Soft Drink Tax

by Nicholas Kristof

When the human body was evolving, almost the only things we drank were breast milk for the first few years and then water, water and more water.

It would obviously have been bad if we had evolved to feel full when water was sloshing about our stomachs because then we wouldn’t have eaten our fill the next time we speared a mastodon. Today, the unfortunate result is that if you drink a bottle of 7-Up, you still don’t feel full — the body treats the liquid as empty calories, like water — and so you won’t eat any less the next time you spear a Big Mac.

That has presented a huge problem in an age of sugary drinks, and some scholars believe they have become a major source of obesity. That’s why the new soda tax proposed by Gov. David Paterson of New York is such a breakthrough.

Mr. Paterson suggested the tax — an 18 percent sales tax on soft drinks and other nondiet sugary beverages — to help raise $400 million a year to plug a hole in the state budget. But it’s also a landmark effort that, if other states follow, could help make us healthier.

Let’s break for a quiz: What was the biggest health care breakthrough in the last 40 years in the United States? Heart bypasses? CAT scans and M.R.I.’s? New cancer treatments?

No, it was the cigarette tax. Every 10 percent price increase on cigarettes reduced sales by about 3 percent over all, and 7 percent among teenagers, according to the 2005 book “Prescription for a Healthy Nation.” Just the 1983 increase in the federal tax on cigarettes saved 40,000 lives per year.

In effect, the most promising cure for lung cancer didn’t emerge from a medical research lab but from money-grubbing politicians. Likewise, the best cure for obesity may turn out to be not a pill but a tax.

These days, sugary drinks are to American health roughly what tobacco was a generation ago. A tax would shift some consumers, especially kids, to diet drinks or water.

“Soft drinks are linked to diabetes and obesity in the way that tobacco is to lung cancer,” says Barry Popkin, a nutrition specialist at the University of North Carolina and author of the excellent new book, “The World Is Fat.” He warns that the cola industry will spend vast sums fighting the proposed tax.

One of industry’s objections is that soft drinks aren’t the only problem. That’s true, and I’d love to see a “Twinkie tax” as well. But evidence is accumulating that sugary drinks are a major contributor to obesity because of the evolutionary heritage I mentioned at the outset: Except for soups, liquid calories don’t register with the body, according to Professor Popkin and other specialists.

If you have a snack, even something unhealthy like potato chips, you’ll eat less at your next meal. But have a Coke, and despite all those calories, you’ll still eat just as much. Indeed, according to some studies, you’ll actually eat more.

“These findings raise the possibility that soft drinks increase hunger, decrease satiety or simply calibrate people to a high level of sweetness that generalizes to preferences in other foods,” said a peer-reviewed article last year in the American Journal of Public Health.

The average American consumes about 35 gallons of nondiet soda each year and gets far more added sugar from soda than from desserts.

Barack Obama has pledged to move toward a system of universal health coverage, and Democrats mostly see health care reform as a matter of providing access to doctors. Access and universal coverage are indeed essential, but there’s only so much doctors can do in this environment.

One priority must be a public health campaign to change social behavior. A starting point is to recognize that risky teen behavior these days can involve not just alcohol, drugs or sex but also extra-large Cokes.

One new study estimates that 24 million Americans now have diabetes, more than four times the number in 1980. The total direct and indirect cost to Americans is $218 billion each year — an average of $1,900 per American household. Each year, diabetes contributes to the deaths of more than 200,000 Americans.

Part of the solution must come from reforming agriculture so that we stop subsidizing corn that ends up as high fructose corn syrup inside soft drinks. Unfortunately, Mr. Obama on Wednesday chose Tom Vilsack, the former governor of Iowa who has longstanding ties to agribusiness interests, as agriculture secretary — his weakest selection so far.

The soft-drink industry will throw enormous resources into defeating the proposed New York tax on sugary drinks. We should stand behind Governor Paterson’s bold gesture. He is blazing a path that other states should follow.

Losing weight is never easy, but one of the most effective diets would start with a soft drink tax.