beverages would exclude this group. From a strictly public health perspective, it may therefore be necessary to think about applying these taxes to SNAP purchases so that there is no group exempted from this policy.

Food taxes generally have not been introduced with the aim of modifying consumption behavior as has been the case in other public health areas such as tobacco use, Powell noted. Where taxes have been imposed on selected categories of foods, such as soft drinks, candy, and snacks in grocery stores and vending machines, the tax rates have been quite low. In those states that do tax soda, rates are generally between 5 and 7 percent. As some jurisdictions adopt higher taxes, the greater variation among states will enable further work on the relationships among taxes, consumption, and weight.

Powell also commented on the importance of tax policy design, noting that excise taxes included in the shelf price of a product may be more effective than sales taxes. A sales tax is applied at the checkout counter, so consumers may be unaware of what taxes are being applied to which products. Also, taxes applied on the basis of liquid volume would be more effective than those applied as a percentage of the sales price since supersizing a drink usually costs relatively little, but the per unit tax would persist on the larger quantity.


In response to a question about the possibility of subsidizing healthy foods, Powell observed that such subsidies are less likely than taxes to raise political opposition. The problem is that most governments do not have the money to implement subsidies. A politically palatable option, noted above, may be to use tax revenues on unhealthy foods to subsidize healthy foods. Powell’s research indicates that such subsidies would increase the consumption of fruits and vegetables among low-income families. However, the subsidies probably would have to be limited to low-income families to be affordable.

Russell Pate, a member of the IOM’s Standing Committee on Childhood Obesity Prevention, asked Powell about building the political will to increase taxes on certain foods. Powell responded that, according to the polls she has seen, people are more likely to accept a tax if the money is dedicated to a specific purpose, particularly to reducing childhood obesity, rather than going into the general fund.

In response to a question about how the issues surrounding expressive conduct apply in schools, Pomeranz observed that schools have the ability to regulate speech and are also a nonpublic forum, which means they could be more heavily regulated than traditional public venues. That they are not

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