• Brian Elbel, Glen B Taksler, Tod Mijanovich, Courtney B Abrams, and L B Dixon.
• Departments of Population Health and Medicine, School of Medicine, New York University, New York, New York. Electronic address: brian.elbel@nyumc.org.
• Am J Prev Med. 2013 Jul 1; 45 (1): 495549-55.

BackgroundTo induce consumers to purchase healthier foods and beverages, some policymakers have suggested special taxes or labels on unhealthy products. The potential of such policies is unknown.PurposeIn a controlled field experiment, researchers tested whether consumers were more likely to purchase healthy products under such policies.MethodsFrom October to December 2011, researchers opened a store at a large hospital that sold a variety of healthier and less-healthy foods and beverages. Purchases (N=3680) were analyzed under five conditions: a baseline with no special labeling or taxation, a 30% tax, highlighting the phrase "less healthy" on the price tag, and combinations of taxation and labeling. Purchases were analyzed in January-July 2012, at the single-item and transaction levels.ResultsThere was no significant difference between the various taxation conditions. Consumers were 11 percentage points more likely to purchase a healthier item under a 30% tax (95% CI=7%, 16%, p<0.001) and 6 percentage points more likely under labeling (95% CI=0%, 12%, p=0.04). By product type, consumers switched away from the purchase of less-healthy food under taxation (9 percentage point decrease, p<0.001) and into healthier beverages (6 percentage point increase, p=0.001); there were no effects for labeling. Conditions were associated with the purchase of 11-14 fewer calories (9%-11% in relative terms) and 2 fewer grams of sugar. Results remained significant controlling for all items purchased in a single transaction.ConclusionsTaxation may induce consumers to purchase healthier foods and beverages. However, it is unclear whether the 15%-20% tax rates proposed in public policy discussions would be more effective than labeling products as less healthy.Copyright © 2013 American Journal of Preventive Medicine.

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