The UK Soft Drinks Industry Levy and childhood hospital admissions for asthma in England

Abstract

Sugar sweetened beverage consumption has been suggested as a risk factor for childhood asthma symptoms. We examined whether the UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, was associated with changes in National Health Service hospital admission rates for asthma in children, 22 months post-implementation of SDIL. We conducted interrupted time series analyses (2012-2020) to measure changes in monthly incidence rates of hospital admissions. Sub-analysis was by age-group (5-9,10-14,15-18 years) and neighbourhood deprivation quintiles. Changes were relative to counterfactual scenarios where the SDIL wasn't announced, or implemented. Overall, incidence rates reduced by 20.9% (95%CI: 29.6-12.2). Reductions were similar across age-groups and deprivation quintiles. These findings give support to the idea that implementation of a UK tax intended to reduce childhood obesity may have contributed to a significant unexpected and additional public health benefit in the form of reduced hospital admissions for childhood asthma.

Fig. 1. Incidence rates (per 100,000 population per month) of hospital admissions for asthma, in children aged 5–18 between January 2012 and February 2020.

Observed and modelled incidence of hospital admissions for asthma. Dark blue points show observed data and dark blue lines (with grey shadows) shows modelled data (and 95% confidence intervals) of incidence. The red line indicates the counterfactual line based on the pre-SDIL announcement trajectory. The first and second dashed vertical lines indicate the date of the SDIL announcement and implementation, respectively.

Fig. 2. Incidence rates (per 100,000 population per month) of hospital admissions for asthma, in children aged 5–18 between January 2012 and February 2020, by age-group.

Observed and modelled incidence of hospital admissions for asthma. Dark blue points show observed data and dark blue lines (with grey shadows) shows modelled data (and 95% confidence intervals). The red line indicates the counterfactual line based on the observed pre-SDIL announcement trajectory. The first and second dashed vertical lines indicate the time of the SDIL announcement and implementation, respectively.

Fig. 3. Incidence rates (per 100,000 population per month) of hospital admissions for asthma, in children aged 5–18 between January 2012 and February 2020, by socioeconomic position, measured by Multiple Index of Deprivation quintiles.

Observed and modelled incidence rates of hospital admissions for asthma. Dark blue points show observed data and dark blue lines (with grey shadows) shows modelled data (and 95% confidence intervals). The red line indicates the counterfactual line based on the observed pre-SDIL announcement trajectory. The first and second dashed vertical lines indicate the time of the SDIL announcement and implementation, respectively.