In this Public Health Expert blog, we reproduce a letter that appeared in the NZ Herald on 2 April 2016. Professors Boyd Swinburn, Rod Jackson, and Cliona Ni Mhurchu led the writing.
Dear Cabinet Ministers,
We are very concerned by New Zealand’s appallingly high rate of childhood obesity, the fourth highest in the world. In addition, every year more than 5000 children under 8 years old require general anaesthetic operations to remove rotten teeth (1). We applaud the government for making childhood obesity a national health priority, however, its action plan of 22 ‘soft’ strategies, which was launched last year with no extra funding, is not sufficient to change current trends. We urge you to implement a significant tax on sugary drinks as a core component of strengthened strategies to reduce childhood obesity and dental caries.
Multiple authoritative bodies world-wide have reviewed the available evidence on sugary drinks taxes (see Annex 1, after signatures). They have concluded that such taxes are likely to be one of the most cost-effective interventions available and have recommended that they should be part of a comprehensive approach to reduce childhood obesity. The recent WHO Commission on Ending Childhood Obesity, co-chaired by Sir Peter Gluckman, the Prime Minister’s Chief Science Advisor, recommended a tax on sugary drinks as its number 2 recommendation. Health Minister, Jonathan Coleman, will vote to endorse the Commission’s recommendations at the World Health Assembly this month. After the Minister says ‘yes’ to the WHO Commission’s report in front of world health ministers in Geneva, it would be opportune and show great leadership to return and say ‘yes’ to one of its main recommendations in front of New Zealand children, adolescents and their parents.
The sugary drinks companies, speaking through the Food and Grocery Council, are behaving exactly like the tobacco industry when faced with the prospect of effective policies aimed at reducing the consumption of their products. The arguments, which the industry lobby group repeats, aim to create doubt in the public’s mind and spook politicians into inaction. Fortunately, the public are not so easily confused and there is majority support for a sugary drinks tax (over 80% in Herald Poll last week). Cabinet Ministers should not allow industry tactics to frighten them off implementing cost-effective policies that could change current trends and help to create a legacy of declining obesity, diabetes and dental caries. The industry arguments are as readily refuted for sugary drinks as they were for tobacco (see Annex 2, after signatures).
Dr Coleman has rightly said on many occasions that there are no magic bullets for reducing childhood obesity. His statements mean that it is an untenable argument to wait for magic bullet evidence before acting. Indeed, the evidence supporting sugary drinks taxes is stronger than the evidence for any of the 22 strategies in the government’s existing plan. In addition, a sugary drinks tax would be expected to raise $30-$40 million which could be used to boost funding for obesity prevention programs.
Recently, the UK Cabinet, backed by a thorough evidence review and a commitment to serious action on childhood obesity, added the UK to the list of seventeen countries which now have sugary drinks taxes.
As a matter of urgency, we urge Cabinet to strengthen its plans to reduce childhood obesity and dental caries by introducing a 20% excise tax on sugary drinks in the forthcoming budget. The evidence, health professionals, and the public strongly support this measure, and current and future generations of New Zealand children will be the beneficiaries of this legacy.
