{Pg "1 MASSEY UNIVERSITY TE KUNENGA KI 16th February, 2018 Prime Minister Parliament House Wellington 60 1 1 New Zealand Through Sir Peter Gluckman PMCSA Centre '{lgblic Heal earch Copy DPMC -- sey University lington Campus "Qrivate Box 756, Dear Prlme . Wellington 5 New Zealand . Administration Sir Peter passed on to me your request for a succinct note on the issue 0 +64 (0)4 380 0602 sugar- -sweetened beverages (8883) as part of New Zealand? approach _e ucing Direct Fax obesity. The following central points summarise the evidence. +54 (0)4 330 0500 4? Consumption of 8835 has risen substantially over the past 2 total sugar intake of adults in NZ is from non-a1coholiqb\e those aged 15- 18. SSBs cause dental caries, a particular problemm a hildren. ts Courier Address 5- 17% (3me Massey University es and higher for Block 3. Level Entrance B, Wallace Street Wellington 6021 New Zealand Both added sugar and SSBs Increase risks for, 3 er conditions, the early changes that lead to heart disease and heap elf, obesity, and type 2 Internet dlabEtES- Increases in the price of SSBs can result??n duction of their consumption. - Real-world taxation provides the st1 ative data. For instance, the Finnish Liggegsi?uer tax on confectionery, ice cream, an showed a continuing decline in Email consumption of high- sugar pro?ts with the imposition of steadily increasing taxes over consecutive year There are similar data fr ?ughEr countries: a study from Mexico showed that an SSB tax has maintained it impact {1 co mption of SSBs over several years. 0 Most crucially, the Eh; Berkeley, USA study showed clearly that a tax of one cent per 30 gm decreased cons?m of SSBs 1n low- -income communities and increased consumption of water. A recent PubE?Health England review concluded that "increasing prices of high sugar foods and nonald6 ic drinks, potentially through taxation, may reduce purchases of these products prophrtio to the level of the price increase imposed?. There is evidence to show that any tax be sufficiently large to actually motivate change. 0 (3i? ave generally been in the range of 10- 20% and 20% has been shown to be effective. ever, to be most effective, the tax should actually be volumetric [as was done' 1n Berkeley] based on sugar content (UK plan], not based on value. This is because an ad valorem tax can cause people to just buy cheaper products with the same sugar content. Reduction of consumption via a tax will probably be greatest among the households with the lowest disposable income. In New Zealand, Maori and Paci?c will bene?t strongly. - Manufacturers can respond by systematic reformulation of products that attract taxes to bring them below a relevant threshold resulting, again, in lower sugar consumption. SSB taxes do not cause unemployment. For tobacco control, price is central in determining smoking uptake and smoking cessation. Shifts in price are most effective in changing behaviour among youth, for tobacco and sugar. - There may be a halo effect that arises as a result of a government signal and public discussion about deleterious health effects of SSBs but the tax itself is central. - An SSB tax that results in lower consumption of ?empty calories? should, in turn, result in beneficial changes in average BMI, in the associated burden of morbidity and mortality. Over time, there may be, in New Zealand, a reduction of 50 deaths per year, especially from diabetes and cardiovascular disease and it will save at least $6 million per year in health costs. However there it is not possible at this stage to estimate the long-term effect sizes of the tax. More immediately, it will raise about $40 million in revenue. Over time, an SSB tax is likely to be cost-saving for the health system, as well as health improving. An SSB tax is only one component of a comprehensive strategy to tackle obesity including nutritional education which is accessible to all and which is authoritatively produced (the #1 recommendation of the recent WHO Commission on Ending Childhood obesity that Sir Peter q, chaired and of which Ms Helen Clark was a member), healthy school~food policies, restrictions on marketing to children, increased opportunities for physical activity, safer biking routes, clear policies and information for the public (including social marketing], incentives, controls, and nudges. - An SSB tax has the virtue of being an evidence-based action that can anchor and reinforce al other strategies. t) Yours truly, VIE w?i\ John Potter MBBS (5 Chief Science Advisor Professor Centre for Public Health Research (4 Massey University Wellington, New Zealand \9