Topic: Sugary Drinks

Brief: Sugary Drink Excise Tax in the City of San Diego

Posted on April 28, 2026

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with the County of San Diego Health and Human Services Agency through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model examining a $0.02-per-ounce excise tax on sugary drinks. This tax would be implemented within the City of San Diego and would aim to decrease the consumption of sugary drinks and improve community health while simultaneously raising much-needed revenue. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Chronic Disease and Health Equity Unit within the Maternal, Child, and Family Health Services Branch, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Cradock AL. Sugary Drink Excise Tax in the City of San Diego {Issue Brief}. County of San Diego Health and Human Services Agency, Public Health Services, San Diego, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: Sugar-Sweetened Beverage Excise Tax in the City of Los Angeles

Posted on March 31, 2026

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with the Los Angeles County Department of Public Health through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.

This brief summarizes a CalFresh Healthy Living–CHOICES Project Learning Collaborative Partnership model of a $0.02-per-ounce volume excise tax on sugar-sweetened beverages (SSBs) in the City of Los Angeles. The SSB tax, which would be administered by the city, aims to reduce consumption of SSBs. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Vos K, Caldwell J, Sklyar L, Shah D, Kuo T, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Cradock AL. Sugar-Sweetened Beverage Excise Tax in the City of Los Angeles {Issue Brief}. Los Angeles County Department of Public Health, Los Angeles, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: Sugar-Sweetened Beverage Excise Tax in Unincorporated Areas of Los Angeles County

Posted on March 31, 2026

Shopping for liter-sized bottles of soda in the grocery store

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model of a $0.02-per-ounce volume excise tax on sugar-sweetened beverages (SSBs) in unincorporated Los Angeles County. The tax, which would be administered by the county, aims to reduce consumption of SSBs. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Vos K, Caldwell J, Sklyar L, Shah D, Kuo T, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Cradock AL. Sugar-Sweetened Beverage Excise Tax in Unincorporated Areas of Los Angeles County {Issue Brief}. Los Angeles County Department of Public Health, Los Angeles, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: Sugar-Sweetened Beverage Excise Tax in the City of San José

Posted on March 31, 2026

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with the County of Santa Clara Public Health Department through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model, a cost-effectiveness analysis examining a sugar-sweetened beverage (SSB) excise tax in the City of San José. The model assessed the health impact and cost-effectiveness of a $0.02 per ounce excise tax in the City of San José. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Cholette V, Coxe N, Shir A, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Cradock AL. Sugar-Sweetened Beverage Excise Tax in the City of San José {Issue Brief}. County of Santa Clara Public Health Department, San José, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Cost-effectiveness and health equity improvements from excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program

Posted on September 8, 2025

This study estimates the cost-effectiveness of excluding sugar-sweetened beverages from eligible purchases in the Supplemental Nutrition Assistance Program and its potential impact on health equity.

Musicus AA, Barrett JL, McCulloch SM, Long MW, Ward ZJ, Cradock AL, Bleich SN, Gortmaker SL. Cost-effectiveness and health equity improvements from excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program. Am J Prev Med. 2025, In press. doi:10.1016/j.amepre.2025.108082. Epub 2025 Sep 8.

Abstract

Background

Although interventions to change nutrition policies, systems, and environments (PSE) for children are generally cost effective for preventing childhood obesity, existing evidence suggests that nutrition education curricula, without accompanying PSE changes, are more commonly implemented.

Introduction

Excluding sugar-sweetened beverages (SSBs) from eligible purchases in the Supplemental Nutrition Assistance Program (SNAP) has been proposed as a strategy to improve diet quality and health. This study estimates the cost-effectiveness of this policy and its potential impact on health equity.

Methods

The Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) microsimulation and systematic review process was used in 2024 to estimate the potential impact of excluding SSBs from SNAP-eligible purchases over a ten-year period (2023-2032) for the U.S. population. Health outcomes related to excess weight, costs, and relative changes in obesity prevalence by income, race, and ethnicity group in 2032 were estimated.

Results

The policy is projected to be cost-saving, prevent 279,000 cases of obesity (95% UI: 149,000−446,000), and contribute 115,000 (95% UI: 60,100−187,000) quality-adjusted life years gained over ten years among SNAP participants. The policy could save an estimated $2.75 billion in healthcare costs related to excess weight over ten years, resulting in $3.35 in healthcare cost savings per dollar spent on implementation. Reductions in obesity prevalence were estimated to be 3.5 times greater among individuals with income ≤130% of the federal poverty level compared to the overall mean, and 3-3.5 times greater among non-Hispanic Black and Hispanic individuals compared to non-Hispanic white individuals.

Conclusions
Excluding SSBs from SNAP-eligible purchases could be a cost-saving strategy to improve health and health equity between income, racial, and ethnic groups. The U.S. Department of Agriculture could use pilot studies to test the real-world effects of excluding SSBs from SNAP.