Signed by the following health professors:
| NAME | DISCIPLINE, DEPARTMENT, INSTITUTION |
| Alistair Woodward | Epidemiology, School of Population Health, University of Auckland |
| Andrew Hornblow | Emeritus / public health, School of Medicine, University of Otago, Christchurch |
| Ann Richardson | Epidemiology, Wayne Francis Cancer Epidemiology Research Group,
University of Canterbury |
| Barry Taylor | Paediatrics, School of Medicine, University of Otago, Dunedin |
| Bernhard Breier | Nutrition, School of Food and Nutrition, Massey University, Albany |
| Boyd Swinburn | Population nutrition, School of Population Health, University of Auckland |
| Bruce Arroll | General practice, School Population Health, University of Auckland |
| Chris Bullen | Public health medicine, National Institute for Health Innovation, University of Auckland |
| Clare Wall | Nutrition, School of Medical Sciences, University of Auckland |
| Cliona Ni Mhurchu | Population nutrition, National Institute for Health Innovation, University of Auckland |
| David Cameron-Smith | Nutrition, Liggins Institute, The University of Auckland |
| David McBride | Occupational epidemiology, Department of Preventive and Social Medicine, University of Otago, Dunedin |
| David Murdoch | Pathology, The Infection Group, University of Otago, Christchurch |
| Dawn Elder | Paediatrics and child health, Department of Paediatrics and Child Health, University of Otago, Wellington |
| Dee Mangin | General practice, Department of General Practice, University of Otago, Christchurch |
| Diana Lennon | Paediatrics, School of Medicine, University of Auckland |
| Diana Sarfati | Cancer epidemiology, Department of Public Health, University of Otago, Wellington |
| Don Schwass | Preventive and restorative dentistry, School of Dentistry, University of Otago, Dunedin |
| Doug Sellman | Psychiatry & addiction medicine, Department of Psychological Medicine, University of Otago, Christchurch |
| Elaine Rush | Nutrition, School of Sport and Recreation, Auckland University of Technology |
| Faafetai Sopoaga | Pacific health, Department of Preventive and Social Medicine, University of Otago, Dunedin |
| George Thomson | Tobacco control, Department of Public Health, University of Otago, Wellington |
| Gillian Abel | Public health, Department of Population Health, University of Otago, Christchurch |
| Harvey White | Cardiology, School of Medicine, University of Auckland |
| Jane Coad | Nutrition, Massey Institute of Food Science and Technology, Massey University, Palmerston North |
| Janet Hoek | Marketing, Department of Marketing, University of Otago, Dunedin |
| Jennie Connor | Public health medicine, Department of Preventive and Social Medicine, University of Otago, Dunedin |
| Jeremy Krebs | Diabetes and endocrinology, Edgar Diabetes and Obesity Research Centre, University of Otago, Wellington |
| Jeroen Douwes | Public health medicine, Centre for Public Health Research, Massey University, Wellington |
| Jim Mann | Nutrition and diabetes, Edgar Diabetes and Obesity Research Centre, University of Otago, Dunedin |
| Jonathan Broadbent | Preventive and restorative dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin |
| John Broughton | Dentistry, Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin |
| Les Toop | General practice, Department of General Practice, University of Otago, Dunedin |
| Louise Signal | Public health, Department of Public Health, University of Otago, Wellington |
| Luts Beckert | Medicine, Department of Medicine, University of Otago, Christchurch |
| Mark Elwood | Epidemiology, School of Population Health, University of Auckland |
| Marlena Kruger | Nutrition, School of Food and Nutrition, Massey University, Palmerston North |
| Mauro Farella | Orthodontics, Department of Oral Sciences, University of Otago, Dunedin |
| Michael Baker | Public health medicine, Department of Public Health, University of Otago, Wellington |
| Michael Keall | Public health, Department of Public health, University of Otago, Wellington |
| Murray Skeaff | Nutrition, Department of Human Nutrition, University of Otago, Dunedin |
| Murray Thomson | Public health dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin |
| Ngaire Kerse | General practice, School of Population Health, University of Auckland |
| Nick Wilson | Public health medicine, Department of Public Health, University of Otago, Wellington |
| Nicholas Chandler | Endodontics, Department of Oral Rehabilitation, University of Otago, Dunedin |
| Papaarangi Reid | Maori health, Department of Maori Health, University of Auckland |
| Patricia Priest | Epidemiology and public health, School of Medicine, University of Otago, Dunedin |
| Paul Brunton | Restorative dentistry, Department of Oral Rehabilitation University of Otago, Dunedin |
| Peter Crampton | Public health medicine, Division of Health Sciences, University of Otago, Dunedin |
| Peter Davis | Health sociology, COMPASS Research Centre, University of Auckland |
| Philip Gendall | Emeritus / public health, Marketing, Department of Marketing, University of Otago, Dunedin |
