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BMJ 2010; 341 doi: (Published 22 December 2010) Cite this as: BMJ 2010;341:c7264

Taxing sugary drinks could cut consumption and generate revenue for anti-obesity initiatives

Everyone agrees that obesity must be controlled, and legislative measures such as taxing sugar sweetened drinks are currently moving up the agenda, at least in the US. Few doubt that taxing drinks such as cola would generate revenue for the government, but would taxes help prevent obesity? Would the price increases hit the poorest hardest? Yes and no, say researchers. They estimate that a heavy tax (40%) on all sugar sweetened drinks bought in shops would reduce daily calorie consumption from drinks by around 12 kcal (50 kJ) per person, resulting in just over 0.5 kg of weight loss over one year. They also estimate that a 40% tax would generate an extra $2.5bn (£1.6bn; €1.9bn) in tax a year, less than $30 a year for each household. In these analyses, households in the highest income bracket paid more of the extra revenue than households in the lowest income bracket ($745m v $510m).

These figures are informed guesswork, based on survey data from typical US families who reported the contents of their weekly shopping trolley for one year (2006). Researchers used these data to model changes in response to various tax strategies. A 40% tax on all sugary drinks was the most productive, cutting more calories and generating more income than conservative strategies, such as taxing only fizzy drinks or capping the tax at 20%. These taxes can work, say the researchers, and would work best if governments used the extra revenue to fund other initiatives to control obesity.

Antibiotic resistance emerges after mass treatments with azithromycin

Liberal use of antibiotics encourages resistance, and researchers recently demonstrated this effect among Ethiopian communities taking part in a trial of azithromycin to control ocular trachoma. At the start of the trial, researchers grew resistant Streptococcus pneumoniae from 3.6% (95% CI 0.8% to 8.9%) of nasopharyngeal swabs taken from …

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