Keywords
health equity; cost-effectiveness; Supplemental Nutrition Assistance Program; nutrition policy; sugar-sweetened beverages

Funding

Research reported in this publication was supported by the National Heart, Lung, and Blood Institute under Award Number R01HL146625, the Centers for Disease Control and Prevention under Award Number U48DP006376, and The JPB Foundation. Dr. Musicus’ time on this work was supported by NIH grants T32CA057711 and T32HL098048. The content of this paper is solely the responsibility of the authors and does not necessarily represent the represent the official views of the Centers for Disease Control and Prevention or any of the other funders. The funders had no role in the study design; collection, analysis, and interpretation of data; writing of the report; and the decision to submit the report for publication. Dr. Musicus is also affiliated with the Center for Science in the Public Interest (CSPI), but this work was completed entirely within her Harvard affiliation and does not reflect the views of CSPI. No financial disclosures were reported by the authors of this paper.

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Coffee Chat: Promoting Healthy Beverage Consumption Among School-Age Children & Adolescents: New Expert-Backed Recommendations

Posted on March 31, 2025

In this coffee chat hosted by the CHOICES Community of Practice, Megan Lott, Deputy Director of Healthy Eating Research at the Duke Global Health Institute, walked through these new recommendations and shared resources that can be used to provide guidance for parents, caregivers, and public health professionals.

View the resource round-up from this coffee chat

Download the March 2025 coffee chat presentation slides

Disclaimer: Our guest speakers share their own perspectives and do not speak for Harvard.

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Coffee Chat: Creating Healthier Spaces for Kids: A Walkthrough of OSNAP Resources for Out-of-School Time

Posted on January 23, 2025

In this coffee chat hosted by the CHOICES Community of Practice, Bekka Lee, Co-Investigator at the Prevention Research Center on Nutrition and Physical Activity & Lecturer in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health and Director of the Community Engagement Program at Harvard Catalyst, provided an in-depth overview of resources from the Out-of-School Nutrition and Physical Activity (OSNAP) initiative including a discussion of how you can implement this evidence-based intervention in your program, city, or state.

View the resource round-up from this coffee chat

Download the January 2025 coffee chat presentation slides

Disclaimer: Our guest speakers share their own perspectives and do not speak for Harvard.

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Coffee Chat: Investing in a Healthier Future: How a Sugary Drink Excise Tax Could Improve Health & Health Equity in Massachusetts

Posted on September 26, 2024

In this coffee chat hosted by the CHOICES Community of Practice, Sara Bleich, Professor of Public Health Policy at the Harvard T.H. Chan School of Public Health and inaugural Vice Provost for Special Projects at Harvard University and Steve Gortmaker, Professor of the Practice of Health Sociology, Director of the Prevention Research Center on Nutrition and Physical Activity, and Director and Co-Principal Investigator of the CHOICES Project at the Harvard T.H. Chan School of Public Health, discussed the progressive health and health equity impacts of a sugary drink excise tax, highlighting recent findings from modeling a statewide tax in Massachusetts.

View the resource round-up from this coffee chat

Download the September 2024 coffee chat presentation slides

Disclaimer: Our guest speakers share their own perspectives and do not speak for Harvard.

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Report: Sugary Drink Excise Tax in Boston, MA

Posted on September 25, 2024

Mom giving glass of water to young daughter

The information in this report is intended to provide educational information on the cost-effectiveness of sugary drink excise taxes.

Executive Summary

Sugary drink consumption has been linked to excess weight gain, obesity, incidence of type 2 diabetes, heart disease, and cancer. Federal, state, and local governments have considered implementing excise taxes on sugary drinks to reduce consumption, prevent obesity, and provide a new source of government revenue.^1-3In Massachusetts, legislative measures to introduce a tiered sugary drink excise tax have been proposed.^4,5The most recent proposed bills specify that tax revenue be dedicated to benefits, services, and programs, including universal free school meals and provision of healthy meals in Head Start and other high need early education settings, for communities most impacted by health inequity and burdened by chronic health outcomes related to sugary drink consumption.^4,5

We modeled the impact of a statewide excise tax on sugary drinks on health outcomes among Boston residents. Consistent with current policy proposals, we assumed tiered tax rates depending on the sugar content of the beverage: $0.01/ounce for beverages with more than 7.5 but less than 30 grams of sugar per 12 fluid ounces and $0.02 for beverages with more than 30 grams of sugar per 12 fluid ounces. CHOICES cost-effectiveness analysis compared the costs and outcomes of implementing a tax with the costs and outcomes expected if the tax were not implemented over 10 years (2023-2032).

The sugary drink excise tax on distributors is projected to be cost-saving. This means that the tax would save more in future healthcare costs than it would cost to implement. This is without consideration of the potential revenue that would be generated, where a tiered $0.01-$0.02/ounce statewide excise tax on sugary drinks in Massachusetts could raise as much as $226 million to $322 million in annual revenue.⁶Among Boston residents, the tax is projected to decrease sugary drink consumption, prevent more than 6,000 cases of obesity, and save $91.2 million in health care costs. People who consume sugary drinks are projected to spend less on these drinks with the excise tax in place. We also project that Black and Hispanic/Latinx Boston residents will experience a greater reduction in obesity rates compared with White, non-Hispanic/Latinx residents after the tax is implemented. These results are summarized below and in the complete report. Projected results for a $0.02/ounce state excise tax based on the volume of sugary drinks were similar.

