Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries

on behalf of the Global Dietary Database collaborators

doi:10.1016/S2214-109X(26)00093-8

Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries

on behalf of the Global Dietary Database collaborators

Tufts University
University of Washington
University of North Carolina at Chapel Hill
Acibadem Mehmet Ali Aydinlar Universitesi
Addis Ababa University
Al Ain University of Science and Technology
All India Institute of Medical Sciences, New Delhi
American University of Beirut
Amrita Vishwa Vidyapeetham
Universitas Andalas
Arab Center for Nutrition
Ardabil University of Medical Sciences
Bacha Khan University
Belgian Public Health Institute
Biodiversity International
Brighton and Sussex Medical School
CREA—Alimenti e Nutrizione
Cadi Ayyad University
Center for Studies of Sensory Impairment, Aging and Metabolism Guatemala
Centre for Media Studies
Centro de Atencion Nutricional Antimano (CANIA)
Centro de Estudios sobre Nutrición Infantil (CESNI)
Addis Ababa Science and Technology University
Consultative Group on International Agricultural Research (CGIAR)
University of Delhi
Departamento de Alimentação Escolar
University of Catania
Cardinal Stefan Wyszynski Institute of Cardiology
National and Kapodistrian University of Athens
Tehran University of Medical Sciences
Directorate for Health Information and Research
National Institute of Public Health and the Environment
Eastern Mediterranean Public Health Network: Emphnet
Egerton University
National Institute for Health Development
Eulji University
FHI 360
Universidad de Santander
Universidade Eduardo Mondlane
University of Colombo
University of Porto
Florida International University
Food and Nutrition Research Institute (DOST-FNRI)
Food and Nutrition Research Institute Manila
Fortis CDOC Center for Excellence for Diabetes
FrieslandCampina
Fundación Cardiovascular de Colombia
Consejo Nacional de Investigaciones Científicas y Técnicas
Fundacion Oftalmologica de Santander (FOSCAL)
Gazi University
University of Geneva
Ghent University
The University of Tokyo
HC Jehangir Medical Research Institute
Hacettepe University
Hanoi Medical University
Harokopio University
Harvard University
Instituto para la Cooperacion Científica en Ambiente y Salud (ICCAS)
National Institute of Nutrition India
IRCCS Istituto Neurologico Mediterraneo Neuromed - Pozzilli (IS)
Institut de recherche pour le développement
Institut de veille sanitaire
Academia Sinica - Institute of Biomedical Sciences
Universidad de Chile
Institute of Public Health of Federation of Bosnia and Herzegovina
Universidade Federal do Rio de Janeiro
World Health Organization
International Food Policy Research Institute
Intitut de Recherche en Sciences de la Sante
Isfahan University of Medical Sciences
Israel Center for Disease Control
Justus Liebig University Giessen
Kenya Medical Research Institute
King Abdulaziz University
King Saud University
King's College London
Korea Disease Control and Prevention Agency
Korea Health Industry Development Institute
Korea University
Kuwait Institute for Scientific Research
Lao Tropical and Public Health Institute
University of Lausanne
Leibniz Centre for Agricultural Landscape Research
Loyola University Chicago
Mahidol University
Malaysian Palm Oil Council (MPOC)
Medical Center Markovs
Ahvaz Jundishapur University of Medical Sciences
Kementerian Kesihatan Malaysia
New York University
National Cancer Center Japan
National Centre of Public Health and Analyses
Swedish National Food Agency
National Food and Nutrition Commission
National Food and Nutrition Institute
National Health Research Institutes Taiwan
National Institute for Health and Welfare
Université de Tunis El Manar
Instituto Nacional de Salud Publica
National Nutrition Institute
National Nutrition and Food Technology Research Institute (NNFTRI): SBMU
Universiti Kebangsaan Malaysia
Nestle
North West University
Oslo Metropolitan University
Perdana University
Public Authority For Food and Nutrition
Public Health Authority of the Slovak Republic
University of Jordan
Shahid Beheshti University of Medical Sciences
Robert Koch-Institut
Rutgers - The State University of New Jersey, New Brunswick
St. John's National Academy of Health Sciences
Statistics Canada
Tabriz University of Medical Sciences
Tallinn University
Teesside University
Technical University of Kenya
University of New Mexico
University of Queensland
Tropical Diseases Research Centre
Unidad de Nutricion Publica
University of Puerto Rico
Universidad San Sebastián
Universidad Técnica del Norte
Universidad de Antioquia
Universidad de Cuenca
Universiti Putra Malaysia
Universiti Sains Malaysia
Dunarea de Jos University of Galati
University of Aberdeen
University of Alberta
University of Bergen
University of Bonn
University of California at Davis
University of Cincinnati
University of Colorado Anschutz Medical Campus
University of Dhaka
University of Edinburgh
University of Göttingen
University of Helsinki
University of Hohenheim
University of Iceland
University of Las Palmas de Gran Canaria
University of Malaya
University of Manchester
University of Mauritius
Carol Davila University of Medicine and Pharmacy
University of Otago
Universidade de São Paulo
University of Saskatchewan
University of Vienna
University of the Southern Caribbean
Wageningen University & Research
Washington University St. Louis
Shahid Sadoughi University of Medical Sciences
Ziauddin University
Global Dietary Database Consortium

Research output: Contribution to journal › Article › peer-review

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).

