Fiscal Policy for Health: Sugar-Sweetened Beverage Tax Design and Soft Drink Consumption Across Geographies, 2010-2024.

Sugar sweetened beverages (SSBs) are an important source of added sugars and a key target for fiscal policies aimed at preventing obesity, type 2 diabetes and other non-communicable diseases. This study assessed the association of SSB taxes, tax structure and tax-design elements and changes in per capita soft drink sales volume across geographies from 2010 to 2024. Annual Euromonitor International Passport sales data were combined with national SSB tax-policy data from the World Bank and macroeconomic indicators. The final sample includes 74 geographies and 1096 geography-year observations. We use a multi-period difference-in-difference technique with staggered implementation of the policy and event-study estimation. SSB taxes were associated with a reduction of 7.286 L per person (p < 0.01), about 10.4% of the sample mean. Taxes with an explicit health objective were associated with larger reductions than taxes without a health objective. Ad valorem, mixed, and specific taxes were related with lower sales volume, although differences across structures were not significant. Importantly, the results imply policy design matters. This indicates that governments should evaluate not only whether to impose SSB taxes but also how to design, position, and communicate them as health-oriented fiscal policies.