Does sugar taxation on sugar-sweetened beverages alter purchasing behaviour of South African consumers? Perspectives of dietitians and key industry role-players

Background:The increasing prevalence of non-communicable diseases and obesity is associated with excessive consumption of sugar. To address this concern the taxation of sugar-sweetened beverages (SSBs), known as the Health Promotion Levy (HPL), was implemented in South Africa in April 2018.Objectives:A study was undertaken to investigate perspectives of dietitians and key industry role-players (KIRs) on the HPL.Design:This was a cross-sectional, descriptive study.Setting:A national study was conducted in South Africa via a virtual platform.Subjects:The participants were registered dietitians (n = 138) and key industry role-players (KIRs) (n = 39) who had expertise in nutrition, food science and/or sugar taxation legislation.Outcome measured:Electronic surveys probed participants' awareness and opinions of the HPL, perceived SSB purchasing of consumers and barriers or facilitators for implementation of the HPL.Results:Dietitians were positive regarding the HPL (75.8%; n = 94/124) but regarded the tax as too little to affect a reduction in obesity (71.8%, n = 89/124). They reported a 19.2% reduction in their perceived clients' daily purchasing of SSBs since implementation of the HPL.The KIRs regarded the HPL as insufficient to influence consumers' purchasing behaviour (64.9%, n = 24/37). Consumers' habitual purchasing was deemed a barrier (83.8%, n = 31/37) and consumer education an enabling factor (76,9%, n = 30/39) to successful implementation.Results:Dietitians were positive regarding the HPL (75.8%; n = 94/124) but regarded the tax as too little to affect a reduction in obesity (71.8%, n = 89/124). They reported a 19.2% reduction in their perceived clients' daily purchasing of SSBs since implementation of the HPL.The KIRs regarded the HPL as insufficient to influence consumers' purchasing behaviour (64.9%, n = 24/37). Consumers' habitual purchasing was deemed a barrier (83.8%, n = 31/37) and consumer education an enabling factor (76,9%, n = 30/39) to successful implementation.Conclusion:Dietitians have a positive opinion on the HPL. They agree that the HPL alone will not influence the purchasing behaviour of consumers or reduce the prevalence of obesity. KIRs regard the HPL to be insufficient to affect consumers' purchasing behaviour. The HPL should form part of a multi-pronged approach to create a supportive environment to reduce sugar consumption. It is recommended that approaches should include fiscal measures, consumer education and controlled marketing of SSBs. Trained dietitians would be able to enhance the goal of the HPL to combat the obesity pandemic.