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Illnesses caused by lifestyle, such as cancer, diabetes, heart disease and strokes, have overtaken infectious diseases to become the biggest killers of the modern age.
Illnesses caused by lifestyle, such as cancer, diabetes, heart disease and strokes, have overtaken infectious diseases to become the biggest killers of the modern age. Photograph: Brian Harris/Rex features
Illnesses caused by lifestyle, such as cancer, diabetes, heart disease and strokes, have overtaken infectious diseases to become the biggest killers of the modern age. Photograph: Brian Harris/Rex features

Tax sugar, alcohol and tobacco to help the poor, say experts

This article is more than 5 years old

On the eve of the UK introduction of a sugary drinks levy, experts urge global adoption of ‘sin taxes’ to deter unhealthy habits and check the spread of disease

So called “sin taxes” on sugary drinks, alcohol and tobacco not only work, but will help rather than unduly penalise the poor, according to a major new international analysis.

Just a day before the UK brings in a levy on sugary drinks, experts are urging every country in the world to use taxes to deter people from the eating, drinking and smoking habits that will damage their health. They warn of the urgent need to check the spread of cancers, diabetes, heart disease, stroke and other conditions caused or exacerbated by our lifestyles which have overtaken infectious diseases as the biggest killers of the modern age.

Five papers published in the Lancet medical journal say these non-communicable diseases (NCDs) are having a big and growing impact in low and middle-income countries, following in the footsteps of affluent nations. Those countries have 80% of resultant deaths. “There is a vicious cycle of NCDs leading to poverty and poverty leading to NCDs,” said Dr David Peters, professor of international health at the Johns Hopkins Bloomberg School of Public Health, one of the authors. But the global scale of the problem has gone under the radar.

“Part of it is the spread of diet and lifestyles and part of it is because people weren’t looking at it before. If you don’t shine a light on it, you don’t see it as a problem,” he said.

NCDs cause 38m deaths a year and 16m of those are premature – in people under 70. The experts analysed the effects of taxes on sugary drinks, tobacco and alcohol in countries that have introduced them and found that the criticism that they are regressive – penalising the poorest – is unfounded.

In Mexico the introduction of a sugary drinks taxes cut consumption by an average of 4.2litres per person. Photograph: William Thomas Cain/Getty Images

They looked at 13 countries: Chile, Guatemala, Panama, Nicaragua, Albania, Poland, Turkey, Tajikistan, Tanzania, Niger, Nigeria, India and Timor-Leste. They found that wealthier families generally spend more on alcohol, soft drinks and snacks. In India, for instance, wealthier households spent seven times more on alcohol and three times more on soft drinks and snacks compared to poorer households. So those households end up paying a larger proportion of any tax.

On the other hand, taxes have a greater impact on the smaller household budgets of poorer families. They respond by buying less, with greater benefits for their health. In the UK, say the authors, the response to the possible introduction of a minimum price for alcohol was estimated to be 7.6 times larger in the poorest households, compared with the wealthiest.

In Mexico, the introduction of a sugary drinks tax resulted in an average of 4.2 litres less of soft drinks purchased per person, with a 17% decrease in purchases among lower income groups and almost no change in higher income groups. In Lebanon, they say, a 50% increase in the price of cigarettes would lead to twice as many people quitting smoking in poorer households as affluent families.

“The evidence suggests that concerns about higher taxes on tobacco, alcohol, and soft drinks harming the poor are overstated,” said Dr Rachel Nugent from RTI International in Seattle, USA, and chair of the Lancet Taskforce on NCDs and economics.

“Some degree of taxation on tobacco is common in many countries, and while we are starting to see progress on alcohol taxes, there is much more governments should be doing – in both high and low income countries – to consider the careful introduction of taxes on other unhealthy products like soft drinks and snacks. Price policies such as taxes will be a key part of the response to rising rates of non-communicable diseases.”

The UK sugar tax is a levy on the manufacturers of 18p per litre for drinks containing 5g of sugar per 100ml and 24p on those with 8g per 100ml. Many companies have reformulated their products, often swapping artificial sweeteners for sugar. Some – like Coca-Cola – have decided to stick to the original recipe and the price will rise, although the bottles and cans will shrink to reduce the impact.

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