Many public health policies can have unintended consequences for some groups and it is important to consider this when implementing new policies," they write.
People of low socioeconomic status and Aboriginal populations in Canada consume more sugar-sweetened beverages than the general population and have higher rates of obesity and diabetes.
"For taxation of sugar-sweetened beverages to be effective as a measure of population health, it must affect consumption in these populations."
The authors suggest that taxing only certain sugar-sweetened beverages, namely soft drinks, may heighten stigma around obesity and further isolate marginalized people. Sweetened coffee drinks, which are mainly consumed in areas where people of higher socioeconomic status live or work, are not being recommended for taxation, despite their increasing consumption.
"A sweetened beverage tax aimed only at regular soft drinks may carry classist and racist overtones that could exacerbate stigma directed at already-marginalized groups," write the authors. "In other words, economically advantaged people may continue to drink their frappuccino, untaxed, while less wealthy people are taxed for their cola, despite similar added sugar content."
Taxing soda could also affect relations with Aboriginal peoples who live on reserves where there are long-term water advisories because of unsafe supply. Many people in these situations rely on soft drinks for hydration.
The authors urge involvement of Aboriginal peoples in developing taxation policies around sugar-sweetened beverages.
"Sugar-sweetened beverages as the new tobacco: examining a proposed tax policy through a Canadian social justice lens" is published March 19, 2018.
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Natalie D. Riediger et al. Sugar-sweetened beverages as the new tobacco: examining a proposed tax policy through a Canadian social justice lens, Canadian Medical Association Journal (2018). DOI: 10.1503/cmaj.170379