Continue reading in the full report.

Contact choicesproject@hsph.harvard.edu for an accessible version of this report.

Citation

McCulloch SM, Barrett JL, Reiner JF, Cradock AL, Gortmaker SL. Boston: Sugary Drink Excise Tax. CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; February 2024. For more information, please visit www.choicesproject.org.

The design for this brief and its graphics were developed by Molly Garrone, MA.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376), and the National Institutes for Health (R01HL146625). The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

For further information, contact choicesproject@hsph.harvard.edu

References

American Public Health Association Taxes on Sugar-Sweetened Beverages. 2012.
Falbe J, Rojas N, Grummon AH, Madsen KA. Higher Retail Prices of Sugar-Sweetened Beverages 3 Months After Implementation of an Excise Tax in Berkeley, California. American Journal of Public Health. 2015;105(11):2194-2201.
World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020 [Internet]. Geneva: WHO. Updated appendix 3, “Best buys” and other recommended interventions for the prevention and control of noncommunicable diseases; [updated 2017; cited 2019 Sep 17]. Available from: https://iris.who.int/bitstream/handle/10665/94384/9789241506236_eng.pdf?sequence=1
Massachusetts Senate Docket No. 959. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/SD959. Filed January 18, 2023. Accessed March 9, 2023.
Massachusetts House Docket No. 1813. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/HD1813. Filed January 18, 2023. Accessed March 9, 2023.
UCONN Rudd Center. Revenue Calculator for Sugary Drink Taxes. Release: April 13, 2021. http://www.uconnruddcenter.org/revenue-calculator-for-sugary-drink-taxes. Accessed December, 2023.

See the report for the full list of references.

See the sugary drink excise tax report for the impact on the Massachusetts population.

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Report: Sugary Drink Excise Tax in Massachusetts

Posted on September 25, 2024

The information in this report is intended to provide educational information on the cost-effectiveness of sugary drink excise taxes.

Executive Summary

We modeled implementation of a state excise tax on sugary drinks in Massachusetts. Consistent with current policy proposals, we assumed tiered tax rates depending on the sugar content of the beverage: $0.01/ounce for beverages with more than 7.5 but less than 30 grams of sugar per 12 fluid ounces and $0.02 for beverages with more than 30 grams of sugar per 12 fluid ounces. CHOICES cost-effectiveness analysis compared the costs and outcomes of implementing a tax with the costs and outcomes expected if the tax were not implemented over 10 years (2023-2032).

The sugary drink excise tax on distributors is projected to be cost-saving. This means that the tax would save more in future health care costs than it costs to implement. This is without consideration of the potential revenue that would be generated, where a tiered $0.01-$0.02/ounce statewide excise tax on sugary drinks in Massachusetts could raise as much as $226 million to $322 million in annual revenue.⁶Among Massachusetts residents, the tax is projected to decrease sugary drink consumption, prevent over 62,000 of cases of obesity, and save $937 million in health care costs. People who consume sugary drinks are projected to spend less on these drinks with the excise tax in place. We also project that Black and Hispanic/Latinx Massachusetts residents will experience a greater than average reduction in obesity levels after the tax is implemented, leading to improved health equity. These results are summarized below and in the complete report. Projected results for a $0.02/ounce state excise tax based on the volume of sugary drinks were similar.

Continue reading in the full report.

Contact choicesproject@hsph.harvard.edu for an accessible version of this report.

Citation

McCulloch SM, Barrett JL, Reiner JF, Cradock AL, Gortmaker SL. Massachusetts: Sugary Drink Excise Tax. The CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; February 2024. For more information, please visit www.choicesproject.org.

The design for this brief and its graphics were developed by Molly Garrone, MA.

Funding

For further information, contact choicesproject@hsph.harvard.edu

References

American Public Health Association Taxes on Sugar-Sweetened Beverages. 2012.
Falbe J, Rojas N, Grummon AH, Madsen KA. Higher Retail Prices of Sugar-Sweetened Beverages 3 Months After Implementation of an Excise Tax in Berkeley, California. American Journal of Public Health. 2015;105(11):2194-2201.
World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020 [Internet]. Geneva: WHO. Updated appendix 3, “Best buys” and other recommended interventions for the prevention and control of noncommunicable diseases; [updated 2017; cited 2019 Sep 17]. Available from: https://iris.who.int/bitstream/handle/10665/94384/9789241506236_eng.pdf?sequence=1
Massachusetts Senate Docket No. 959. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/SD959. Filed January 18, 2023. Accessed March 9, 2023.
Massachusetts House Docket No. 1813. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/HD1813. Filed January 18, 2023. Accessed March 9, 2023.
UCONN Rudd Center. Revenue Calculator for Sugary Drink Taxes. Release: April 13, 2021. http://www.uconnruddcenter.org/revenue-calculator-for-sugary-drink-taxes. Accessed December, 2023.

See the report for the full list of references.

See the sugary drink excise tax report for the impact on the Boston, MA population.

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