Lisa M. Powell, PhD; Julien Leider, MA; Pierre Thomas Léger, PhD
Note: Dr. Powell had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Disclaimer: The contents of this publication do not necessarily reflect the views or policies of Bloomberg Philanthropies.
Grant Support: By a grant from the Bloomberg Philanthropies' Obesity Prevention Initiative (www.bloomberg.org).
Disclosures: Drs. Powell and Léger and Mr. Leider report grants from Bloomberg Philanthropies during the conduct of the study. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2961.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Reproducible Research Statement: Study protocol and data set: Not available. Statistical code: Available from Dr. Powell (e-mail, email@example.com).
Corresponding Author: Lisa M. Powell, PhD, Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, MC 923, Chicago, IL 60612; e-mail, firstname.lastname@example.org.
Current Author Address: Dr. Powell: Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, MC 923, Chicago, IL 60612.
Mr. Leider: Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, MC 275, Chicago, IL 60608.
Dr. Léger: Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, MC 923, Chicago IL 60612.
Author Contributions: Conception and design: L.M. Powell.
Analysis and interpretation of the data: L.M. Powell, J. Leider, P.T. Léger.
Drafting of the article: L.M. Powell, J. Leider.
Critical revision for important intellectual content: L.M. Powell, J. Leider, P.T. Léger.
Final approval of the article: L.M. Powell, J. Leider, P.T. Léger.
Statistical expertise: L.M. Powell, J. Leider, P.T. Léger.
Obtaining of funding: L.M. Powell.
Collection and assembly of data: L.M. Powell.
Sugar-sweetened beverage (SSB) consumption is linked to adverse health outcomes.
To evaluate the impact of the 2017 Cook County, Illinois, Sweetened Beverage Tax (SBT) on the volume of taxed and untaxed beverages sold in Cook County and its 2-mile border area.
Pre–post intervention–comparison site difference-in-differences study.
Cook County, Illinois, and St. Louis City and County, Missouri, 2016 to 2017.
Universal product code–level store scanner data from supermarkets and grocery, convenience, drug, mass merchandise, and dollar stores.
Beverage volume sold of taxed and untaxed beverages, across product categories and sizes.
Volume sold of taxed beverages decreased by 27% (ratio of incidence rate ratios [RIRR], 0.73 [95% CI, 0.70 to 0.75]) on average in Cook County relative to St. Louis during the 4 months that the SBT was in effect (compared with the same 4-month pretax period), with a net decrease of 21% after increases in volume sold in its border area (cross-border shopping) were taken into account. The magnitude of the decrease in volume sold across types of taxed beverages was heterogeneous: −32% (RIRR, 0.68 [CI, 0.65 to 0.72]) for soda versus −11% (RIRR, 0.89 [CI, 0.82 to 0.97]) for energy drinks, −37% (RIRR, 0.63 [CI, 0.59 to 0.66]) for artificially sweetened beverages versus −25% (RIRR, 0.75 [CI, 0.72 to 0.79]) for SSBs, and −29% (RIRR, 0.71 [CI, 0.68 to 0.74]) for family-size versus −19% (RIRR, 0.81 [CI, 0.79 to 0.84]) for individual-size beverages. There was no significant change in volume sold of untaxed beverages in Cook County or its border area.
Data source did not allow for evaluation by store type or distance of outlets from the border.
The Cook County SBT led to a substantial reduction in the volume sold of taxed beverages in Cook County. Part of this effect was offset by cross-border shopping. Cross-border shopping was limited to tax avoidance and did not extend to untaxed beverages.
Powell LM, Leider J, Léger PT. The Impact of a Sweetened Beverage Tax on Beverage Volume Sold in Cook County, Illinois, and Its Border Area. Ann Intern Med. 2020;172:390–397. [Epub ahead of print 25 February 2020]. doi: https://doi.org/10.7326/M19-2961
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Published: Ann Intern Med. 2020;172(6):390-397.
Published at www.annals.org on 25 February 2020
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