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BMJ 2009; 339 doi: (Published 21 September 2009) Cite this as: BMJ 2009;339:b3877

A tax on sugary drinks would improve public health, say US experts

A panel of public health experts from across the US have urged federal and state governments to tax sugary drinks in an attempt to control the obesity epidemic. They propose taxing producers and wholesalers 1 cent per fluid ounce on all drinks containing added sugars.

The evidence linking sweetened drinks to obesity and poor health is already compelling, they write. So is the evidence that taxing unhealthy products reduces consumption. Public support for some kind of tax is growing, particularly if tax revenues are earmarked for public health programmes to tackle obesity and encourage healthy lifestyles.

The panel estimates that a 1 cent per ounce tax would reduce calorie consumption from sugary drinks by around 10%. This drop would be enough to produce measurable health benefits in a population that has doubled its intake of sugary drinks over the past few decades. A national tax would generate nearly $15bn (£9.2bn; €10bn) in the first year.

The health problems caused by overweight and obesity currently cost $147bn, nearly 10% of all US healthcare expenditures. Governments have a right to recoup some of these costs from the drinks industry and should be prepared for strong opposition, including the kind of tactics previously employed by tobacco companies in response to taxes on cigarettes. The drinks industry has already established an organisation called “Americans Against Food Taxes,” and other similar initiatives are likely to follow.

Administrative staff help treat depression in small practices

Case management is an effective strategy for treating depressed patients in a primary care setting. It’s also beyond the means of many small general practices. So researchers evaluated telephone support given by trained healthcare assistants already employed by small practices in Germany.

In a cluster randomised trial, patients who were telephoned regularly by trained assistants had slightly but significantly lower symptom scores after 12 months than patients who …

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