Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries
Issued Date
2026-06-01
Resource Type
ISSN
2572116X
eISSN
2214109X
Scopus ID
2-s2.0-105042121588
Pubmed ID
42259348
Journal Title
Lancet Global Health
Volume
14
Issue
6
Rights Holder(s)
SCOPUS
Bibliographic Citation
Lancet Global Health Vol.14 No.6 (2026)
Suggested Citation
Loaeza L.M., Lara-Castor L., Sharib J.R., Cudhea F., Wang M., Li P., Mozaffarian D., Bas M., Haidar Ali J., Abumweis S., Krishnan A., Misra P., Hwalla N.C., Janakiram C., Liputo N.I., Musaiger A., Pourfarzi F., Alam I., DeRidder K., Termote C., Memon A., Turrini A., Lupotto E., Piccinelli R., Sette S., Anzid K., Vossenaar M., Mazumdar P., Rached I., Zapata M.E., Rovirosa A., Taye Asayehu T., Aluso L., Oduor F., Boedecker J., Ortiz-Ulloa J., Meenakshi J.V., Castro M., Grosso G., Waskiewicz A., Thanopoulou A., Malekzadeh R., Calleja N., Etemad Z., Ocke M., Al Nsour M., Waswa L.M., Nurk E., Lee H.J., Arsenault J., Lopez-Jaramillo P., Mehio Sibai A., Damasceno A., Arambepola C., Lunet N., Severo M., Lopes C., Torres D., Palacios C., Angeles Agdeppa I., Desnacido J., Capanzana M., Misra A., Ai Ng S., Tan-Khouw I., Gamboa Delgado E., Caballero M., Otero J., Koksal E., Guessous I., Lachat C., De Henauw S., Sekiyama M., Chiplonkar S., Arici M., Ngoan L.T., Panagiotakos D., Ding E., Li Y., Trichopoulou A., Barengo N., Ekbote V., Khadilkar A., Kovalskys I., Meshram I., Avula L., Arlappa N., Rajkumar H., Rachakulla H., Hemalatha R., Laxmaiah A., Lacoviello L., Costanzo S., Bonaccio M., Martin-Prevel Y., Castetbon K., Hsieh Y.T., Olivares S., Hadziomeragic A., de Moura Souza A. Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries. Lancet Global Health Vol.14 No.6 (2026). doi:10.1016/S2214-109X(26)00093-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117459
Title
Understanding sugar-sweetened beverage tax implementation globally: a 34-year, population-based observational study in 183 countries
Author(s)
Loaeza L.M.
Lara-Castor L.
Sharib J.R.
Cudhea F.
Wang M.
Li P.
Mozaffarian D.
Bas M.
Haidar Ali J.
Abumweis S.
Krishnan A.
Misra P.
Hwalla N.C.
Janakiram C.
Liputo N.I.
Musaiger A.
Pourfarzi F.
Alam I.
DeRidder K.
Termote C.
Memon A.
Turrini A.
Lupotto E.
Piccinelli R.
Sette S.
Anzid K.
Vossenaar M.
Mazumdar P.
Rached I.
Zapata M.E.
Rovirosa A.
Taye Asayehu T.
Aluso L.
Oduor F.
Boedecker J.
Ortiz-Ulloa J.
Meenakshi J.V.
Castro M.
Grosso G.
Waskiewicz A.
Thanopoulou A.
Malekzadeh R.
Calleja N.
Etemad Z.
Ocke M.
Al Nsour M.
Waswa L.M.
Nurk E.
Lee H.J.
Arsenault J.
Lopez-Jaramillo P.
Mehio Sibai A.
Damasceno A.
Arambepola C.
Lunet N.
Severo M.
Lopes C.
Torres D.
Palacios C.
Angeles Agdeppa I.
Desnacido J.
Capanzana M.
Misra A.
Ai Ng S.
Tan-Khouw I.
Gamboa Delgado E.
Caballero M.
Otero J.
Koksal E.
Guessous I.
Lachat C.
De Henauw S.
Sekiyama M.
Chiplonkar S.
Arici M.
Ngoan L.T.
Panagiotakos D.
Ding E.
Li Y.
Trichopoulou A.
Barengo N.
Ekbote V.
Khadilkar A.
Kovalskys I.
Meshram I.
Avula L.
Arlappa N.
Rajkumar H.
Rachakulla H.
Hemalatha R.
Laxmaiah A.
Lacoviello L.
Costanzo S.
Bonaccio M.
Martin-Prevel Y.
Castetbon K.
Hsieh Y.T.
Olivares S.
Hadziomeragic A.
de Moura Souza A.
Lara-Castor L.
Sharib J.R.
Cudhea F.
Wang M.
Li P.
Mozaffarian D.
Bas M.
Haidar Ali J.
