Connecticut lawmakers consider sticking it to big soda

The state of Connecticut is currently considering an excise tax on sugar-sweetened beverages. I have now testified twice before committees of the Legislature in favor of the bill, which would impose a 1 cent per ounce tax on the miscellaneous beverages that serve as delivery vehicles for added sugar under all of its aliases.

The case for an excise tax on sugar-sweetened beverages, or SSBs, is almost entirely concordant with the case for such taxes on tobacco. First, the intent of an excise tax is not to impose a financial burden on the buyer, but rather a financial penalty on the seller for the privilege of peddling wares with serious liabilities. Naturally, the financial burden is passed along from seller to buyer, so this distinction is more one of principle than practical value, but the intent is worth noting.

SSBs are, like tobacco, products no one actually needs; there are many better alternatives to soda than unsatisfied thirst, water noteworthy among them. There is a case to make that both products are addictive as well, although nicotine may satisfy every nuance of that definition a bit more decisively than sugar. The difference, though, is of degree not kind.

The aggressive marketing of dubious food and drink to children as well as adults has resulted in second-hand obesity, diabetes, and worse. The degradation of our diet quality in the service of corporate profit is prominent among reasons why what was “adult onset” diabetes when I went to medical school in the 1980s is now called “type 2” and diagnosed routinely among children. Big Soda is in the vanguard of the profitably culpable.

Importantly, there is evidence that SSB taxes work as intended to reduce consumption. There is precedent in the U.S., and abroad.

Perhaps the quintessential argument against taxing SSBs is the “nanny state” objection, the idea that this is government telling responsible adults what to do. This contention is both misguided and naïve SSBs are marketed aggressively to children, and to select populations the soda companies must deem particularly vulnerable to their messaging. Such marketing, informed by expertise in everything from psychology to the secret life of the hypothalamus (the brain region where the human appetite center resides), and relying on insights from such sources as functional MRI scans, is far more “manipulative” than anything the state might do. Worrying about “big brother” in the halls of government, this preoccupation overlooks a bigger, less compassionate, and utterly unaccountable brother in the marblelined halls of big business.

What I consider the best argument against such a tax is that it is regressive, imposing its greatest burden on the socioeconomically disadvantaged. In light of the prevailing trends regarding who gets taxed and at what rate in this country, the idea that legislatures are genuinely concerned about regressivity seems far-fetched, but let’s take it at face value. The argument is spurious, for several reasons.

First, the consequences of excess SSB consumption, the very consequences the tax is intended to help redress, are massively regressive. Obesity, diabetes, and every attendant insult and injury fall disproportionately on the socioeconomically disadvantaged. The most important costs of such ill health are measured in years lost from lives, and life lost from years, but medical care comes at a high cost in dollars, too. An excise tax on SSBs, like that on tobacco, is intended to level this playing field —- and has meaningful potential to alleviate rather than compound the financial burden on those least able to pay the bills.

Second, as noted, nobody needs to drink SSBs, and unquenched thirst need not be the consequence of just saying “no.” To any for whom an additional penny per ounce is truly an unbearable financial burden, the obvious answer is, as the policy intends, to drink less soda. That expedient choice has the potential to dodge the financial burden, and reap the health benefits of doing so.

The notion that SSBs can’t be so bad because they weren’t always so bad is nostalgia gone awry. Context is everything. Soda as an occasional treat in a generally wholesome diet would be fine; we certainly aren’t there any more. The dose, the context, and the epidemiologic consequences define the poison and SSBs are indicted accordingly.

Arguments for an excise tax on SSBs, here in Connecticut, and everyplace else, are strong. Arguments against such a tax are weak, and submit readily to the arguments against the arguments against. As for the reliance on a stick, the science of behavioral economics, and the history of tobacco, both tell us it’s what works. Just the same, I side with those who favor discounting carrots, too.