Fabrice Etilé

Taxing sugary drinks is a public health measure that has been enacted in a growing number of jurisdictions over the past 15 years. This intervention needs to be evaluated, and its aims clarified. Based on the results of a multidisciplinary research project, in this article we report on the conditions that led to the revision of the taxation of sugar-sweetened beverages in France in 2018. We found an intention to improve the nutritional quality of the beverage offer rather than directly influence consumer behavior. We discuss some of the effects associated with the tax implementation.

This paper investigates the association between several mental health indicators (depression, anxiety, stress, and loneliness) and the overall tendency to follow official recommendations regarding self-protection against COVID-19 (i.e., overall compliance). We employ panel data from the COME-HERE survey, collected over four waves, on 7,766 individuals (22,878 observations) from France, Germany, Italy, Spain, and Sweden. Employing a flexible specification that allows the association to be non-monotonic, we find a U-shaped relationship, in which transitions to low and high levels of mental health are associated with higher overall compliance, while transitions to medium levels of mental health are associated with less overall compliance. Moreover, anxiety, stress, and loneliness levels at baseline (i.e., at wave 1) also have a U-shaped effect on overall compliance later (i.e., recommendations are followed best by those with lowest and highest levels of anxiety, stress, and loneliness at baseline, while following the recommendations is lowest for those with moderate levels of these variables). These U shapes, which are robust to several specifications, may explain some of the ambiguous results reported in the previous literature. Additionally, we observe a U-shaped association between the mental health indicators and a number of specific health behaviours (including washing hands and mask wearing). Importantly, most of these specific behaviours play a role in overall compliance. Finally, we uncover the role of gender composition effects in some of the results. While variations in depression and stress are negatively associated with variations in overall compliance for men, the association is positive for women. The U-shaped relation in the full sample (composed of males and females) will reflect first the negative slope for males and then the positive slope for females.

In order to promote healthier diets, public authorities are taking action to better inform consumers, encourage manufacturers to improve the nutritional composition of their products, and control the marketing of these products. In recent years, the taxation of foods and beverages with unhealthy nutritional profiles has been one of the measures attracting interest. Taxing sugary drinks, or the “soda tax”, is one of the measures recommended by the World Health Organization (WHO) (WHO 2022). In France, a soda tax was introduced in January 2012. Modified in July 2018, it is now indexed to the added sugar content in the drink (Ministry of Public Action and Accounting 2018). At a time when other countries are considering whether to introduce or optimize such a measure, this change provides an opportunity to learn from its development, implementation and effects on supply and consumption. This is the perspective behind the Soda-Tax research project (2019-2023), coordinated by the Ecole des hautes études en santé publique (EHESP) in collaboration with the Paris School of Economics, the Institut National de la Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), the Université Sorbonne Paris Nord (USPN), and Nantes Université. This project was co-funded by the Ligue Contre le Cancer as part of the Institut pour la Recherche en Santé Publique (IReSP) general call for projects – prevention and health promotion component 2018. This report summarizes the results of the research. Some of them have already been published. Other results will be submitted in the coming months to scientific journals whose peer review process could in some cases lead them to evolve. These results are therefore communicated here on a preliminary basis, with the dissemination of this report intended to inform the steering of the measure and the interested parties in a more timely manner.

Objectives: Consideration of future consequences (CFC) distinguishes individuals who adopt behaviors based on immediate needs and concerns from individuals who consider the future consequences of their behaviors. We aimed to assess the association between CFC and diet, and testing the mediating role of food choice motives on this relationship. Design: Individuals (age≥18 years) completed the CFC-12 questionnaire in 2014, at least three 24-h dietary records, and a food choice motive questionnaire. A multiple mediator analysis allowed to assess the mediating effect of food choice motives on the cross-sectional association between CFC and diet, adjusted for socio-demographic factors. Setting: Data from the NutriNet-Santé cohort study. Participants: 27,330 participants. Results: CFC was associated with all food choice motives (P < 0.001), with the strongest positive associations for avoidance for environmental reasons, absence of contaminants and health motives, and the strongest negative associations for innovation and convenience). Positive total effects were found between CFC and the consumption of healthy food groups (fruits and vegetables, whole-grain foods, legumes); and negative total effects for alcohol, meat and poultry and processed meat (P < 0.001). CFC was positively associated with diet quality (P < 0.001). Across food groups, major mediators of these relationships were higher health (8.4-32.6%), higher environmental (13.7-22.1 %) and lower innovation (7.3-25.1 %) concerns. Conclusions: CFC was associated with healthier dietary intake, essentially mediated by a greater motivation of future-oriented participants for self-centered and altruistic outcomes, including health and environment. Focusing on the awareness of future benefits in public health interventions might lead to healthier dietary behaviors.