Abumweis S.
Krishnan A.
Misra P.
Hwalla N.C.
Janakiram C.
Liputo N.I.
Musaiger A.
Pourfarzi F.
Alam I.
DeRidder K.
Termote C.
Memon A.
Turrini A.
Lupotto E.
Piccinelli R.
Sette S.
Anzid K.
Vossenaar M.
Mazumdar P.
Rached I.
Zapata M.E.
Rovirosa A.
Taye Asayehu T.
Aluso L.
Oduor F.
Boedecker J.
Ortiz-Ulloa J.
Meenakshi J.V.
Castro M.
Grosso G.
Waskiewicz A.
Thanopoulou A.
Malekzadeh R.
Calleja N.
Etemad Z.
Ocke M.
Al Nsour M.
Waswa L.M.
Nurk E.
Lee H.J.
Arsenault J.
Lopez-Jaramillo P.
Mehio Sibai A.
Damasceno A.
Arambepola C.
Lunet N.
Severo M.
Lopes C.
Torres D.
Palacios C.
Angeles Agdeppa I.
Desnacido J.
Capanzana M.
Misra A.
Ai Ng S.
Tan-Khouw I.
Gamboa Delgado E.
Caballero M.
Otero J.
Koksal E.
Guessous I.
Lachat C.
De Henauw S.
Sekiyama M.
Chiplonkar S.
Arici M.
Ngoan L.T.
Panagiotakos D.
Ding E.
Li Y.
Trichopoulou A.
Barengo N.
Ekbote V.
Khadilkar A.
Kovalskys I.
Meshram I.
Avula L.
Arlappa N.
Rajkumar H.
Rachakulla H.
Hemalatha R.
Laxmaiah A.
Lacoviello L.
Costanzo S.
Bonaccio M.
Martin-Prevel Y.
Castetbon K.
Hsieh Y.T.
Olivares S.
Hadziomeragic A.
de Moura Souza A.
Author's Affiliation
The University of Tokyo
The University of North Carolina at Chapel Hill
Universiteit Gent
Consejo Nacional de Investigaciones Científicas y Técnicas
Universidade Federal do Rio de Janeiro
Universidade do Porto
National and Kapodistrian University of Athens
Harvard T.H. Chan School of Public Health
Università degli Studi di Catania
Universidad de Chile
Hacettepe Üniversitesi
Tufts University
All India Institute of Medical Sciences, New Delhi
Florida International University
Hôpitaux Universitaires de Genève
Tufts University School of Medicine
Gazi Üniversitesi
American University of Beirut
Addis Ababa University
IRD Centre de Montpellier
Rijksinstituut voor Volksgezondheid en Milieu
Cadi Ayyad University
Faculdade de Medicina da Universidade do Porto (FMUP)
Universitas Andalas
Istituto Neurologico Mediterraneo Neuromed, Pozzilli
Acıbadem Mehmet Ali Aydınlar Üniversitesi
Eulji University
Brighton and Sussex Medical School
Harokopio University of Athens
Academia Sinica, Institute of Biomedical Sciences
Al Ain University
Instytut Kardiologii im. Prymasa Tysiaclecia Stefana Kardynała Wyszynskiego
Herbert Wertheim College of Medicine
FHI 360
Hanoi Medical University
Universidade Eduardo Mondlane
Ardabil University of Medical Sciences
University of Cuenca
National Institute of Nutrition India
University of Colombo Faculty of Medicine
Institute for Health Metrics and Evaluation
Egerton University
Addis Ababa Science and Technology University
Delhi School of Economics
Bacha Khan University
Universidad de Santander
Institut de Veille Sanitaire
Digestive Diseases Research Institute
Tervise Arengu Instituut
FrieslandCampina
Fundación Cardiovascular de Colombia
Jehangir Hospital, Pune
Fundación Oftalmológica de Santander
Amrita School of Dentistry
Food and Nutrition Research Institute
Center for Studies of Sensory Impairment, Aging and Metabolism Guatemala
CGIAR System Organization
Eastern Mediterranean Public Health Network
Centro de Estudios Sobre Nutrición Infantil “Dr. Alejandro O`Donnell”
Institute of Public Health of Federation of Bosnia and Herzegovina
Arab Center for Nutrition
Belgian Public Health Institute
Centre For Media Studies
ICCAS (Instituto para la Cooperacion Científica en Ambiente y Salud)
CREA-Alimenti e Nutrizione
Fortis CDOC Center for Excellence for Diabetes
Food and Nutrition Research Institue (DOST-FNRI)
Biodiversity International
Centro de Atencion Nutricional Antimano (CANIA)
Departamento de Alimentacao Escolar
Directorate for Health Information & Research
The University of North Carolina at Chapel Hill
Universiteit Gent
Consejo Nacional de Investigaciones Científicas y Técnicas
Universidade Federal do Rio de Janeiro
Universidade do Porto
National and Kapodistrian University of Athens
Harvard T.H. Chan School of Public Health
Università degli Studi di Catania
Universidad de Chile
Hacettepe Üniversitesi
Tufts University
All India Institute of Medical Sciences, New Delhi
Florida International University
Hôpitaux Universitaires de Genève
Tufts University School of Medicine
Gazi Üniversitesi
American University of Beirut
Addis Ababa University
