The Guardian view on the sugar tax: fewer tooth extractions is great news for public health | Editorial

The combination of the pandemic, vast NHS waiting lists and a stream of worrying reports about rising obesity and mental illness in young people means that good news about children’s health has become a rare treat. So a study showing that the soft drinks industry levy has brought unexpected benefits, particularly for the youngest children, is a surprise as well as a relief. Researchers in Cambridge and Glasgow examined records of tooth extractions in English hospitals, and found that they fell by 12% over the period during which the levy was introduced – although children aged over 10 did not experience an improvement.

Growing concern about obesity rates was what drove the policy, which came into force in 2018. A study published earlier this year suggested that the product reformulation it led to made a difference. Some 8% fewer year 6 girls (aged 10-11) were found to be obese in 2020 than would have been the case had the levy not been introduced – there had been no change for boys. The latest finding of an improvement to young children’s dental health – with an estimated 5,638 reduction overall in the number of those having teeth pulled out – can be regarded as an additional benefit over and above the original aim of weight loss. Since poor dental health in early childhood is correlated with problems later on, this is a shift with long-term significance as well as an obvious advantage to the children who have avoided rotten teeth.

As ever, it is unwise to draw sweeping conclusions from a single study. Currently, very little evidence on the impact of sugar levies exists, although countries including France and Mexico have also introduced charges aimed at incentivising manufacturers to make less unhealthy foods. While this piece of research was based on hospital data, there are reasons to be extremely concerned about children’s dental health more broadly. The pandemic made it harder to access care, while the departure of dentists from the NHS had led to some counties being described as “dental deserts”.

Still, taken together, the two studies offer promising indications of the results that can be achieved by politicians who are prepared to make active fiscal and regulatory interventions to support public health. After years in which voluntary schemes for industry and an overemphasis on the role of behavioural nudges were the preferred tools of policymakers, the sugar tax – which led to a 21.6% reduction in the total sugar content of UK soft drinks – was an admission that this approach had failed.

Boris Johnson’s government made promises on food that it failed to keep, while a ban on advertising junk food to children was scrapped by Liz Truss. But while anti-regulation ideologues and food industry lobbyists can be expected to carry on objecting to measures that restrict businesses from doing as they choose, guided by no motive but profit, the evidence from polling is that the public support a tougher stance from the government.

Public health and safety measures once regarded as controversial, such as the smoking ban and mandatory seatbelts, are now widely regarded as no-brainers. There is no reason why the principle behind the soft drinks levy could not be applied to other drinks and foods. Given the weight of evidence about the connections between poor diet and ill health, and the unsustainable pressure on the NHS, politicians sitting back and doing nothing should be off the table.


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