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Understanding Sugar-Sweetened Beverage Tax Implementation Globally: A 34-Year, Population-Based Observational Study in 183 Countries Publisher Pubmed



Loaeza L M ; Lara Castor L ; Sharib J R ; Cudhea F ; Wang M ; Li P ; Mozaffarian D ; Bas M ; Haidar Ali J ; Abumweis S ; Krishnan A ; Misra P ; Hwalla N C ; Janakiram C Show All Authors
Authors
  1. Loaeza L M
  2. Lara Castor L
  3. Sharib J R
  4. Cudhea F
  5. Wang M
  6. Li P
  7. Mozaffarian D
  8. Bas M
  9. Haidar Ali J
  10. Abumweis S
  11. Krishnan A
  12. Misra P
  13. Hwalla N C
  14. Janakiram C
  15. Liputo N I
  16. Musaiger A
  17. Pourfarzi F
  18. Alam I
  19. Deridder K
  20. Termote C
  21. Memon A
  22. Turrini A
  23. Lupotto E
  24. Piccinelli R
  25. Sette S
  26. Anzid K
  27. Vossenaar M
  28. Mazumdar P
  29. Rached I
  30. Zapata M E
  31. Rovirosa A
  32. Taye Asayehu T
  33. Aluso L
  34. Oduor F
  35. Boedecker J
  36. Ortiz Ulloa J
  37. Meenakshi J V
  38. Castro M
  39. Grosso G
  40. Waskiewicz A
  41. Thanopoulou A
  42. Malekzadeh R
  43. Calleja N
  44. Etemad Z
  45. Ocke M
  46. Al Nsour M
  47. Waswa L M
  48. Nurk E
  49. Lee H J
  50. Arsenault J
  51. Lopez Jaramillo P
  52. Mehio Sibai A
  53. Damasceno A
  54. Arambepola C
  55. Lunet N
  56. Severo M
  57. Lopes C
  58. Torres D
  59. Palacios C
  60. Angeles Agdeppa I
  61. Desnacido J
  62. Capanzana M
  63. Misra A
  64. Ai Ng S
  65. Tan Khouw I
  66. Gamboa Delgado E
  67. Caballero M
  68. Otero J
  69. Koksal E
  70. Guessous I
  71. Lachat C
  72. De Henauw S
  73. Sekiyama M
  74. Chiplonkar S
  75. Arici M
  76. Ngoan L T
  77. Panagiotakos D
  78. Ding E
  79. Li Y
  80. Trichopoulou A
  81. Barengo N
  82. Ekbote V
  83. Khadilkar A
  84. Kovalskys I
  85. Meshram I
  86. Avula L
  87. Arlappa N
  88. Rajkumar H
  89. Rachakulla H
  90. Hemalatha R
  91. Laxmaiah A
  92. Lacoviello L
  93. Costanzo S
  94. Bonaccio M
  95. Martin Prevel Y
  96. Castetbon K
  97. Hsieh Y T
  98. Olivares S
  99. Hadziomeragic A
  100. De Moura Souza A
  101. Pan W H
  102. Huybrechts I
  103. De Brauw A
  104. Moursi M
  105. Nawidimbasba Zeba A
  106. Maghroun M
  107. Sarrafzadegan N
  108. Mwangi M
  109. Mohammadifard N
  110. Goldsmith R
  111. Keinan Boker L
  112. Shimony T
  113. Jordan I
  114. Bukania Z
  115. Kombe Y
  116. Alissa E
  117. Sabico S
  118. Al Daghri N
  119. Gulliford M
  120. Oh K
  121. Kweon S
  122. Park S
  123. Kim C I
  124. Cho Y
  125. Al Hooti S
  126. Douangvichit D
  127. Siengsounthone L
  128. Luangphaxay C
  129. Marques Vidal P
  130. Rybak C
  131. Luke A
  132. Piaseu N
  133. Sundram K
  134. Baykova D
  135. Abedi P
  136. Fadzil F
  137. Bukhary N B I
  138. Chen Y
  139. Tsugane S
  140. Sawada N
  141. Rangelova L
  142. Duleva V
  143. Petrova S
  144. Bergman P
  145. Lindroos A K
  146. Moraeus L
  147. Petrelius Sipinen J
  148. Siamusantu W
  149. Szponar L
  150. Chang H Y
  151. Tapanainen H
  152. Lindstrom J
  153. Virtanen S
  154. Polasa K
  155. Nagalla B
  156. Boindala S
  157. El Ati J
  158. Barquera S
  159. Rodriguez Ramirez S
  160. Ramirez Silva I
  161. Sanchez Romero L M
  162. Illescas Zarate D
  163. Rivera Dommarco J
  164. Zaghloul S
  165. Abdollahi M
  166. Mohammadi Nasrabadi F
  167. Houshiar Rad A
  168. Mahdy Z A
  169. Karupaiah T
  170. Eldridge A
  171. Kruger H
  172. Henjum S
  173. Fernandez A
  174. Al Hamad N
  175. Janska V
  176. Tayyem R
  177. Mirmiran P
  178. Kelishadi R
  179. Warensjo Lemming E
  180. Wieler L
  181. Richter A
  182. Mensink G
  183. Hoffman D
  184. Kuriyan Raj R
  185. Swaminathan S
  186. Garriguet D
  187. Dastgiri S
  188. Vaask S
  189. Zohoori F V
  190. Esteghamati A
  191. Noshad S
  192. Hashemian M
  193. Mwaniki E
  194. Yakes Jimenez E
  195. Lennert Veerman J
  196. Forsyth S
  197. Mwanza S
  198. Chileshe J
  199. Lera Marques L
  200. Preston A M
  201. Duran Aguero S
  202. Oleas M
  203. Posada L
  204. Ochoa A
  205. Shamsuddin K
  206. Mohd Shariff Z
  207. Manan W
  208. Jan Mohamed H J B
  209. Bovet P
  210. Nicolau A
  211. Tudorie C
  212. Abbott P
  213. Pakseresht M
  214. Sharma S
  215. Strand T
  216. Nothlings U
  217. Alexy U
  218. Brown K
  219. Carmikle J
  220. Koster J
  221. Jayawardena R
  222. Waidyatilaka I
  223. Lanerolle P
  224. Khan U S
  225. Mastiholi S C
  226. Hambidge K M
  227. Tejeda G
  228. Long J
  229. Diba T S
  230. Haque A
  231. Suarez Ortegon M F
  232. Keding G B
  233. Roos E
  234. Freese R
  235. Korkalo L
  236. Erkkola M
  237. Eleraky L
  238. Stuetz W
  239. Gunnarsdottir I
  240. Thorsdottir I
  241. Serra Majem L
  242. Moy F M
  243. Anderson S
  244. Jeewon R
  245. Zugravu C A
  246. Ng S W
  247. Adair L
  248. Skeaff S
  249. Fisberg R
  250. Marchioni D
  251. Ersino G
  252. Zello G
  253. Henry C
  254. Elmadfa I
  255. Meyer A
  256. Mitchell C
  257. Balfour D
  258. Geleijnse J M
  259. Manary M
  260. El Kour T
  261. Nikiema L
  262. Mirzaei M
  263. Hakeem R
  264. Kally O
  265. Bradshaw D
  266. Trichopoulos D
  267. Enghardt Barbieri H
  268. Sygnowska E
  269. Vartiainen E
  270. Fen Chan M
  271. Swan G
  272. Haerpfer C
  273. Pekcan G
  274. Gauci D
  275. Tedla B
  276. Kandiah M
  277. Odenkirk J
  278. Beer Borst S
  279. Mathee A
  280. Ginnela B
  281. Steingrimsdottir L
  282. Sinkko H
  283. Johansson L
  284. Ma G
  285. Riley L
  286. Hopping B
  287. Ling A
  288. Yap M
  289. Duante C
  290. Naska A
  291. Bundhamcharoen K
  292. Ovaskainen M L
  293. Fernando D
  294. Chuah K A
  295. Palmer P
  296. Tedstone A
  297. Jonsdottir O
  298. Ma Y
  299. Orfanos P
  300. Vollenweider P
  301. Zarina K
  302. Inoue M
  303. Farzadfar F
  304. Don R
  305. Lukito W
  306. Van Oosterhout C
  307. Szabo M
  308. Hung S Y
  309. Masni Ibrahim H
  310. Biro L
  311. Gaspoz J M
  312. Wu S
  313. Cowan M
  314. Nelis K
  315. Hjdaud Z
  316. Lee M S
  317. Yusof S
  318. Myhre J
  319. Salanave B
  320. Yaakub R
  321. Leclercq C
  322. Hadden W
  323. Hotz C
  324. Sioen I
  325. Templeton R
  326. Selamat R
  327. Asciak R
  328. Jitnarin N
  329. Pitsavos C
  330. Becker W
  331. Rahbar A R
  332. Zajkas G
  333. Cerdena C
  334. Ikeda N
  335. Al Zenki S
  336. Rehm C
  337. Cao X
  338. Lai Y

