JAMA health forum

2689-0186512024Jan05JAMA health forumJAMA Health ForumEvaluation of Changes in Prices and Purchases Following Implementation of Sugar-Sweetened Beverage Taxes Across the US.e234737e234737e23473710.1001/jamahealthforum.2023.4737Sugar-sweetened beverage (SSB) taxes are promoted as key policies to reduce cardiometabolic diseases and other conditions, but comprehensive analyses of SSB taxes in the US have been difficult because of the absence of sufficiently large data samples and methods limitations.To estimate changes in SSB prices and purchases following SSB taxes in 5 large US cities.In this cross-sectional study with an augmented synthetic control analysis, changes in prices and purchases of SSBs were estimated following SSB tax implementation in Boulder, Colorado; Philadelphia, Pennsylvania; Oakland, California; Seattle, Washington; and San Francisco, California. Changes in SSB prices (in US dollars) and purchases (volume in ounces) in these cities in the 2 years following tax implementation were estimated and compared with control groups constructed from other cities. Changes in adjacent, untaxed areas were assessed to detect any increase in cross-border purchases. Data used for this analysis spanned from January 1, 2012, to February 29, 2020, and were analyzed between June 1, 2022, and September 29, 2023.The main outcomes were the changes in SSB prices and volume purchased.Using nutritional information, 5500 unique universal product codes were classified as SSBs, according to tax designations. The sample included 26 338 stores-496 located in treated localities, 1340 in bordering localities, and 24 502 in the donor pool. Prices of SSBs increased by an average of 33.1% (95% CI, 14.0% to 52.2%; P < .001) during the 2 years following tax implementation, corresponding to an average price increase of 1.3¢ per oz and a 92% tax pass-through rate from distributors to consumers. SSB purchases declined in total volume by an average of 33.0% (95% CI, -2.2% to -63.8%; P = .04) following tax implementation, corresponding to a -1.00 price elasticity of demand. The observed price increase and corresponding volume decrease immediately followed tax implementation, and both outcomes were sustained in the months thereafter. No evidence of increased cross-border purchases following tax implementation was found.In this cross-sectional study, SSB taxes led to substantial, consistent declines in SSB purchases across 5 taxed cities following price increases associated with those taxes. Scaling SSB taxes nationally could yield substantial public health benefits.KaplanScottSDepartment of Economics, US Naval Academy, Annapolis, Maryland.WhiteJustin SJSDepartment of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts.MadsenKristine AKASchool of Public Health, University of California, Berkeley.BasuSanjaySInstitute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.Villas-BoasSofia BSBDepartment of Agricultural & Resource Economics, University of California, Berkeley.SchillingerDeanDDivision of General Internal Medicine, Center for Vulnerable Populations, San Francisco General Hospital/University of California, San Francisco.engP30 DK092924DKNIDDK NIH HHSUnited StatesP30 DK098722DKNIDDK NIH HHSUnited StatesU18 DP006526DPNCCDPHP CDC HHSUnited StatesJournal Article20240105