| Philippa Howden-Chapman | Public health, Department of Public Health, University of Otago, Wellington |
| Rachael Taylor | Medicine, Edgar Diabetes and Obesity Research Centre, University of Otago, Dunedin |
| Richard Edwards | Public health medicine, Department of Public Health, University of Otago, Wellington |
| Robert Beaglehole | Emeritus / epidemiology, School of Population Health, University of Auckland |
| Robert Doughty | Preventive Cardiology, School of Medicine, University of Auckland |
| Robert Scragg | Epidemiology, School of Population Health, University of Auckland |
| Robin Gauld | Health policy and systems, Department of Preventive and Social Medicine, University of Otago, Dunedin |
| Robert McGee | Health promotion, Department of Preventive and Social Medicine, University of Otago, Dunedin |
| Rod Jackson | Epidemiology, School of Population Health, University of Auckland |
| Roger Hughes | Public health nutrition, School of Public Health, Massey University, Wellington |
| Ruth Bonita | Emeritus / epidemiology, School of Population Health, University of Auckland |
| Rozanne Kruger | Dietetics and nutrition, School of Food and Nutrition, Massey University, Albany |
| Sally Casswell | Public health, SHORE and Whariki Research Centre, Massey University, Auckland |
| Shanthi Ameratunga | Public health medicine, School of Population Health, University of Auckland |
| Sheila Skeaff | Nutrition, Department of Human Nutrition, University of Otago, Dunedin |
| Simon Hales | Environmental epidemiology, Department of public health, University of Otago, Wellington |
| Stephen Chambers | Pathology, Department of Pathology, University of Otago, Christchurch |
| Sue Pullon | General practice, Department of Primary Health Care & General Practice, University of Otago, Wellington |
| Susan Morton | Epidemiology, Centre for Longitudinal Research, University of Auckland |
| Susan Wells | Public health medicine, School of Population Health, University of Auckland |
| Tim Cundy | Diabetes, School of Medicine, University of Auckland |
| Tony Blakely | Epidemiology, Department of Public Health, University of Otago, Wellington |
| Wayne Cutfield | Paediatrics, Liggins Institute, University of Auckland |
World Health Organization Commission on Ending Childhood Obesity, 2016
Public Health England, 2015
Lancet Obesity Series, 2015
British Medical Association, 2015
World Cancer Research Fund International, 2015
Organisation for Economic Co-operation and Development (OECD), 2014
New Zealand Medical Association, 2014
McKinsey Global Institute, 2014
Credit Suisse, 2013
Childhood Obesity Foundation (includes American Medical Association, American Academy of Pediatrics, American Public Health Association, and Oral Health America), 2012
Taxes certainly change the consumption of tobacco and alcohol and evidence from over 50 studies in the published literature suggests the same is true for targeted sugary drinks taxes.
Education is necessary as part of a comprehensive program to improve diet but by itself has only very small effects.
True, but that is not an argument against trying to reduce consumption of those products, like sugary drinks, which have no nutritional benefits and directly contribute to obesity, diabetes and dental caries.
This is possible for measures which do not conflict with the profit-making requirements of business, such as selling more diet products, but for ‘sell less’ measures, taxes and regulations are needed.
False. The list of authoritative bodies recommending sugary drinks taxes is very long and the majority of the New Zealand public support a sugary drinks tax with funding directed to childhood obesity prevention programs.
This is only true for those who do not reduce their consumption. Since people on lower incomes consume more sugary drinks and reduce consumption more in response to a price rise, they get proportionally greater health benefits, and may even spend less in total on sugary drinks.
Eighteen countries have sugary drinks taxes in place already they can be relatively simple and are actually cost-saving to implement because of reduced health care costs.
They would only potentially harm the sugary drinks businesses and since that is a low-employment industry, new employment related to other foods would create a net increase in jobs.
False. When a new tax is put in place, tax revenue will increase even with marked reductions in consumption, even allowing for GST (under plausible scenarios).
The evidence from sugary drinks taxes which have been implemented is that the full amount of the tax tends to be passed through onto the retail price of sugary drinks, though it is possible for companies to undermine the public health intent of the tax by spreading it across all its products. Careful design and implementation of the tax is needed.
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(1) In total, about 35,000 children and 275,000 adults have rotten teeth extracted every year under general or local anaesthetic.
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