The largely affects the healthcare system in the

The policy of local tax
payment of one cent per ounce on soda and sugar sweetened beverage (SSB) was
approved in November 2016 in San Francisco, California to reduce the public’s exposure
to obesity and type 2 diabetes. This is a state level policy and will be
implemented from January 2018 onwards. Distributors of SSBs in San Francisco will be responsible for paying
this tax; the tax will not apply to retail sales of SSBs1. A
beverage that contains added sugar and 25 or more calories per 12 ounces is a
sugar sweetened beverage1. This includes few soft drinks, sports
drinks, iced tea, juice drinks and energy drinks1. The tax will also
be applied on syrups and powders that can be turned into SSBs. Approximately
12 percent of adults in California consume soda at least once per day2. Berkeley passed a similar local soda
tax in 2014 in the United States. Soda and SSBs may not be the only cause of
obesity, however, the consumption
of beverages that are high in added sugar and calories contributes
significantly to negative health outcomes. SSBs are associated with weight gain
because of their increased sugar content. High sugar content is associated with
high blood glucose levels and high calorie intake, which increases the
deposition of fat (Adipose tissue) in the peripheral tissues leading to obesity.
In addition to changing behavior, an
SSB tax can provide additional revenue to the city, which the city can then use
for any governmental purpose or for public welfare1.

Obesity is one of the chronic diseases which needs attention for medical
treatment and prevention in the United States. It is a leading cause of mortality
and morbidity within the nation, and the high prevalence of obesity largely
affects the healthcare system in the United States.
It is reported that 69% of adults in
the United States are overweight, and more than one-third (35%) are obese3.
Among adults in California the prevalence of obesity increased from 19
percent in 2001 to 25 percent in 2011-122. Diabetes is also increasing at an alarming rate across the
United States. From 1980 through 2014, the number of Americans diagnosed with
diabetes increased fourfold from 5.5 million to 22 million3.
Adults who consumed soda/SSBs one or more times per day were more prone to being
obese than those who consumed these sugary beverages less often2.
SSBs are one such factor that increases the risk for obesity and type 2

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Intended effects:

·       Reducing
the rates of Obesity: Consumption of SSBs like soda has been
associated with higher calorie intake, lower dietary quality, and increase in
weight. Local tax on SSB will help in reducing the consumption of these drinks,
which is directly linked to causing obesity. It has been reported that a higher
proportion of adults who consume soda daily were obese (30 percent) compared to
adults who consume soda less frequently (24 percent)2.

·       Reducing
the occurrence of Diabetes: SSBs tend to increase the blood sugar and insulin levels due to their
high sugar content. If consumed in large amounts, they lead to an increased dietary
glycemic load4. Obese individuals are more prone to increased
glucose intolerance and insulin resistance induced by a high glycemic diet,
which increases the risk of type 2 diabetes4.

·       SSBs are also linked to high incidence of dental
caries, and subsequent oral health issues in children and adults. The proposal
will help in reducing the rates of dental caries, and thereby improving the
oral health of the population1.

·       A
study published by the American Journal of Public Health showed that there was 21% reduction in SSB
consumption and 63% increase in water consumption in Berkeley after the
implementation of SSB tax5. Adding a
tax on SSBs will make buying them expensive, which can make an individual who
is thirsty consume water instead of having soda/SSBs.


Unintended effects:


·       Consumers may be likely to substitute soda with other
calorie containing products, which will lead to similar health consequences of
obesity, diabetes, and incidence of dental caries.

·       People with high socioeconomic status will still
be at risk because they can afford to buy these beverages even after the local tax
is applied.