Sugar-Sweetened Beverages’ Low Taxes in Maryland May Be a Poison for Children and Adults


Other group member: Mujan Varasteh Kia

In 2015, 30% of the people in Maryland were clinically obese. Sugar-Sweetened Beverages (SSB) is strongly associated with obesity which can lead to the number one leading cause of preventative deaths (1 in 4 deaths) due to heart disease, stroke, type 2 diabetes, and certain types of cancer, and can play a role in preterm delivery.

A constructive SSB taxation policy can help to reduce many of the obesity-related health problems and alleviate the amount of money spent to treat these cases long-term. The goal is that “increasing [the tax] will discourage individuals, especially children, and teenagers, from excessive consumption of these beverages.” Currently, Maryland imposes a 6% sale tax on SSBs. No significant reduction in obesity has been recognized as a result of this taxation. It has been argued that the sales tax is too little to prevent people from reducing their bad habits which urges the need for a more substantial taxation to reduce soda consumption. In a study, they found that participants would buy fewer SSBs with 20% tax and would completely eliminate their SSB consumption if 50-100% tax was implemented.

Shortly after Mexico passed soda tax law in 2013, there was an average 12% decline in soda sales and a 4% increase in bottled water purchases. The soda industries have argued that soda taxation is not going to “change the behaviors that lead to obesity,” and that the public will find their calories elsewhere. However, in the studies they referred to the taxes were too small or they were applied in the form of sales taxes that could have gone unnoticed by the consumers.

Philadelphia was the first big city in the nation to pass a soda taxation policy in 2016. Despite the approximate $5 million advertisements against this taxation by The American Beverage Association, a non-profit campaign was created with the help of the former New York City Mayor, Michael Bloomberg to support the soda taxation law. We also urge the Maryland state legislature to support and follow the same initiatives as those of Philadelphia mayor’s 1.5-cents-per-ounce levy on SSBs. These policies may not fully eliminate the obesity crisis, but even a small reduction in soda consumption will make a difference.


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9 Responses to “Sugar-Sweetened Beverages’ Low Taxes in Maryland May Be a Poison for Children and Adults”

  1. ryandlangblog Says:

    This was an excellent post. I agree that the consumption of sugar-sweetened beverages is one of the most significant risk factors influencing the development of obesity. In my internal medicine practice, I counsel dozens of patients who are obese, and the conversation usually includes an assessment of their drinking patterns. Many of these patients are regular soda drinkers, usually in excess of what is considered a healthy practice.

    I strongly support legislation that introduces taxes on sugar-sweetened beverages as this is one of the most effective ways to limit consumption of these drinks. In Baltimore, there are many individuals and organizations that also support this legislation as well. City Heath a Commissioner Dr. Leana Wen is a prime example as she commended Philadelphia health officials after passing their own soda tax legislation (, and she could provide expert testimony to state elected officials on this issue of obesity related to sugary drink consumption. Sugar Free Kids Maryland is another strong supporter of healthy vending options for children and would likely be a great ally in this push as well ( If I would do anything differently than what is suggested in this post, I would advocate for this tax being introduced first in Baltimore and then, if successful, petition the state to consider this tax.

  2. marysmithsbf Says:

    Thank you for this post. I, like you, was interested in the problem of SSB related obesity, but did not consider a legislative sales tax solution, which I think is a very interesting proposition. I completely agree with your assessment and studies that showed that a 20%, 50%, or 100% sales tax would drastically decrease SSB consumption, I am only dubious of the feasibility of passing such legislation, and would the opposition prove too much to surmount? For example, I know that the president of Maryland Retailers Association, Cailey Tolle, vehemently opposes SSB legislation, stating that it puts undue burden on business owners and would make it harder to conduct business (1). Also, Ellen Valentino, the executive vice president of the Maryland-Delaware-DC Beverage Association, voiced the association’s concern in the press that the city’s already struggling to retain businesses and grocery stores in the area, and a taxation would unfairly further hamper retailers (1). Although, in theory, a taxation bill which would increase the existing sales tax would be extremely helpful in combating the city’s obesity epidemic, I fear it with such heavily funded opposition, it would be very difficult to get passed.
    While of speaking of heavily funded opposition, another interesting option would be to targeting the marketing and advertisement of sugar sweetened beverages. Beverage companies spend billions of dollars marketing sugar sweetened beverages, with a large portion targeted at children and teenagers 2-17 years old (2). In addition, Studies have shown that beverage companies disproportionately market to low-income communities that are already disproportionately affected by health disparities (3). Although, the beverage industry is a multi-billion dollar industry that would be difficult opposition, a top-down targeting approach starting directly with advertisement could be very effective if accomplished.


  3. bulumkofutshane Says:

    Thank you for this excellent post.I really enjoyed it and find it informative, it raised my interest in the topic. South Africa is busy drafting a policy to regulate sugar-sweetened beverages and from this fiscal year treasury has introduced what we call “sugar-tax”. There has been a lot of resistance from the industry but I was quite amazed about the resistance coming from several political parties. This made me to research more about the topic and also try to understand which interests these group are protecting. I think South Africa can learn a lesson or two from countries and states that have implemented this policy and the possible challenges we might be faced with.

  4. shawngul Says:

    Great post! This is a very controversial topic, but I enjoyed your blog post and I agree with your argument. As you mentioned, SSBs have been shown to worsen many health outcomes, and thus place a public health burden. In order to deter the behavior and generate government revenue that can be used for health care costs, a tax is certainly warranted. If Philadelphia’s tax has demonstrated a greater efficacy in deterring SSB consumption, it seems like a great idea for Maryland to look into implementing something similar.

