The past few weeks haven’t been great for the soda industry. Recently, studies have linked sugar-sweetened drinks to an increased risk of death and implicated them in tumor growth. On Monday, two major medical groups compiled evidence for soda’s ill effects from the annals of scientific journals and delivered it to the world of public policy, demanding that the United States government help protect kids from sugar-sweetened drinks.
In a joint statement, the American Academy of Pediatrics and the American Heart Association called sugary drinks a “grave threat” to child health, arguing that actions must be taken to help combat them.
More than one of their self-described “landmark” recommendations is reminiscent of the historical crackdown of public health agencies on tobacco companies. They aim to regulate advertising aimed at kids, impose taxes that increase prices, and change the social context in which products are sold.
A Crackdown on Soda Advertising
The authors make the case that teens are exposed to a lot of marketing around sugary drinks, referencing a 2012 Federal Trade Commission Report stating that in 2009, carbonated beverage companies spent $395 million on advertising directed at youth, and 97 percent of that was directed at teenagers. In the statement, the authors draw a comparison to tobacco companies that have directly appealed to kids in the past. A more contemporary comparison may be e-cigarette companies, which have been condemned by the FDA for marketing to teens.
“Similar to tobacco companies, sugary drink manufacturers aim to appeal to children and adolescents by associating their product with celebrity, glamour, and coolness,” the authors write.
The policy recommendations argue that the government should make it more expensive for companies to market to kids by not allowing them to deduct costs associated with advertising as business operating expenses. That recommendation is not as directly punitive as other laws, like the Family Smoking Prevention and Tobacco Control Act, which strictly regulates the locations where tobacco companies can advertise; for example, they can’t advertise within 1,000 feet of an outdoor playground. Still, the authors argue that removing even that one deduction could curb 129,000 cases of obesity over a decade.
They also recommend excise taxes on added sugar that would raise the price of soda. Excise taxes are already used on cigarettes, which range from 0.17 cents in some states to nearly $5 in others.
Recent scientific evidence supports their claims that raising the price of soda actually does curb consumption. In February, researchers publishing in the American Journal of Public Health showed that in Berkeley, California, “soda taxes” caused a 52 percent decrease in soda consumption.
What the new report doesn’t do is actually explain how much the proposed soda tax should be. The authors reference a report from the World Health Organization suggesting that taxes should aim to increase the retail price of soda by 20 percent or more to truly curb consumption but leave it up to the “stakeholders” to “propose a price.”
Soda taxes could be supported by federal and state governments, they suggest. That would be a change from the city-level taxes on sugar-sweetened beverages that already exist, like those in Berkeley, Seattle, or Philadelphia, among others.
“Social Norms” Around Unhealthy Drinks
Finally, the report makes a salient point about how the behavior of doctors and hospitals can affect the way the public views soda and other products that impact health. They write that in the 1950s and ‘60s, hospital rounds were “conducted in smoke-filled rooms,” and, occasionally, hospitals even sold cigarettes in vending machines and gift shops. These authors argue that the same thing is happening with sugary drinks right now.
Being able to buy soda in a hospital, or seeing a doctor chug a Coke, they say, reinforces the idea that drinking soda habitually is both safe and, crucially, normal.
“As with the ban on tobacco, leadership by hospitals and health plans to eliminate the sale of sugary drinks can improve the health of their employees, increase public awareness about the contribution of sugary drinks to obesity, and thereby change social norms regarding sugary drinks,” they write.
Hospitals are just a starting point. If healthcare institutions cut ties with sugary drinks, the authors note, “employers and leaders in other settings” may be encouraged to follow suit.
Is This Really the End of Soda?
These policy recommendations suggest that time really is up for soda. At least these two medical groups think that it’s worth taking action against sugar-sweetened beverages, and to do that, they’re turning to the well-tested public health playbook that helped change perceptions of smoking — especially among teens .
These recommendations may or may not actually go into place — the onus is now on policymakers to contend with inevitable resistance from the food industry — but at the very least, they are a sign of more to come.