The Sweet Victory of Mexico’s Bold Experiment
Picture this: every kid in Mexico was drinking over 250 Coca-Cola products per year before 2014. South African 9- and 10-year-olds drink an average of 254 Coca-Cola products per year (compared with the global average of 89), making Mexican children some of the world’s heaviest consumers of sugary drinks. When Mexico implemented its one peso per liter tax in 2014, something remarkable happened that caught the entire public health world’s attention. The results of the evaluation of the tax in Mexico revealed reductions in SSB purchases of 8.2% on average over the first two years. What made this even more impressive was how the effects didn’t fade away after the initial shock. Purchases of taxed beverages decreased 5.5 percent in 2014 and 9.7 percent in 2015, yielding an average reduction of 7.6 percent over the study period. Even more encouraging, the poorest households showed the biggest changes, which means the tax was helping exactly the people who needed it most.
United Kingdom’s Masterful Reformulation Strategy
The UK took a completely different approach that turned out to be pure genius. Instead of just slapping on a tax and hoping for the best, they gave companies two whole years to reformulate their drinks before the levy kicked in. The primary mechanism driving these reductions has been recipe reformulation, representing 83% of SDIL-associated reductions in weekly calorie intake from soft drinks. Talk about playing the long game! The total sugar sold in soft drinks by retailers and manufacturers decreased by 35.4% between 2015 and 2019, from 135,500 tonnes to 87,600 tonnes. Companies literally raced to get under the tax threshold, and consumers barely noticed because their favorite brands tasted almost exactly the same. A 2024 study led by the University of Cambridge found that, in the 11 months after the implementation of the tax, daily sugar consumption from drinks had fallen on average by 3.0g in children and 5.2g in adults. Now that’s what you call a win-win situation where everyone comes out healthier.
South Africa Tackles a Continental Crisis
When South Africa introduced its Health Promotion Levy in 2018, they were facing a crisis that would make any health minister lose sleep. According to the South African Demographic and Health Survey (2016), 68% of women, 31% of men and 13% of children are overweight or obese. That’s not just a number – that’s a health emergency waiting to explode. In fact, in 2018, diabetes was the second-largest cause of death among South Africans after tuberculosis. The sugar tax came with a unique twist: it was based on actual sugar content, not just volume. Daily consumption of SSBs reportedly declined by 7.7% when participants in Cape Town noticed the price increase and mainly substituted it with water or sugar-free carbonated drinks. What’s fascinating is that even at the relatively modest 11% tax rate, the tax has reduced consumers’ consumption of sugary beverages by about 2g per capita per day. Every gram counts when you’re fighting a diabetes epidemic.
Portugal’s Double-Barreled Approach
Portugal decided to get creative with their 2017 sugar tax by creating a two-tier system that really made companies think twice about loading their drinks with sugar. A two-tiered SSB tax was introduced in Portugal in 2017 at a rate of €0.8 per L and €0.16 per L for drinks with sugar contents of <80 g per L and ≥80 g per L, respectively. Nearly 100% of the tax was passed on to consumers. A 7% reduction in SSB sales was reported in the first year, with reformulation leading to an 11% reduction. The Portuguese weren't messing around – they wanted to see real change, not just token gestures. Reformulation processes led to an 11% reduction of total energy intake through sweetened beverages' consumption by the Portuguese population. What makes Portugal special is that they actually went back and made their tax even better after seeing the initial results. Portugal is the first country redesigning its taxation model to maximise sugar reduction and reformulation among producers. They're basically showing the world how to fine-tune these policies for maximum impact.
France’s Quiet Revolution
France has been flying under the radar with their sugar tax since 2012, but don’t let their low-key approach fool you. We find that the tax is transmitted to the prices of taxed drinks, with full transmission for soft drinks and partial transmission for fruit juices. While the French tax might seem modest at €0.0716 per liter, it’s been doing exactly what it was designed to do: make people think twice about that extra can of soda. The evidence on purchase responses is mixed and less robust, indicating at most a very small reduction in soft drink purchases (about half a litre per capita per year), an impact which would be consistent with the low tax rate. Sometimes steady progress beats dramatic headlines, and France has proven that even small changes can add up over time. The fact that they’ve kept this tax running for over a decade without major political backlash shows that sustainable policy-making sometimes means starting small and building momentum.
Philadelphia’s Urban Experiment
Philadelphia became America’s guinea pig for sugar taxes, and boy, did they learn some hard lessons about implementation. A 1.5¢ per oz tax on SSBs (including diet soft drinks but excluding fruit juices and milk drinks) was introduced in the city of Philadelphia in 2017. The tax was fully passed on to consumers, leading to a price increase of 21% for the taxed drinks one year later. The results were actually pretty impressive when you dig into the numbers. Even after accounting for cross-border shopping (e.g. from nearby towns without the tax), there was a 35% overall reduction in SSB sales across the city. Adults in Philadelphia reduced their consumption of sugars from SSBs by an average of 6 g per day after one year of the tax. The challenge was that people started driving to neighboring towns to buy their drinks, which is the classic problem with local taxes. But even accounting for that cross-border shopping, Philadelphia still saw massive reductions in sugary drink consumption within city limits.
Berkeley’s Pioneering Spirit
Berkeley, California, deserves a special place in sugar tax history because they were the brave first ones to try this in America back in 2015. A 1¢ per fl oz SSB tax was introduced in Berkeley, California in 2015, resulting in an average price increase of 0.83¢ per fl oz. One year after the introduction of the tax, there was a 20% decrease in SSB consumption. What makes Berkeley’s story so compelling is that the effects didn’t just last for a few months and then fade away. A 2019 study relying on self-reporting found a 53% drop in consumption in low-income neighborhoods after three years. That’s the kind of sustained change that public health advocates dream about. Berkeley showed that American cities could actually do this without the sky falling, and they paved the way for other cities to follow their lead. Sometimes being first means taking all the heat, but Berkeley proved that sugar taxes could work in the American context.
