Global Patterns in Price Elasticities of Sugar-sweetened Beverage Intake and Potential Effectiveness of Tax Policy: a Cross-sectional Study of 164 Countries by Sex, Age and Global-income Decile

Objective: To quantify global relationships between sugar-sweetened beverage (SSB) intake and prices and examine the potential effectiveness of tax policy.

Design: SSB intake data by country, age and sex from the Global Dietary Database were combined with gross domestic product and price data from the World Bank. Intake responsiveness to income and prices was estimated accounting for national income, age and sex differences.

Setting: 164 countries.

Population: Full adult population in each country.

Main Outcome Measures: A consumer demand modelling framework was used to estimate the relationship between SSB intake and prices and derive own-price elasticities (measures of percentage changes in intake from a 1% price change) globally by age and sex. We simulated how a 20% tax would impact SSB intake globally. Tax policy outcomes were examined across countries by global income decile for representative age and sex subgroups.

Results: Own-price responsiveness was highest in lowest income countries, ranging from -0.70 (p<0.100) for women, age 50, to -1.91 (p<0.001) for men, age 80. In the highest income countries, responsiveness was as high as -0.49 (p<0.001) (men, age 20), but was mostly insignificant for older adults. Overall, elasticities were strongest (more negative) at the youngest and oldest age groups, and mostly insignificant for middle-aged adults, particularly in middle-income and high-income countries. Sex differences were mostly negligible. Potential intake reductions from a 20% tax in lowest income countries ranged from 14.5% (95% CI: 29.5%, -0.4%) in women, 35 ≤ age < 60, to 24.9% (44.4%, 5.3%) in men, age ≥60. Intake reductions decreased with country income overall, and were mostly insignificant for middle-aged adults.

Conclusions: These findings estimate the global price-responsiveness of SSB intake by age and sex, informing ongoing policy discussions on potential effects of taxes.