The effect of the Israeli sugar sweetened beverage tax implementation and repeal on beverage price and purchases

Objectives Israel's sugar-sweetened beverage (SSB) tax, combining ad-valorem and tiered components, was implemented in January 2022 and repealed after one year. We evaluated the effect of tax implementation and repeal, on beverage price and sales. Study design A longitudinal analysis using national sales data. Methods Beverages were categorized by sugar content and volume into 6 beverage groups: Large non-taxed, large reduced-tax, large full-tax, small non-taxed, small reduced-tax and small full-taxed beverages. Changes in price and sales across three periods (pre-tax, tax and post-tax) were assessed between groups using Welch ANOVA test (Games-Howell post-hoc analysis, Bonferoni adjustment), and the linear mixed-effects model with restricted maximum likelihood estimation. Results With implementation of the tax, the prices of all beverage categories increased by 3.03–38.89 % and remained high after tax repeal by 6.8–13.63 %, compared to pre-tax levels. Negative correlations between the change in beverage price and sales were observed during the tax (r = −0.54, p < 0.001) and post-tax (r = −0.29, p < 0.001) periods. A price increase of ≥17 % was associated with significant sales declines during the year of the tax. Sales of large reduced-tax beverages declined by −30.7 % and those of large full-taxed beverages by −24.1 % following tax implementation. After tax repeal, sales levels gradually increased compared to those during the tax period, but remained below pre-tax levels by −24 % and −13 %, respectively. Small-taxed beverages showed no significant change in sales between study periods . Conclusions The Israeli SSB tax implementation and repeal, provides critical insights regarding the significant effectiveness of this public health policy. The tax led to a significant increase in the price of all beverage categories, and reduced sales of large-taxed beverages, which contribute the vast majority of national beverage sales. Tax repeal was followed by a gradual rise in sales of taxed beverages, having a potentially negative effect on public health. An effective policy should consider higher tax rates for smaller packaged beverages. Future studies should address longer follow-up and assessment of individual purchase and consumption practices.