Editorial, Tuesday September 29, 2015

Peter Jackson, editor, The Northland Age

POLL results released last week suggested New Zealand is slowly warming to the idea of taxing sugary drinks as a means of reducing obesity, particularly amongst children, and more importantly reducing the burgeoning rate of Type 2 diabetes. Those in favour are now in a slight majority, up from 44 per cent a year ago, which probably won't be enough to prompt political action but at least has raised the issue for debate once again.

Should the day ever come when softdrinks are taxed purely as a means of making them less attractive we will hopefully adopt the more pragmatic approach of taxing sugar per se, as opposed to a narrow range of products that contain more of it than is good for us. A whopping great tax on sugar itself would obviously make the offending drinks more expensive (along with a whole raft of products that are not generally associated with high sugar content), thereby reducing consumption, but brace yourself for complaints about that hurting the poor.

We heard that argument when the process of making smoking an expensive habit began, that poor people smoke more than wealthy ones, and lifting taxes simply deprived them of one of their few available vices. There might be some truth in that, although saving people, whatever their income, from the horrible diseases that can afflict users of tobacco is surely a worthy aim. The same can be said for taxing sugar.

The alternative would be to carry on as we are, accepting that obesity and Type 2 diabetes are inevitable outcomes of a lifestyle that we share with many other developed societies, although one day, just as we are bound one day to become a republic or change our flag (but not this time, hopefully), we will undoubtedly support the principle that many of us need protecting from ourselves.

There is something of a double standard in this country when it comes to wielding taxes as a public health weapon, as there is in terms of mass medication.

The issue of fluoridating public water supplies will always be controversial, there being no sign of movement by those who see it as a cheap and effective means of protecting teeth and those who regard it as a poison. The fundamental argument against fluoridation though is that it is inherently wrong to mass medicate in a manner that leaves the individual very little choice but to ingest the substance.

On the other hand, no one in living memory has objected to the addition of iodine to table salt as a means of reducing the risk of goitre, and the addition of folic acid to some cereals, bread and fruit juice, which became legal in 1996, to reduce the risk of neural tube defects in infants, barely registered on the public radar, even though those who might benefit from it, pregnant women and their unborn babies, were and are a very small proportion of those who will and presumably do unwittingly consume it.

No one seriously challenges the argument that lifting the price of alcohol reduces consumption, especially by younger people, who generally speaking are at greatest risk of harming their health by drinking it, although again some believe that the poor should not be driven to forced teetotalism.

The same argument will be raised in regard to a sugar tax, supported no doubt by those who sell muffins and the like for a living. They were up in arms a year or two ago over the price of butter, which they reckoned was eroding their profit margins. The writer doesn't know how many muffins can be made with one block of butter, but fears that bakeries were on the verge of being driven into bankruptcy always seemed a touch exaggerated.

The same will be said if a significant tax is placed on sugar, but the stakes are high, and getting higher. And those who believe that we have the right to eat and drink what we like will not be encouraged to hear that a 10 per cent tax on softdrinks in Mexico has reportedly reduced consumption there by 6 per cent.

There are those who hark back to their childhood years, when softdrinks and confectionary were consumed without thought for what the sugar content might be doing to them, but that is increasingly irrelevant. A couple of generations ago sugary treats were exactly that, treats, whereas today they seem to have become the staple diet of many young people in particular. And of course a couple of generations ago children, and many adults, were much more physically active than they are now.

The public health benefits of a substantial sugar tax are undeniable, but the issue isn't as simple as that. Last week saw the release of a survey showing that a majority of respondents patronised their local fast food outlets because it was cheaper than cooking meals at home.

That's debatable. More convenient, obviously, but hardly likely to be cheaper. Problem is, dependence upon fast foods these days goes beyond convenience. One of the effects of the demise of the nuclear family is the loss of domestic skills that were once universal, the ability to turn unprocessed ingredients into nutritional food among them.

One only has to look at the fast food options in Kaitaia to get an idea of how cooking at home has gone out of fashion. The town's main street boasts no fewer than 20 establishments where one might buy anything from a pie and a Coke to a fully-cooked meal to eat in or take away. Add McDonald's, off the main street, and there are 21.

This is in a community that presents itself as poorer than many and with higher unemployment and general benefit dependency than most. It's no coincidence that fast food chains target poorer communities rather than wealthy ones, because they know who their customers are.

Again we hear that the answer is education, but anyone who believes that is dreaming. There can be few people now who do not know the deleterious effects of poor nutrition, or more specifically the consumption of vastly more sugar than their bodies need or can process.

The only way to reduce sugar consumption, and to begin reducing the twin evils of obesity and diabetes, is to give those most at risk a clear incentive to change their dietary habits. And the only incentive that will work is financial.

The barrier that has to be overcome is our natural disinclination to interfere in people's lives. If we weren't so reluctant to do that we would be making much greater inroads in the scourge of domestic violence, child abuse, lack of educational achievement, youth offending, and the willingness of some parents to let others feed their children.

Taxing sugar to the point where products that clearly do the consumer harm would be one small step towards addressing two health problems, but don't expect to see one any time soon. And if a tax is introduced, don't expect it to be more than a token gesture.

We are a very long way from believing, as we once did, that the greater good outweighs individual rights, and those who are least likely to hear what is being said about the harm sugar does are the most likely to continue consuming it at a potentially deadly rate, bringing an increasingly intolerable burden to bear on a public health system that is already struggling to cope.