ArticleThe international journal of behavioral nutrition and physical activity2022
Are intentions to change, policy awareness, or health knowledge related to changes in dietary intake following a sugar-sweetened beverage tax in South Africa? A before-and-after study.
Article in The international journal of behavioral nutrition and physical activity, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- Taxation of sugar-sweetened beverages: Perspectives of adults and nursing practitioners in Makhanda, Eastern Cape, South Africa.Journal of public health research · 2026Article
- Understanding Research Approaches to Assess Sugar-Sweetened Beverage Taxation Policy Implementation and Response in Low- and Middle-Income Countries: Results From a Scoping Review.Nutrition reviews · 2026Article
- Consumption of Sugary Beverages by Adults Prior to Sugary Drink Tax in Colombia: An Analysis of the National Nutrition Survey 2015.Nutrients · 2026Article
- (Un)sweetened deal? Young people's views on the South African Health Promotion Levy and food in Khayelitsha, Cape Town.PLOS global public health · 2026Article
- Beyond the sugar tax: public acceptability of a comprehensive food policy bundle in urban Ghana.Frontiers in nutrition · 2026Article
- Consumption of Sugar-Sweetened Beverages by Polish Young Adults: A Preliminary Study on the Importance of Sugar Tax Familiarity and Health Effects.Foods (Basel, Switzerland) · 2024Article
- Impact of the Philadelphia Beverage Tax on Perceived Beverage Healthfulness, Tax Awareness, and Tax Opinions.Journal of nutrition education and behavior · 2024Article
- Economic priorities over population health: A political dilemma in addressing noncommunicable diseases in developing countries.Health science reports · 2024Article
- Attitudes of Chinese residents toward sugar-sweetened beverage tax and their willingness to pay: a cross-sectional survey.Frontiers in nutrition · 2023Article
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Abstract
backgroundIn April 2018, South Africa implemented the Health Promotion Levy (HPL), one of the first sugar-sweetened beverage (SSB) taxes to be based on each gram of sugar (beyond 4 g/100mL). The objectives of this study were to examine whether the psychological constructs tax awareness, SSB knowledge, SSB risk perception, and intentions to reduce SSB intake were associated with taxed beverage intake, whether they changed from pre- to post-tax, and whether they modified the effect of the HPL.
methodsWe collected single day 24-hour dietary recalls surveyed from repeat cross-sectional surveys of adults aged 18-39 years in Langa, South Africa. Participants were recruited in February-March 2018 (pre-tax, N = 2,481) and February-March 2019 (post-tax, N = 2,507) using door-to-door sampling. Surveys measured tax awareness, SSB knowledge, SSB risk perception, and intention to reduce SSB intake. SSB intake was estimated using a two-part model. To examine changes over time, logistic regression models were used for binary outcomes (tax awareness and intention to reduce SSB consumption) and linear regression models for continuous outcomes (SSB knowledge SSB risk perceptions). Effect modification was tested using interaction terms for each psychological construct with time.
resultsNo constructs were associated with SSB intake at baseline. At post-tax, the predicted probability to consume taxed beverages was 33.5% (95% CI 28.5-38.5%) for those who expressed an intention to reduce SSB intake compared to 45.9% (95% CI 43.7-48.1%) for those who did not. Among consumers, intending to reduce SSB intake was associated with 55 (95% CI 28 to 82) kcal/capita/day less SSBs consumed. Tax awareness, SSB knowledge, and SSB risk perception increased by a small amount from pre- to post-tax. Intentions to reduce SSB intake was lower in the post-tax period. The tax effect on SSB intake was modified by SSB knowledge and intention to reduce SSB intake, with higher levels of each associated with lower SSB intake.
conclusionAfter the South African SSB tax was implemented, SSB knowledge and risk perception increased slightly, tax awareness remained low, and only SSB knowledge and behavioral intention to change were significantly associated with taxed beverage intake among participants recruited from a low-income South African township.
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