Efforts to reduce the consumption of sugary drinks through taxation across the European Region have been persistently opposed, disrupted and undermined by soft drink manufacturers, according to a new study published in the European Journal of Public Health.

The study was a collaboration between the WHO European Office for the Prevention and Control of Noncommunicable Diseases and researchers at the University of Bath. It examined if experts involved in processes to introduce sugar-sweetened beverage (SSB) taxes across European countries have encountered industry opposition, and what this looked like. They found that opposition originated primarily from business associations representing SSB and other producers, and large SSB producers themselves, and most often involved direct lobbying.

Unhealthy diets are a major contributor to non-communicable diseases (NCDs) and mortality worldwide. Nutrient-poor, high-calorie sugary drinks are a major contributor to excess sugar intake and have thus become an increasingly popular target for public health regulation. There is growing evidence that taxing SSBs, as recommended by the World Health Organization, is a cost-effective means of reducing consumption of these products, and thereby reducing their impacts on health. To date, over 40 countries globally have implemented SSB taxes, 10 of which are located within the WHO European Region.

This study aimed to map oppositional behaviour towards SSB taxation in Europe, to help policymakers predict and pre-empt potential pushback they may encounter when seeking to introduce, implement, or maintain such policies. The researchers gathered evidence from 23 experts in nine different European countries, all of whom had been involved in SSB tax processes. They found that:

• Transnational SSB producers and their business associations were seen as the most active opponents of SSB taxation. The Coca-Cola Company, including its local subsidiaries, was mentioned by 14 of 15 respondents who provided examples of companies opposing an SSB tax.
  
• Industry claims that tax policies would have negative economic effects were seen by participants to be the most common and powerful arguments.
  
• Direct lobbying was reported in all study countries, and shifts in political behaviour from industry were recognisable across stages of the policy process, moving from outright opposition to attempts to delay or weaken the policy after its announcement.

Although it can be difficult to measure the impact of industry opposition, study participants felt that strong industry pushback contributed to weaker policy designs or delayed implementation. Participants from Estonia, which had abandoned plans to introduce an SSB tax in the final stages, and Norway, which had recently abolished a long-standing SSB tax, felt that industry had played a significant role in these policy failures.

The researchers suggest several measures that may work to counter or prevent these obstructive efforts:

• Outlining a clear public health rationale for the policy to gain public support, and providing evidence of expected benefits and potential economic impacts.
  
• Collaboration with sectors beyond health, such as finance and agriculture, to create broad support for the policy and ensure health objectives are considered throughout.
  
• Establishing measures to ensure transparency surrounding political and charitable donations, lobbying and research funding (for example a comprehensive lobbying register)

Discussing the findings, lead author Dr Kathrin Lauber said:

We know that taxation can be a cost-effective way of reducing the consumption of unhealthy products. The continued opposition to cost-effective policy measures designed to protect public health stands in stark contrast with the responsible public image many multinational food companies are keen to portray. The tactics used by industry to oppose soda taxes resemble the well-documented efforts by tobacco companies to undermine tobacco control measures. As such, drawing on established tools developed by the tobacco control community to safeguard policy from corporate interference might present an opportunity for policymakers working on improving our food systems.

Further information: Dr Kathrin Lauber was funded by the Roger and Sue Whorrod PhD studentship via the University of Bath, and the WHO European Office for the Prevention and Control of NCDs. Dr Lauber and Prof Anna Gilmore are members of the SPECTRUM consortium. SPECTRUM is funded by the UK Prevention Research Partnership, an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities.

This study has been produced with the financial assistance of Member States within the context of the WHO European Office for the Prevention and Control of NCDs.

The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.