Giving up sugary drinks might not mean choosing healthier options

Nearly seven in ten Australians surveyed would consider switching to water under proposed beverage taxes or warning labels, but many also favored juice and diet drinks, raising questions about whether taxing sugary beverages alone is enough to encourage healthier choices.

Study: What happens when sugar-sweetened beverage labelling and tax policies are extended to non-sugar sweetened beverages? A national study of Australians’ responses. Image credit: fongbeerredhot/Shutterstock.com

Published in Frontiers in Public Health, the study found that around half of Australian adults believed warning labels or taxes would discourage their consumption of sugar-sweetened beverages (SSBs). Fewer than half thought extending these measures to non-sugar-sweetened beverages (NSSBs), such as diet drinks, would discourage their consumption of those alternatives.

Why researchers are looking beyond sugary drinks

More than 80 countries have introduced taxes on sugary drinks, while others have adopted or are developing front-of-pack warning labels to discourage consumption.

Although such measures can reduce sugary drink purchases, they may also encourage consumers to switch to untaxed alternatives, including artificially sweetened drinks and 100% fruit juice, rather than water.

This raises concerns because fruit juice contains free sugars, and observational research has linked non-sugar-sweetened beverage consumption with several adverse health outcomes. The World Health Organization also advises against using non-sugar sweeteners for weight control.

To investigate whether broader policies might address these concerns, researchers surveyed 2,876 Australian adults recruited through the probability-based Life in Australia panel.

Participants were randomly assigned to evaluate either a warning label or a hypothetical 20% beverage tax. Each group first considered a policy targeting sugary drinks alone, followed by a scenario extending the same measure to artificially sweetened beverages.

Researchers examined whether participants believed the policies would discourage their consumption and which alternative drinks they would consider choosing.

Around half said taxes or labels would discourage consumption

Warning labels were associated with slightly greater reported willingness to reduce sugary drink consumption than taxation, with 55.8% of participants agreeing that labels would discourage their intake compared with 51.3% for a tax. The difference was statistically significant after adjustment for participant characteristics, with the tax group showing 18% lower odds of agreement than the labeling group.

When policies were extended to artificially sweetened drinks, 44.2% of participants in both groups agreed that the measures would discourage their NSSB consumption.

Responses also varied by age, socioeconomic disadvantage and existing drinking habits.

Adults aged 18–34 had 72% higher odds of agreeing that an NSSB tax would discourage their consumption than those aged 55 or older. Conversely, people living in the most disadvantaged areas were less likely than those in the least disadvantaged areas to believe either SSB or NSSB taxation would discourage their consumption.

Regular sugary drink consumers were also less likely to believe warning labels would discourage their SSB intake, while regular consumers of artificially sweetened drinks were less receptive to policies targeting NSSBs.

Existing drinking habits strongly influence potential beverage swaps

More than 80% of participants said they would consider at least one alternative beverage under the sugary drink policies, with water the most frequently selected option.

Around 68–70% considered switching to water across the scenarios, followed by 100% fruit juice (approximately 53–58%). Under policies targeting sugary drinks alone, 43–46% considered artificially sweetened alternatives. Existing drinking habits strongly influenced these preferences.

Regular consumers of artificially sweetened beverages had approximately sixfold higher odds of considering NSSBs under sugary drink labeling and ninefold higher odds under taxation, compared with less frequent NSSB consumers.

Similarly, regular juice and bottled water drinkers were more likely to consider their usual beverages as alternatives.

Regular sugary drink consumers were generally less likely to consider switching to water, including under SSB taxation, where their odds were approximately 51% lower than those of less frequent consumers.

These findings suggest that while beverage policies could encourage healthier choices, they may also reinforce existing preferences for sweetened drinks.

Extending beverage taxes could help limit unhealthy substitutions

The researchers suggest that extending taxes and warning labels to artificially sweetened drinks could help reduce substitution away from sugary beverages towards other sweetened alternatives. However, the study did not establish whether broader policies would actually reduce consumption or prevent substitution.

Its findings were based on hypothetical scenarios and self-reported responses rather than observed purchases. Participants also considered sugary drink policies before their extension to NSSBs, meaning the latter responses cannot be interpreted as independent assessments of NSSB policies.

The researchers emphasize that beverage taxes and warning labels should form part of a broader public health strategy, alongside measures such as social marketing, healthier drink availability and subsidies.

They also highlight the importance of addressing the needs of regular sugary drink consumers and monitoring how both consumers and manufacturers respond to policy changes.

Overall, the findings suggest that expanding beverage policies beyond sugary drinks may help address unintended substitution, but further real-world research is needed to determine whether these measures lead to healthier drinking habits.