Tax sugary drinks? Here’s how to spend the money

Even these days, there can be surprising power left in a penny.

It’s been estimated that increasing taxes on sugar-sweetened beverages to a penny an ounce would mean a 5% reduction in the prevalence of obesity and overweight over 10 years and cut medical costs by $17 billion, according to an article in the January issue of Health Affairs.

In that light, such a tax on sugar-sweetened beverages may well be appealing to lawmakers. But they also may feel that their good deed ends in collecting the tax. Not so. The American Medical Association has offered well-informed guidance on what should happen when all those pennies are collected.

In June, the AMA’s House of Delegates adopted policy that if and when such taxes are levied, the revenue primarily should go toward programs that prevent and treat obesity and related conditions, particularly in communities and schools most affected by obesity.

The delegates did not take a position on the beverage taxes themselves, but did address a problem already well-demonstrated by how states have handled money from the tobacco industry. States are expected to receive $25.6 billion in fiscal 2012 from tobacco taxes and the 1998 court settlement with that industry. But an analysis from the Campaign for Tobacco-Free Kids finds that states will spend only 1.8% of that money — well under $500 million — on anti-tobacco programs.

The beverage industry says sugary drink taxes — which do, in fact, exist in 40 states but not at penny-an-ounce levels — are misguided and blocks them whenever it can. Its position, not surprisingly, is that taxing sugar-sweetened beverages does not significantly reduce obesity.

The Health Affairs article stands in sharp contrast to that industry stance. The authors estimated not only the drop in obesity noted above, but assert that a penny-an-ounce tax over 10 years would reduce sugary drink consumption by 15%, thus preventing 95,000 coronary heart events, 8,000 strokes and 26,000 premature deaths.

But while the question of tax or no tax is fought out in front of lawmakers, the facts about sugary drinks paint a disturbing picture.

AMA delegates voting on the issue of the taxes were responding to a report on sugar-sweetened beverages presented by the AMA’s Council on Science and Public Health. The report states that half of Americans older than age 2 drink sugar-sweetened beverages on any given day, and the biggest users are teens and young adults. Such products contribute to 46% of Americans’ added sugar intake.

The AMA and American Heart Assn. recommend limiting added caloric sweeteners, with the AHA advising that women should drink no more than 100 calories daily of added sugar and men no more than 150 such calories. Trouble is, a 12-ounce sugar-sweetened beverage contains 130 to 150 calories of added sugar.

Sugar-sweetened beverages have been linked to increased body weight and blood pressure, and a higher risk for type 2 diabetes and coronary heart disease, according to the CSAPH report. Physicians can help by reminding patients that liquid calories can pile up in a sneaky but substantial way. People typically don’t compensate for such calories like they do for food, the CSAPH report notes.

Such one-on-one physician involvement is one element of what ultimately must be a multifaceted approach to address the obesity risk of sweetened drinks. Broader campaigns to educate the public and programs to fight obesity also should be a part of that endeavor. If there will be taxes placed on sugar-sweetened beverages, that money should be directed to those initiatives.