Anticipatory changes in British household purchases of soft drinks associated with the announcement of the Soft Drinks Industry Levy: A controlled interrupted time series analysis

Abstract

Background: Sugar-sweetened beverage (SSB) consumption is positively associated with obesity, type 2 diabetes, and cardiovascular disease. The World Health Organization recommends that member states implement effective taxes on SSBs to reduce consumption. The United Kingdom Soft Drinks Industry Levy (SDIL) is a two-tiered tax, announced in March 2016 and implemented in April 2018. Drinks with ≥8 g of sugar per 100 ml (higher levy tier) are taxed at £0.24 per litre, drinks with ≥5 to <8 g of sugar per 100 ml (lower levy tier) are taxed at £0.18 per litre, and drinks with <5 g sugar per 100 ml (no levy) are not taxed. Milk-based drinks, pure fruit juices, drinks sold as powder, and drinks with >1.2% alcohol by volume are exempt. We aimed to determine if the announcement of the SDIL was associated with anticipatory changes in purchases of soft drinks prior to implementation of the SDIL in April 2018. We explored differences in the volume of and amount of sugar in household purchases of drinks in each levy tier at 2 years post announcement.

Methods and findings: We used controlled interrupted time series to compare observed changes associated with the announcement of the SDIL to the counterfactual scenario of no announcement. We used data from Kantar Worldpanel, a commercial household purchasing panel with approximately 30,000 British members that includes linked nutritional data on purchases. We conducted separate analyses for drinks liable for the SDIL in the higher, lower, and no-levy tiers controlling with household purchase volumes of toiletries. At 2 years post announcement, there was no difference in volume of or sugar from purchases of higher-levy-tier drinks compared to the counterfactual of no announcement. In contrast, a reversal of the existing upward trend in volume (ml) of and amount of sugar (g) in purchases of lower-levy-tier drinks was seen. These changes led to a -96.1 ml (95% confidence interval [CI] -144.2 to -48.0) reduction in volume and -6.4 g (95% CI -9.8 to -3.1) reduction in sugar purchased in these drinks per household per week. There was a reversal of the existing downward trend in the amount of sugar in household purchases of the no-levy drinks but no change in volume purchased. At 2 years post announcement, these changes led to a 6.1 g (95% CI 3.9-8.2) increase in sugar purchased in these drinks per household per week. There was no evidence that volume of or amount of sugar in purchases of all drinks combined was different from the counterfactual. This is an observational study, and changes other than the SDIL may have been responsible for the results reported. Purchases consumed outside of the home were not accounted for.

Conclusions: The announcement of the UK SDIL was associated with reductions in volume and sugar purchased in lower-levy-tier drinks before implementation. These were offset by increases in sugar purchased from no-levy drinks. These findings may reflect reformulation of drinks from the lower levy to no-levy tier with removal of some but not all sugar, alongside changes in consumer attitudes and beliefs.

Trial registration: ISRCTN Registry ISRCTN18042742.

Fig 1. Observed and modelled volume (ml) of drinks liable to the Soft Drinks Industry Levy and weight of confectionery (g) purchased per household per week, March 2014–March 2018.

Notes. Points are observed data, thick lines (with shadows) are modelled data (and 95% confidence intervals); thin lines (without shadows) are the counterfactual had the announcement not happened; blue points and lines are drinks/confectionary; red points and lines are the control category of toiletries; the vertical dashed line indicates the point of announcement of the SDIL; Y-axes vary in scale between panels to maximise the resolution of figures; modelled purchases include all adjustments as described in the methods section.

Fig 2. Observed and modelled amount of sugar (g) in drinks liable to the Soft Drinks Industry Levy and confectionery (g) purchased per household per week, March 2014–March 2018.

Notes. Points are observed data, thick lines (with shadows) are modelled data (and 95% confidence intervals); thin lines (without shadows) are the counterfactual had the announcement not happened; blue points and lines are drinks/confectionary; red points and lines are the control category of toiletries; the vertical dashed line indicates the point of announcement of the SDIL; Y-axes vary in scale between panels to maximise the resolution of figures; modelled purchases include all adjustments as described in the methods section.