IRD Centre de Montpellier
Rijksinstituut voor Volksgezondheid en Milieu
Cadi Ayyad University
Faculdade de Medicina da Universidade do Porto (FMUP)
Universitas Andalas
Istituto Neurologico Mediterraneo Neuromed, Pozzilli
Acıbadem Mehmet Ali Aydınlar Üniversitesi
Eulji University
Brighton and Sussex Medical School
Harokopio University of Athens
Academia Sinica, Institute of Biomedical Sciences
Al Ain University
Instytut Kardiologii im. Prymasa Tysiaclecia Stefana Kardynała Wyszynskiego
Herbert Wertheim College of Medicine
FHI 360
Hanoi Medical University
Universidade Eduardo Mondlane
Ardabil University of Medical Sciences
University of Cuenca
National Institute of Nutrition India
University of Colombo Faculty of Medicine
Institute for Health Metrics and Evaluation
Egerton University
Addis Ababa Science and Technology University
Delhi School of Economics
Bacha Khan University
Universidad de Santander
Institut de Veille Sanitaire
Digestive Diseases Research Institute
Tervise Arengu Instituut
FrieslandCampina
Fundación Cardiovascular de Colombia
Jehangir Hospital, Pune
Fundación Oftalmológica de Santander
Amrita School of Dentistry
Food and Nutrition Research Institute
Center for Studies of Sensory Impairment, Aging and Metabolism Guatemala
CGIAR System Organization
Eastern Mediterranean Public Health Network
Centro de Estudios Sobre Nutrición Infantil “Dr. Alejandro O`Donnell”
Institute of Public Health of Federation of Bosnia and Herzegovina
Arab Center for Nutrition
Belgian Public Health Institute
Centre For Media Studies
ICCAS (Instituto para la Cooperacion Científica en Ambiente y Salud)
CREA-Alimenti e Nutrizione
Fortis CDOC Center for Excellence for Diabetes
Food and Nutrition Research Institue (DOST-FNRI)
Biodiversity International
Centro de Atencion Nutricional Antimano (CANIA)
Departamento de Alimentacao Escolar
Directorate for Health Information & Research
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Taxes on sugar-sweetened beverages can improve public health. We aimed to characterise the extent and types of sugar-sweetened beverage taxes implemented worldwide and the national characteristics predicting implementation, such as sugar-sweetened beverage intake amounts, disease rates, or economic development. Methods: This longitudinal analysis aggregated serial global datasets (including the Global Dietary Database, Non-Communicable Diseases Risk Factor Collaboration, Global Burden of Disease study, and World Bank data) from 1990 to 2024 in 183 countries to assess sugar-sweetened beverage tax characteristics and national predictors of policy adoption. Sugar-sweetened beverage taxes for public health purposes were identified and characterised, including amounts, fiscal instruments, structures, and covered beverages. Sugar-sweetened beverage consumption, obesity and diabetes prevalence, gross domestic product (GDP), and sociodemographic index (SDI) were assessed as predictors of tax implementation using Cox proportional hazards models with time-varying covariates. Findings: From 1990 to 2024, 64 countries implemented sugar-sweetened beverage taxes, accelerating over time and covering 3·5 billion people globally. South Asia led in adoption (50% of countries; median tax rate 7·5%), followed by southeast and east Asia (47·8%; 5·0%), the Middle East and North Africa (30·0%; 17·0%), and Latin America and the Caribbean (31·3%; 7·0%). Taxes were ad valorem (ie, based on price; 45%), volume-based (44%), sugar-content-based (5%), or mixed (6%), and 13% of countries earmarked revenue for public health. Multivariable-adjusted predictors of tax implementation included diabetes prevalence (hazard ratio [HR]=1·22 [95% CI 1·05–1·43]), obesity prevalence (1·14 [1·00–1·29]), GDP per capita (HR per $10 000: 1·19 [1·06–1·34]), and SDI (0·70 [0·57–0·86]), but not sugar-sweetened beverage intake (0·77 [0·42–1·39]). Interpretation: Global adoption of sugar-sweetened beverage taxes has rapidly accelerated since 1990; however, there is important heterogeneity by region and tax structure, and the taxes are shaped by a country's economic capacity, social development, and health conditions. Funding: This work was supported by the National Institutes of Health (R01HL115189).