An exploration of the impending 2018 sugar-sweetened beverage tax on the purchases of Black African women, shopping at the Edendale mall in Pietermaritzburg.

Abstract

Introduction: The incidence of death from non-communication diseases (NCDs) is escalating steadily. Rapid urbanisation and changing diets in the developing countries are currently producing a “silent emergency” called overnutrition or obesity. Several studies conducted in South Africa have shown that obesity is more severe among females than males, particularly in the Black African race group. Recent literature suggested that the consumption of sugarsweetened beverages (SSBs) could have contributed towards this problem. Fiscal interventions such as taxes are increasingly being recognised worldwide as an effective tool that can help to combat the obesity epidemic at a population level. The increased price of SSBs is an important factor that could influence the purchasing decisions of consumers. Increased negative health effects of SSBs have led to action to be taken in order to limit their consumption. In conjunction with this, on February 2016, the South African Government decided to consider the use of fiscal policies by introducing taxes on SSBs in order to improve the health standards of the public. At the time of this study the SSBs tax had not been implemented, however it was important to investigate what effect the impending tax would have on the current SSB purchasing practices of Black African women. Aim: Investigating the impact of the impending 2018 sugar-sweetened beverage tax on the purchases of Black African women aged 19 and older, shopping at the Greater Edendale Mall in Pietermaritzburg. Objectives: To determine the demographic characteristics of Black African women who purchase SSBs; to determine the types of SSB Black African women are purchasing; to assess the frequency of SSB purchases by Black African women; to investigate the factors that influence Black African women to purchase SSBs and to determine the effect of the impending 2018 SSB tax on respondent purchases of SSBs. Methods: A cross sectional study with aim of investigating the impact of the impending 2018 sugar-sweetened beverage tax was conducted among 439 Black African women aged 19 and older, shopping at the Greater Edendale Mall in Pietermaritzburg. Non-probability sampling was used to recruit the respondents. A five-part questionnaire was used to gather demographic information; characteristics of respondents who purchase the SSBs; the types of SSBs iii purchased; the frequency of purchases; what motivated the respondents to purchase SSBs; and what impact the impending SSBs tax would have on SSB purchases once implemented. Results: The study population consisted of 439 Black African women. The mean age of the respondents was 33.69 years with minimum and maximum ages of 19 and 55 respectively. Around two thirds (n=328, 74.7%) had an education level of matric or up to Grade 12. Only one third (n=111, 25.4%) had a post matric qualification. Among all SSBs purchased by respondents, carbonated fizzy drinks were the most frequently purchased beverage (n= 391, 89.0%), while sport drinks were purchased least frequently (0.9%, n=4) ahead of energy drinks (n=5, 1.1%). Squashes, concentrates and syrups (Juices) were the second most frequently purchased SSBs (n=25, 4.9%), followed by flavoured water drinks (n=15, 3.4%). Most respondents (n=396, 90.2%) indicated that they purchased SSBs between one and four times a month. Price and taste were rated as being significantly important factors that influenced respondents to purchase SSBs, whilst design and packaging, recommendation by friends/family and loyalty to the product were less important factors. Most respondents (n=359, 82.0%) reported that they were not aware of the impending SSB tax. The main findings of the study revealed that nearly half of the respondents (n=213, 48.5%) indicated the intention to continue purchasing and consume their preferred beverages as usual despite the price increase due to the SSBs tax. Around one-third of respondents (n= 151, 35.1%) reported that they would reduce their SSB purchases and start consuming smaller amounts of SSBs. Few respondents (n=68, 15.5%) indicated that they would switch to cheaper drinks whilst very few (n=4, 1.0%) would opt to stop purchasing SSBs. The results of sub-group analysis in relation to the impact of impending tax depending on education level and income status revealed the existence of a significant negative correlation for price with education. A significant number of respondents with matric and less (n=188, 62.8%) indicated that they will continue purchasing SSBs as usual after the implementation of SSBs tax while significantly more of those with a higher education level (n=73, 78.5%) confirmed their intention to reduce SSB purchases. Most respondents, who earned up to R5553 as their monthly total household income (n=96, 63.2% and n=29, 19.1%), indicated that they would either continue purchasing SSBs as usual or switch to cheaper drinks respectively. iv Conversely, respondents with a higher income including those who earned R44949 per month and above (n=3, 0.7%), between R18545 – R44948 (n=35, 8.0%) as well as between R10010 – R 18544 (n=37, 8.4%) indicated that they will reduce their SSB purchases once the tax had been implemented. Conclusion: The findings from this study highlight the need to further investigate the long term effect of SSB consumption contributing to overweight and obesity, particularly in Black African women and their family members. Since differences in SSB purchases were observed depending on education and income status of the respondents, the high frequency of consumption of added sugars from carbonated fizzy drinks by respondents and their family members entails more exploration. This would give direction for appropriate policies and initiatives, along with the SSB tax that could promote healthier dietary intake habits and reduce the burden of obesity related NCDs in Black African women and their family members.