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首页> 美国卫生研究院文献>BMJ Global Health >The potential health and revenue effects of a tax on sugar sweetened beverages in Zambia
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The potential health and revenue effects of a tax on sugar sweetened beverages in Zambia

机译：对赞比亚含糖甜饮料征收税收可能对健康和税收产生影响

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The global burden of non-communicable diseases (NCDs) has been rising. A key risk factor for NCDs is obesity, which has been partly linked to consumption of sugar sweetened beverages (SSBs). A tax on SSBs is an attractive control measure to curb the rising trend in NCDs, as it has the potential to reduce consumption of SSBs. However, studies on the potential effects of SSB taxes have been concentrated in high-income countries with limited studies in low-income and middle-income countries. Using data from the 2015 Zambia Living Conditions Monitoring Survey (LCMS) data, the 2017 Zambia NCD STEPS Survey, and key parameters from the literature, we simulated the effect of a 25% SSB tax in Zambia on energy intake and the corresponding change in body mass index (BMI), obesity prevalence, deaths averted, life years gained and revenues generated using a mathematical model developed using Microsoft Excel. We conducted Monte Carlo simulations to construct 95% confidence bands and sensitivity analyses to account for uncertainties in key parameters. We found that a 25% SSB would avert 2526 deaths, though these results were not statistically significant overall. However, when broken down by gender, the tax was found to significantly avert 1133 deaths in women (95% CI 353 to 1970). The tax was found to potentially generate an additional US$5.46 million (95% CI 4.66 to 6.14) in revenue annually. We conclude that an SSB tax in Zambia has the potential to significantly decrease the amount of disability-adjusted life years lost to lifestyle-related diseases in women, highlighting important health equity outcomes. Women have higher baseline BMI and therefore are at higher risk for NCDs. In addition, an SSB tax will provide government with additional revenue which if earmarked for health could contribute to healthcare financing in Zambia.
机译：非传染性疾病（NCD）的全球负担一直在上升。非传染性疾病的关键危险因素是肥胖，肥胖与食用糖甜饮料（SSB）有部分联系。对SSB征税是抑制NCD上升趋势的一种有吸引力的控制措施，因为它有可能减少SSB的消费。但是，关于SSB税的潜在影响的研究主要集中在高收入国家，而在低收入和中等收入国家的研究却很少。使用2015年赞比亚生活条件监测调查（LCMS）数据，2017年赞比亚NCD STEPS调查的数据以及文献中的关键参数，我们模拟了赞比亚25％的SSB税对能量摄入和人体相应变化的影响质量指数（BMI），肥胖症患病率，避免的死亡，获得的寿命和使用Microsoft Excel开发的数学模型产生的收入。我们进行了蒙特卡洛模拟，以构建95％的置信带，并进行敏感性分析以解决关键参数的不确定性。我们发现25％的SSB可以避免2526例死亡，尽管这些结果总体上没有统计学意义。但是，按性别细分时，发现该税可显着避免妇女死亡1133人（95％CI 353至1970）。人们发现，这项税收每年可能额外产生546万美元（95％CI 4.66至6.14）的收入。我们得出的结论是，赞比亚的SSB税有可能显着减少妇女因与生活方式有关的疾病而失去的残疾调整生命年的数量，这突出了重要的健康平等成果。妇女的基线BMI较高，因此罹患非传染性疾病的风险较高。此外，SSB税将为政府提供额外的收入，如果将其指定用于卫生，则可以为赞比亚的医疗保健融资做出贡献。

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