    I know this was our first blog post, so it was difficult to know this ahead of time, but it is difficult to read the text in the graphic you included alongside your post. I’m not sure, but it could also be my computer that’s not allowing me to click the image.

    In any case, great job again! You argued your perspective very well and I agree with your plan!

  5. csalmero Says:

    Wonderful and very timely post, as the latest health affairs publication features a study that reports the success and potential long-term sustainability of Mexico’s SSB tax. ( The study found that not only did purchases of taxed beverages decrease by 5.5% in the first year, but they continued to decrease even more ~9% in 2015. Furthermore, they have data suggesting that the lowest SES level households stand to benefit the most from such taxes as they showed the largest decreases in purchases of SSB in the two year study. In cities like Baltimore that have a large population suffering from diabetes and other obesity caused illness primarily, amongst low SES populations, these types of policy changes and monetary incentives or disincentives may be the most effective route. Along with promotion of healthier alternatives the SSB tax is poised to really make a difference. I completely agree that it’s time that Maryland get on board with SSB tax legislation and make plans to use the generated funds to reinvest into the much needed health promotion programs within the state.

  6. xiyuwangblog Says:

    Thanks for bringing in this interesting post! I also firmly support the idea that Maryland increase sugar-sweetened beverage taxes to reduce consumption and maintain government earnings. Changing consumer behavior through introducing taxes on goods sold has proven to be effective in tobacco control ( and alcohol consumption ( Moreover, this post reminds me of my RA work at the JHSPH Injury Research Unit, which has been making efforts to ensure that academic institutions and NGOs not to receive funding from the alcohol industry. In fact, multiple studies have shown that the alcohol, tobacco and sugar-sweetened beverage industries who often use channels like sponsoring events and monetary donations to non-profits as an indirect way of advertising their products. Unlike tobacco and alcohol whose negative impact on population health can be fatal, immediate and obvious (lung cancer, stomach cancer, road traffic crashes, severe mental disorder, etc.), the negative impact on health from sugar-sweetened beverage takes much longer time to see, so it would be harder for public health professionals and policy makers to implement stringent rules like high tax and limited (or banned) direct advertisement towards consumers.

  7. drrakshagupta Says:

    Thanks for this blog post and raising a key issue in the public health world. Sugar consumption in the form of SSB has been in the notice for quite some time and I have come across many emerging policies and backlashes regarding this. Although I agree that consumption of sugar products is alone of the major causes of early onset obesity and diabetes, and raising taxes might solve some aspects of this issue. But I strongly advocate that raising taxes along with stringent ban or limit in the sale of these products in regions where they are readily available to kids might help more. I have observed in the grocery stores and recreational parks, that the most popular aisle or most frequently taken paths have big hoardings or sections of SSB. That makes them so visibly available and also in the aisle during wait times many kids and also adults just buy them because they just can’t abstain from the sudden urge for sugar load. These tactics are exploited by SSB companies and there should be stringent steps taken in this issue.
    Also I think, health is not something you can give or offer to someone, so there is a need to provide healthy options and safe walking pavements so that it is easy to acquire these habits.
    Rest I loved reading the post.

  8. tamiloreareola Says:

    Very interesting post. I noted you mentioning how the existing 6% tax has not decreasing SSB consumption. This might have to do with varying price elasticities with different tax percentages. The lack of past success might suggest a need for evidence-based decisions that consider price elasticities.

  9. zcatanz Says:

    I agree that the negative health consequences associated with excess sugar consumption- and therefore products like SSBs- are major contemporary health concerns. However, I disagree with the method of increasing taxation, and thereby cost, in order to achieve this end. The reason I disagree with this method, sometimes called a “sin tax,” is not because it is ineffective. There appears to be sufficient evidence from the tobacco industry that such increased taxation can result in decreases in consumption (although there may be some harmful displacement, such as people switching from premium pre-rolled cigarettes to cheaper filter-less “loose” tobacco).
    The primary reason I disagree with the “sin tax” method is that it violates human rights by disproportionately affecting the poor. Some may regard this as providing greater benefit for the poor, arguing that the poor are more strongly affected by the tax and therefore tend to show the greatest decrease in consumption (naturally). However, this disregards a number of factors. First, the poor are not necessarily willful participants and are, essentially, being coerced. Second, although increased cost may be associated with decreased consumption, this may not result in a decrease in expenditure but rather simply having fewer goods.

    In addition, it would seem the case of sugar is quite distinct from tobacco. First, sugar is a basic commodity and certain sugars and certain amounts of these sugars are essential for health, unlike tobacco. Second, the sugar industry is much less easily regulated. Does an increased tax on SSBs also come with an increased tax on sugar generally? This is a slippery slope especially when we considered sugary drinks that are sold dry and how easily sugar can be added to a beverage. Moreover, while it may be true that SSBs are primary drivers of the negative consequences of excess sugar, a great many products include what many professionals might consider excess sugar. Do we stop at sugar? Saturated fat is also a major cause of obesity, heart disease, and other negative health consequences. What about a fat tax? Applying reductio ad absurdum, we find this logic leads us to a place where only the rich can afford options while the poor must meet strict dietary standards.

    Ultimately, this is a punitive capitalist approach that, were it the only effective solution, might be appropriate. However, this is not only not the only option but I believe that a seemingly minor, yet all important, twist in the logic can be applied that steers policy in a better direction. Rather than increasing the cost of the “bad” through a punishment approach, why not consider decreasing the cost of the “good” through a reward approach? If economic attractiveness is believed to be the mechanism of change then it would seem we could be equally effective by making healthier options more affordable. Although funding methods may have to be more creative, tax incentives that redistribute from the wealthy to poor would be capable of both addressing the primary issue- negative health outcomes associated with poor diets- while simultaneously generating greater equity rather than lesser.

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