Public acceptability of the UK Soft Drinks Industry Levy: Repeat cross-sectional analysis of the International Food Policy Study (2017-2019)

Jean Adams*, David Pell, Tarra L. Penney, David Hammond, Lana Vanderlee, Martin White

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Objectives To determine whether public acceptability, in terms of both support for and perceived effectiveness of, the UK Soft Drinks Industry Levy (SDIL) changed between 4 months prior to, and 8 and 20 months after, implementation. Design Repeat cross-sectional online survey. Setting The UK. Participants UK respondents to the International Food Policy Study aged 18-64 years who provided information on all variables of interest in November-December 2017 (4 months prior to SDIL implementation), 2018 (8 months after) or 2019 (20 months after; n=10 284). Outcome measures Self-reported support for, and perceived effectiveness of, the SDIL. Results The adjusted logistic regression model predicted that 70% (95% CI: 68% to 72%) of participants supported the SDIL in 2017, 68% (95% CI: 67% to 70%) in 2018 and 68% (95% CI: 66% to 70%) in 2019. There was no evidence of a difference in support in 2018 vs 2017 (OR: 0.93; 95% CI: 0.81 to 1.05); or in 2019 vs 2017 (OR: 0.90; 95% CI: 0.78 to 1.03). The adjusted logistic regression model predicted that 72% (95% CI: 70% to 74%) of participants perceived the SDIL to be effective in 2017, 67% (95% CI: 65% to 69%) in 2018 and 67% (95% CI: 64% to 69%) in 2019. There was evidence that perceived effectiveness decreased a small amount in 2018 vs 2017 (OR: 0.78; 95% CI: 0.69 to 0.88). The difference in 2019 vs 2017 was similar. Conclusions We found high support for the SDIL among UK adults and this did not change between 4 months before implementation and 8 or 20 months after. While perceived effectiveness remained high, there was evidence that this decreased slightly after implementation in 2018, but no further in 2019. Greater understanding of influences on public acceptability of effective structural public health interventions is required.

Original languageEnglish
Article numbere051677
JournalBMJ Open
Issue number9
Publication statusPublished - 24 Sep 2021
Externally publishedYes

Bibliographical note

Funding Information:
Funding Funding for this project was provided by a Canadian Institutes of Health Research (CIHR) Project Grant (PJT-162167). Additional support was provided by an International Health Grant from the Public Health Agency of Canada (PHAC, no grant number available), and a PHAC-CIHR Chair in Applied Public Health (no grant number available). Collection of 2017 and 2018 UK data was supported by the Health Foundation (no grant numbers available). JA and MW are supported by the Medical Research Council (grant number MC_UU_ 00006/7) and the Centre for Diet and Activity Research (CEDAR) which is a UKCRC Public Health Research Centre of Excellence (grant number MR/K023187/1) funding for CEDAR from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.


  • health policy
  • nutrition & dietetics
  • public health


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