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
N1 - Publisher Copyright:
© 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/
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 -