背景:世界卫生组织建议对苏打征税以减少糖的消耗,但社会经济群体的影响尚不清楚。
目标:我们评估了4个有苏打税的欧洲国家和5个比较国家的青少年每日苏打消费量的16年趋势,家庭富裕。
方法:使用了五轮基于学校的国际“学龄儿童的健康行为”调查(2001/2002至2017/2018学年,重复横断面设计)。芬兰,法国,比利时,葡萄牙在此期间推出或更新了汽水税。为了比较,我们选择了5个没有这种税的邻国。全国代表性的13岁和15岁青少年样本(n=165,521;51.2%的女孩)完成了标准化问卷,包括一个关于苏打水消费频率的问题。使用家庭富裕程度量表(FAS),我们将青少年分类为较低-,中等或更高的富裕群体。在每个国家独立评估每日苏打消费量的变化。
结果:税前,在法国和比利时,生活水平较低的青少年中,每日苏打水的消费量较高(P<0.001,社会经济不平等),而在芬兰和葡萄牙,FAS组的消费量相似(无不平等).税后,芬兰所有FAS组的每日苏打水消费量都减少了,比利时,和葡萄牙(P相互作用≥0.33)。在法国,仅在富裕程度较低的青少年中观察到税后下降(或较低,0.76;95%CI:0.60,0.96;不等式减少)。在同一时期,3个比较国家的社会经济模式保持稳定(P相互作用≥0.38),在其余2个比较国家(P相互作用≤0.08,不平等加剧),中等富裕或较高富裕青少年的每日苏打水消费量减少幅度较大.
结论:在4个国家中的3个实施税收后,社会经济模式没有改变,法国的社会经济不平等现象减少了。对苏打水征税可能是一种有效的措施,或者至少不会加剧,青少年日常苏打水消费中的社会经济不平等。是JClinNutr20XX;xx:xx-xx。
The WHO recommends soda taxes to reduce sugar consumption, but the effect across socioeconomic groups is unclear.
We assessed 16-y trends in daily soda consumption among adolescents in 4 European countries with a soda tax and 5 comparison countries, by family affluence.
Five rounds of the international \"Health Behaviour in School-Aged Children\" school-based survey were used (school years 2001/2002 to 2017/2018, repeated cross-sectional design). Finland, France, Belgium, and Portugal introduced or updated a soda tax during this period. For comparison, we selected 5 neighboring countries without such a tax. Nationally representative samples of adolescents aged 13 and 15 y (n = 165,521; 51.2% girls) completed a standardized questionnaire, including a question on soda consumption frequency. Using the family affluence scale (FAS), we categorized adolescents into lower-, middle- or higher-affluent groups. Changes in daily soda consumption were assessed in each country independently.
Before taxation, daily soda consumption was more likely among lower-affluent adolescents in France and Belgium (P < 0.001, socioeconomic inequalities) and was similar across FAS groups in Finland and Portugal (no inequalities). After the tax, daily soda consumption was reduced across all FAS groups in Finland, Belgium, and Portugal (Pinteractions ≥ 0.33). In France, a posttax decrease was observed only among lower-affluent adolescents (ORlower, 0.76; 95% CI: 0.60, 0.96; reduced inequalities). During the same periods, socioeconomic patterns remained stable in 3 comparison countries (Pinteractions ≥ 0.38), and larger reductions in daily soda consumption were observed among middle- or higher-affluent adolescents compared with lower-affluent adolescents in the remaining 2 comparison countries (Pinteractions ≤ 0.08, increased inequalities).
Socioeconomic patterns did not change after the tax implementation in 3 out of 4 countries, and socioeconomic inequalities were reduced in France. Taxing sodas might be an effective measure to attenuate, or at least not exacerbate, socioeconomic inequalities in adolescent daily soda consumption. Am J Clin Nutr 20XX;xx:xx-xx.