Not long ago, cigarettes and sugary sodas were staples in convenience stores, celebrated in films, and marketed to almost everyone. However, a transformation began as lawmakers and voters raised taxes on cigarettes, and millions of dollars went into public education campaigns about smoking’s harms.
The media tirelessly chronicled the perilous addiction to cigarettes and the lengths to which companies would go to obscure their hazards and ensnare more users. This concerted effort led to a dramatic cultural shift, rendering smoking increasingly unacceptable and driving usage down to unprecedented lows, particularly among youth.
Now, new research from UC Berkeley indicates that sugar-sweetened beverages could be following a similar path. The city of Berkeley’s first-in-the-nation soda tax a decade ago, along with more recent Bay Area tax increases on sugar-sweetened drinks, have not only led to reduced sales.
They are also associated with significant changes in social norms and attitudes about the healthfulness of sweet drinks, said Kristine A. Madsen, a professor at UC Berkeley’s School of Public Health and senior author of a paper.
Over the span of just a few years, taxes coupled with significant media attention significantly affected the public’s overall perceptions of sugar-sweetened beverages, which include sodas, some juices, and sports drinks. Such a shift in the informal rules surrounding how people think and act could have major implications for public health efforts more broadly, Madsen said.
“Social norms are really powerful. The significant shift we saw in how people are thinking about sugary drinks demonstrates what else we could do,” Madsen said. “We could reimagine a healthier food system. It starts with people thinking, ‘Why drink so much soda?’ But what if we also said, ‘Why isn’t most of the food in our grocery stores food that makes us healthy?'”
Madsen and colleagues from UC San Francisco and UC Davis undertook an insightful analysis of surveys involving 9,128 residents from lower-income neighborhoods in Berkeley, Oakland, San Francisco, and Richmond.
By examining data collected from 2016 to 2019 and 2021, they aimed to uncover year-to-year changes in how people perceive sugar-sweetened beverages. Their research specifically sought to determine the impact of four local taxes in the Bay Area on the social norms surrounding sugary drinks—those unspoken rules that profoundly dictate our choices, whether in the foods we consume, the clothes we choose to wear, or our behaviors around the dining table.
Although these norms are not visible, their influence is undeniably strong; think about how easily someone can be persuaded to buy a product simply because an influencer endorsed it on social media. To gather insights, researchers posed questions regarding the frequency with which participants believed their neighbors indulged in sodas, sports drinks, and fruity beverages.
They also rated the healthiness of various drinks, which reflected their personal attitudes toward those beverages. The researchers discovered a 28% reduction in the social acceptability of consuming sugar-sweetened beverages.
In Oakland, positive perceptions of peers’ consumption of sports drinks declined after the tax increase, especially when compared to other cities. Likewise, in San Francisco, attitudes toward the healthfulness of sugar-sweetened fruit drinks also took a downturn.
Essentially, individuals felt that their neighbors were consuming fewer sugar-sweetened beverages, which in turn influenced their own inclination to consume sodas, juices, and sports drinks.
“What it means when social norms change is that people say, ‘Gosh, I guess we don’t drink soda. That’s just not what we do. Not as much. Not all the time,'” Madsen said. “And that’s an amazing shift in mindsets.”
The latest research from UC Berkeley sheds light on the profound impact of the nation’s first soda tax on consumption patterns over the past decade. A study conducted in 2016 revealed a drop in soda consumption and a rise in the preference for water. Research from 2019 highlighted a significant reduction in the consumption of sugar-sweetened beverages.
Earlier this year, Berkeley researchers confirmed that purchases of these drinks fell dramatically and consistently across five major American cities after the tax was enacted. The implementation of a penny-per-ounce tax on sugary beverages, imposed on distributors who ultimately transfer the cost to consumers, serves as a powerful avenue for public health messaging, as noted by Madsen.
The research captured over 700 media stories about the taxes on sugar-sweetened beverages during the study period. That level of messaging was likely a major force in driving public awareness and norms.
Madsen emphasized that future public health initiatives should take this into account. This approach contributed to reducing cigarette smoking and appears to be effective with sugary drinks as well. Ultimately, these efforts can foster individual behavior changes.
“If we change our behaviors, the environment follows,” Madsen said. “While policy really matters and is incredibly important, we as individuals have to advocate for a healthier food system.”
Journal reference:
Emily Altman, Dean Schillinger, Sofia Villas-Boas, Laura Schmidt, Jennifer Falbe, Kristine A Madsen. De-normalizing sugar-sweetened beverage consumption: effects of tax measures on social norms and attitudes in the California Bay Area. BMC Public Health, 2024; DOI: 10.1186/s12889-024-20781-6