Taxing Soda to prevent obesity?

Obesity has become the most important public health initiative since cigarette smoking. And like cigarette smoking, The New England Journal of Medicine (NEJM)'s most recent health policy report suggests taxing soda and sugary sweetened beverages. Soda is linked to increased obesity. The NEJM report cites studies which link sugar sweetened beverages to obesity. Because of that, the NEJM report suggests that taxation could decrease soda consumption and in turn, could reduce obesity.

The proponents for taxation on soda and similar beverages assert that this initiative, like the tax on cigarette smoking, will decrease soda and sugary beverage consumption and generate cash.The NEJM reports: "A national tax of 1 cent per ounce on sugar-sweetened beverages would raise $14.9 billion in the first year alone. " The plan for those dollars would then be to put them back into public health initiatives to prevent and treat obesity.

Critics to taxation argue that it is the poor who will be paying the large portion of taxes for these beverages. They also argue that if we start levying taxes on food items such as soda, why not fast food and junk foods which are linked to obesity as well. And will taxation on one item really lead to a decrease in obesity?

Regardless of your thoughts around taxation of soda and sugary beverages it is a fact that obesity has large economic costs. Hospitalizations due to childhood obesity have increased and costs related to that have near doubled in just a few years as documented by Health Affairs. Health care and lost productivity due to obesity cost California $41.2 billion in 2006. California Controller John Chiang estimates "the economic cost to California of adults who are obese, overweight and physically inactive is equivalent to more than a third of the state's total budget." So even if you are not obese, overweight or unhealthy, you are paying for someone who is.

Pediatricians do inform their patients about the risks of soda consumption. Unfortunately, soda and similar beverages are inexpensive and easily accessible. Our American cultural acceptance of soda and sugary sweetened beverages plays a role in the excess consumption of these beverages. Before reading the NEJM report, I was reluctant to consider taxing my patients and their parents, because in these hard economic times, every penny counts. However, my goal is to keep my patients healthy. And despite my multiple discussions with families on nutrition and exercise, I rarely see measurable progress. This is heart breaking for me, because I understand the medical challenges related to obesity which including heart disease and diabetes. So, if taxation is the one way that these kids will decrease their consumption then I believe it is worth considering.