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Natalie RiedigerA ‘pop tax’ is hardly a simple solution to the rising problem of obesity in Canada, despite the chorus of support.

A recent Senate report on obesity in Canada recommends a tax on sugar-sweetened beverages be examined and points to tobacco product taxes as a successful example worth imitating.

But have taxes on tobacco products been as successful as is often claimed?

The prevalence of smoking has decreased considerably since the introduction of various smoking policies across Canada – taxation being just one of the major ones. But the decline in smoking has not been uniform across the population as a whole.

Over the last 30 years, more Canadians of high socio-economic status have quit smoking or not started smoking. However, during the same period, smoking has decreased very little among low socio-economic populations.

This gap is particularly evident for heavy smoking – 29 percent of women with less than a high school education were heavy smokers in 1974. That number was only modestly improved by 2005, to 24 percent.

In comparison, 18 percent of women with a university degree were heavy smokers in 1974. By 2005, the number dropped to fewer than three percent.

These numbers stand in the face of the fact that individuals with lower income are disproportionately burdened by the tobacco tax.

The same pattern has been observed in the United States. Between 1996 and 2012, counties in the top income brackets experienced faster declines in smoking rates that counties with lower income levels. And European countries have observed the same socio-economic disparities in smoking prevalence over time.

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So why didn’t tobacco taxes work for people of lower socio-economic status?

People don’t smoke because it’s cheap, just like people don’t drink pop because it’s cheap.

Smoking makes people feel good in the short-term, as do sugar-sweetened beverages. Who doesn’t enjoy an iced-cold cola?

Ultimately, tobacco tax just contributed to a societal change in the way smoking was viewed, which in turn pushed more people, especially people with resources and support, to quit or not smoke at all.

In fact, the effect of smoking policies like taxation likely widened the health equity gap.

Smoking-related diseases – lung cancer, chronic obstructive pulmonary disease, diabetes and cardiovascular disease – disproportionately affect those with lower socio-economic status. Using Canadian census mortality data, researchers have recently reported that death due to these specific diseases is substantially higher for individuals of lower income and education.

So will taxing sugar-sweetened beverages reduce obesity across Canada?

I predict a similar societal change in the way we view sugar-sweetened beverages if a tax is implemented. People with resources, support and education will be better situated to identify, afford, prepare and ultimately care about the food they eat.

People of lower socio-economic status, however – including the over four million food insecure Canadians – will more likely continue to focus on adequate access to food instead, as well as gaining a home to prepare their food in.

Like the tobacco tax, the ultimate goal of a pop tax would be to improve health outcomes. And we know that the burden of obesity, diabetes and cardiovascular disease are greater among populations of low socio-economic status.

So a sugar-sweetened beverage tax alone would likely do very little to improve health if it fails to change behaviour among low socio-economic populations. There is no research that indicates otherwise and unless there is, we should refrain from implementing the tax.

Instead, we should establish policies geared to improving eating habits and, ultimately, public health. And we should focus on food security. Emerging evidence suggests that food insecurity results in greater healthcare costs in comparison to obesity.

We need to look for solutions to benefit low-income and marginalized Canadians. These solutions must be developed in partnership with marginalized populations and need to include roles for both government and industry.

Slapping a pop tax on sugar-sweetened beverages looks like a quick fix, but is more Band-Aid than solution.

Natalie Riediger is an assistant professor in the Departments of Community Health Sciences and Human Nutritional Sciences and at the Manitoba First Nations Centre for Aboriginal Health Research, University of Manitoba.

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