Does the Mexican sugar-sweetened beverage tax have a signaling effect? ENSANUT 2016

ObjectiveTo evaluate the potential signaling effect of the Mexican tax on sugar-sweetened beverages (SSBs) by analyzing the association between awareness of and opinions about its effectiveness with current consumption of taxed SSBs and with a self-reported change in consumption of SSBs since the implementation of the tax. We also examined the association between psychosocial and environmental determinants of SSB consumption with current consumption of taxed SSBs and with a reported change in consumption of SSBs.MethodsCross-sectional analyses of survey and food-frequency questionnaire data from the Mexican National Health and Nutrition Survey 2016. Participants were Mexican adults (20–59 years, N = 6,650). Logistic regression was used to evaluate the probability of a person reporting a decrease in SSB consumption, given their awareness of the tax, opinion about its effectiveness, psychosocial (SSB health-related beliefs, self-efficacy, and liking of SSBs) and environmental (availability of potable water) determinants. Multiple linear regression analysis was utilized to examine the association between the aforementioned factors and current consumption of taxed SSBs.ResultsCompared with adults not aware, adults who were aware of the SSB tax were more likely (OR = 1.30) to report a decrease in SSB consumption (p = .012). In urban areas, adults aware of the tax drank a significantly lower amount of taxed SSBs (-15.7%; p = .023) than those not aware. Self-efficacy and liking of SSBs were significantly associated with a reported decrease in consumption and with current consumption (p ConclusionsImplementation of an SSB tax accompanied by highly visible campaigns may further influence the impact of taxes on SSBs consumption. Future public health and nutrition education campaigns designed to increase knowledge and enhance motivation should be complemented by programs to assist individuals develop self-efficacy and self-regulation skills.研究目的：本研究旨在通过分析对墨西哥含糖饮料（sugar-sweetened beverages, SSBs）税的知晓程度、有效性评价，与当前征税含糖饮料消费量、以及自该税实施以来自我报告的含糖饮料消费量变化之间的关联，评估该税收的潜在信号效应。本研究同时探讨了含糖饮料消费的社会心理与环境决定因素，与当前征税含糖饮料消费量、以及自我报告的消费量变化之间的关联。 研究方法：本研究对2016年墨西哥全国健康与营养调查的问卷及食物频率问卷数据进行横断面分析。研究对象为20~59岁的墨西哥成年人（N=6650）。本研究采用logistic回归分析，基于个体对该税收的知晓情况、对其有效性的评价、社会心理因素（含糖饮料相关健康信念、自我效能感及对含糖饮料的喜好程度）与环境因素（饮用水可获得性），评估个体自我报告含糖饮料消费量减少的概率。同时采用多元线性回归分析，探讨上述因素与当前征税含糖饮料消费量之间的关联。 研究结果：与未知晓该含糖饮料税的成年人相比，知晓该税收的成年人自我报告减少含糖饮料消费量的可能性更高（优势比OR=1.30，p=0.012）。在城市地区，知晓该税收的成年人相较于未知晓者，其征税含糖饮料的消费量显著更低（降低15.7%，p=0.023）。自我效能感及对含糖饮料的喜好程度，与自我报告的消费量减少及当前消费量均存在显著关联。 研究结论：伴随高可见度宣传活动的含糖饮料税实施，或可进一步强化税收对含糖饮料消费的影响。未来旨在提升公众认知、增强消费动机的公共卫生与营养教育项目，应辅以相关计划以帮助个体培养自我效能感与自我调节技能。