Supporting a sugar tax in New Zealand: sugar sweetened beverage (`fizzy drink') consumption as a normal behaviour within the obesogenic environment

Background. Excessive intake of sugar sweetened beverages (SSBs) is a preventable cause of death. While some countries have implemented a tax on SSBs, other countries, such as New Zealand, rely on industry self-regulation and individual responsibility, such as referring to labels, to control one's own sugar intake from SSBs. The present study examines whether SSB consumers consciously control their diet and therefore interventions such as better labelling might be effective, or alternatively, whether SSB consumers engage in a general pattern of unhealthy eating, and in which case government regulation would be advisable. Aim. To explore self-reported dietary consumption and conscious healthy eating behaviours of New Zealand consumers who had consumed SSBs over a 24 hour period. Method. A cross-sectional survey of a representative sample of 2007 New Zealanders, measuring their food and beverage intake over a 24 hour period and self-reported intentions to eat healthily. Within this was a measurement of SSB consumption in the 24 hour period. Results. Multivariable logistic regression revealed that compared to non-SSB consumers, SSB consumers were more likely to have eaten the following: confectionery; fast food; pre-prepared food; biscuits, cakes or pastries; takeaways; ice-cream/dessert. SSB consumption was also associated with a lower likelihood of referring to food labels, less conscious effort to eat healthily, and to less likely to avoid: sugar; fat; calories; food additives; pre-prepared food. SSB consumers were also less likely to have eaten breakfast, or made a meal at home made from scratch. Conclusion. SSB consumers were more likely than non-SSB consumers to demonstrate a general pattern of unhealthy eating and were less likely to report consciously controlling their diet. The findings raise significant concerns regarding the efficacy of individual and industry self-regulation and lend support to stronger government targeted interventions.