Original language	English
Article number	103948
Journal	The Lancet Global Health
Volume	14
Issue number	6
DOIs	https://doi.org/10.1016/S2214-109X(26)00093-8
State	Published - Jun 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 8 Decent Work and Economic Growth

Access to Document

10.1016/S2214-109X(26)00093-8

Cite this

@article{595e794135a34c6c91167c26419f6b4c,

title = "Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries",

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). ",

keywords = "Global Health, Humans, Longitudinal Studies, Obesity, Sugar-Sweetened Beverages, Taxes",

author = "\{on behalf of the Global Dietary Database collaborators\} and Loaeza, \{Lizbeth Moreno\} and Laura Lara-Castor and Sharib, \{Julia R.\} and Frederick Cudhea and Meng Wang and Peizhi Li and Dariush Mozaffarian and Murat Bas and \{Haidar Ali\}, Jemal and Suhad Abumweis and Anand Krishnan and Puneet Misra and Hwalla, \{Nahla Chawkat\} and Chandrashekar Janakiram and Liputo, \{Nur Indrawaty\} and Abdulrahman Musaiger and Farhad Pourfarzi and Iftikhar Alam and Karin DeRidder and Celine Termote and Anjum Memon and Aida Turrini and Elisabetta Lupotto and Raffaela Piccinelli and Stefania Sette and Karim Anzid and Marieke Vossenaar and Paramita Mazumdar and Ingrid Rached and Zapata, \{Mar{\'i}a Elisa\} and Alicia Rovirosa and \{Taye Asayehu\}, Tamene and Lilian Aluso and Francis Oduor and Julia Boedecker and Johana Ortiz-Ulloa and Meenakshi, \{J. V.\} and Michelle Castro and Giuseppe Grosso and Anna Waskiewicz and Anastasia Thanopoulou and Reza Malekzadeh and Neville Calleja and Zohreh Etemad and Marga Ocke and \{Al Nsour\}, Mohannad and Waswa, \{Lydiah M.\} and Eha Nurk and Lee, \{Hae Jeung\} and Joanne Arsenault",

note = "Publisher Copyright: {\textcopyright} 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/",

year = "2026",

month = jun,

doi = "10.1016/S2214-109X(26)00093-8",

language = "Ingl{\'e}s",

volume = "14",

journal = "The Lancet Global Health",

issn = "2572-116X",

number = "6",

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TY - JOUR

T1 - Understanding sugar-sweetened beverage tax implementation globally

T2 - a 34-year, population-based observational study in 183 countries

AU - on behalf of the Global Dietary Database collaborators

AU - Loaeza, Lizbeth Moreno

AU - Lara-Castor, Laura

AU - Sharib, Julia R.

AU - Cudhea, Frederick

AU - Wang, Meng

AU - Li, Peizhi

AU - Mozaffarian, Dariush

AU - Bas, Murat

AU - Haidar Ali, Jemal

AU - Abumweis, Suhad

AU - Krishnan, Anand

AU - Misra, Puneet

AU - Hwalla, Nahla Chawkat

AU - Janakiram, Chandrashekar

AU - Liputo, Nur Indrawaty

AU - Musaiger, Abdulrahman

AU - Pourfarzi, Farhad

AU - Alam, Iftikhar

AU - DeRidder, Karin

AU - Termote, Celine

AU - Memon, Anjum

AU - Turrini, Aida

AU - Lupotto, Elisabetta

AU - Piccinelli, Raffaela

AU - Sette, Stefania

AU - Anzid, Karim

AU - Vossenaar, Marieke

AU - Mazumdar, Paramita

AU - Rached, Ingrid

AU - Zapata, María Elisa

AU - Rovirosa, Alicia

AU - Taye Asayehu, Tamene

AU - Aluso, Lilian

AU - Oduor, Francis

AU - Boedecker, Julia

AU - Ortiz-Ulloa, Johana

AU - Meenakshi, J. V.

AU - Castro, Michelle

AU - Grosso, Giuseppe

AU - Waskiewicz, Anna

AU - Thanopoulou, Anastasia

AU - Malekzadeh, Reza

AU - Calleja, Neville

AU - Etemad, Zohreh

AU - Ocke, Marga

AU - Al Nsour, Mohannad

AU - Waswa, Lydiah M.

AU - Nurk, Eha

AU - Lee, Hae Jeung

AU - Arsenault, Joanne

PY - 2026/6

Y1 - 2026/6

N2 - 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).

AB - 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).

KW - Global Health

KW - Humans

KW - Longitudinal Studies

KW - Obesity

KW - Sugar-Sweetened Beverages

KW - Taxes

UR - https://www.scopus.com/pages/publications/105042121588

U2 - 10.1016/S2214-109X(26)00093-8

DO - 10.1016/S2214-109X(26)00093-8

M3 - Artículo

C2 - 42259348

AN - SCOPUS:105042121588

SN - 2572-116X

VL - 14

JO - The Lancet Global Health

JF - The Lancet Global Health

IS - 6

M1 - 103948

ER -

Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries

Abstract

UN SDGs

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