Impact of Tonga’s taxes on food and drinks high in fat, salt, and sugar: controlled before-and-after household survey — The Association Specialists
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  3. Impact of Tonga’s taxes on food and drinks high in fat, salt, and sugar: controlled before-and-after household survey

Impact of Tonga’s taxes on food and drinks high in fat, salt, and sugar: controlled before-and-after household survey (23871)

Andrea M Teng 1 , Alice HM Kim 1 , Viliami Puloka 1 , Sione Lolohea 2 , Nick Wilson 1
  1. Department of Public Health, University Of Otago, Wellington, Wellington, New Zealand
  2. Tonga Statistics Department, Nuku-alofa, Tonga

Background: This study investigates the impact of the Tongan Government’s 1 July 2016 taxes on food and beverages high in fat, salt, and sugar (HFSS), and whether impacts varied by household income.

 

Methods: Using the 2015/16 Tonga Household Income and Expenditure Survey we compared households surveyed before and after tax (1215 and 586 households respectively). Primary outcomes for taxed foods were (a) the proportion of households who purchased/acquired the food (acquisition); (b) calories acquired; (c) expenditure, and (d) volumes acquired (controlled analysis compared to Cook Islands and Tuvalu). Complex survey regressions adjusted for differences in household characteristics.

 

Results: There was a suggestive decline in acquisition (OR 0.74, 95%CI: 0.37–1.49) and calories (RR 0.89, CI: 0.79–1.01) from taxed foods post-tax, particularly ice cream (RR 0.55, CI: 0.42–0.72) and sweetened beverage (RR 0.67, CI: 0.45–1.01) calories. Post-tax, lower-income households appeared one-third as likely to acquire taxed foods, with a pattern of smaller declines in calories vs higher-income households. Overall expenditure on taxed foods remained similar post-tax (RR 0.98, CI: 0.86–1.11) with a suggestion that lower-income households slightly increased expenditure (RR 1.09, CI: 0.92–1.28) while higher-income households reduced expenditure (RR 0.90, CI: 0.77–1.07). Households in Tonga tended to purchase less taxed food volumes post-tax (RR 0.75, CI: 0.53–1.07) compared to control countries, with a suggested greater decline in higher-income households (-28% vs -17%).  

 

Conclusion: Tax increases on HFSS foods appear to reduce calories from these sources. Such policies are likely to be effective in a variety of settings for improved nutrition and reduced chronic disease risk. Findings suggested that lower-income households were more likely to stop purchasing taxed foods while higher-income households reduced volumes and expenditure more, albeit from higher baselines. Study results highlight the importance of investing tax revenue in fiscal and health benefits for lower-income households.