Source: The Lancet Global Health Published:2026


Abstract

Background: Taxes on sugar-sweetened beverages can improve public health. We aimed to characterise the extent and types of sugar-sweetened beverage taxes implemented worldwide and the national characteristics predicting implementation, such as sugar-sweetened beverage intake amounts, disease rates, or economic development. Methods: This longitudinal analysis aggregated serial global datasets (including the Global Dietary Database, Non-Communicable Diseases Risk Factor Collaboration, Global Burden of Disease study, and World Bank data) from 1990 to 2024 in 183 countries to assess sugar-sweetened beverage tax characteristics and national predictors of policy adoption. Sugar-sweetened beverage taxes for public health purposes were identified and characterised, including amounts, fiscal instruments, structures, and covered beverages. Sugar-sweetened beverage consumption, obesity and diabetes prevalence, gross domestic product (GDP), and sociodemographic index (SDI) were assessed as predictors of tax implementation using Cox proportional hazards models with time-varying covariates. Findings: From 1990 to 2024, 64 countries implemented sugar-sweetened beverage taxes, accelerating over time and covering 3·5 billion people globally. South Asia led in adoption (50% of countries; median tax rate 7·5%), followed by southeast and east Asia (47·8%; 5·0%), the Middle East and North Africa (30·0%; 17·0%), and Latin America and the Caribbean (31·3%; 7·0%). Taxes were ad valorem (ie, based on price; 45%), volume-based (44%), sugar-content-based (5%), or mixed (6%), and 13% of countries earmarked revenue for public health. Multivariable-adjusted predictors of tax implementation included diabetes prevalence (hazard ratio [HR]=1·22 [95% CI 1·05–1·43]), obesity prevalence (1·14 [1·00–1·29]), GDP per capita (HR per $10 000: 1·19 [1·06–1·34]), and SDI (0·70 [0·57–0·86]), but not sugar-sweetened beverage intake (0·77 [0·42–1·39]). Interpretation: Global adoption of sugar-sweetened beverage taxes has rapidly accelerated since 1990; however, there is important heterogeneity by region and tax structure, and the taxes are shaped by a country's economic capacity, social development, and health conditions. Funding: This work was supported by the National Institutes of Health (R01HL115189). © 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/