The United Kingdom (UK) announced the Soft Drinks Industry Levy (SDIL) in 2016, and introduced it into law in April 2018. The levy applies to sugar sweetened beverages (SSBs), seeking to encourage industry stakeholders to reduce their sugar content and provide healthier choices for consumers.

In this two-part interview, FDI Member, the British Dental Association (BDA), delves deeper on the impact of the levy and highlights its importance  for tackling the burden of oral diseases and other noncommunicable diseases (NCDs).

Read the first part of the interview

How did the soft drinks industry and other stakeholders respond to the SDIL? Were any industry interferences encountered for this policy?

Responses to a consultation on the levy, in December 2016, indicated that over half of the respondents were in favor of the levy, with many wishing to extend the scope of the levy to other products. In particular 95% of medical and health bodies who responded to the consultation were supportive of the proposals, and 73% of retailers. A majority of manufacturers and associated trade bodies were opposed to the levy (78%).

A BMJ Open study, published in 2023, on the views of industry with respect to the SDIL concluded that whilst they were accepting of the levy as an attempt to create a level playing field, this was inadequate due to the exclusion of milk-based drinks. Those surveyed indicated that the SDIL was complex, expensive and time consuming to implement, with a need for leadership buy-in and felt it unfairly targets the drinks industry.

The BDA did not experience industry interference from companies advocating against the legislation, however we are aware of the resources the food industry has at its disposal in both marketing and influencing policy makers, than those in health organizations and charities, such as ourselves.

Can you provide an estimate of the funds raised through this levy?

The latest headlines for SDIL statistics are:

• provisional SDIL receipts were £355 million for the financial year 2022 to 2023, compared to £334 million in the previous financial year (2021 to 2022) and £299 million in 2020 to 2021.
• provisional year-to-date receipts for the current financial year (April to August 2023) are £172 million.

Looking at these results, overall there were positive responses from those who campaigned for the SDIL, however we all recognize that further measures, including the expansion of the levy, are needed, and we continue to campaign for those and to support efforts in reducing sugar consumption and improving oral (and general) health.

What further measures to the soft drinks industry levy are needed for improved oral and general health?

The BDA is calling for the expansion of the SDIL, given reports of its success. The inclusion of products, such as milk-based drinks, biscuits and sweets on the scope of the levy would help encourage consumers to select products that are less damaging to oral and systemic health. It would also seek to drive widespread reformulation of high sugar foods and would not need to raise costs for consumers.

We are also calling for stronger enforcement measures around misleading health and nutrition claims to be addressed, alongside the high levels of sugar, in some baby foods. Market analysis conducted by the BDA of 109 food pouches aimed at children aged under 12 months indicated that over a quarter contained more sugar by volume than Coca Cola, with parents of infants as young as four months marketed pouches that contain the equivalent of up to 150% of the sugar levels of the soft drink.

Is the British Dental Association exploring other opportunities to measure the impact of this levy?

We have no plans to measure the impact of the levy, due to resource/capacity required, however we would be very supportive of a follow up to the November 2023 study published in BMJ Nutrition, Prevention & Health, for example using lived experience and additional data points.

However, we would like to point out that we are considering qualitative surveys to further understand the public perception on preventative programmes such as the SDIL and its expansion.  Dental caries are largely preventable, and there could be potential to utilize tooth extraction data in children to measure the cost of preventing oral diseases.

Are there any important lessons that other National Dental Associations seeking to undertake similar advocacy efforts can keep in mind?

Yes, we would advise other National Dental Associations seeking to undertake similar efforts to put an emphasis on public health messaging regarding the impact of soft drinks. Including additional messages on reduced sugar versions, on oral health, and the role sugar- and sugar-free soft drinks play in dietary habits, for example increase in sugary snack consumption, can further support the need for preventive policies.

In our efforts, the BDA had expressed support for the revenue generated by the levy to be utilized for oral health, however we also recognize the need to engage and liaise with key stakeholders of other public health priorities, such as obesity, diabetes and physical activity. This alignment with other interest groups may broaden the policy ask to wider health issues, which would include oral health, and help target areas of high levels of inequalities. We also advise strengthening the ask for the revenue generated by SDIL to be properly ring fenced.

Furthermore, it is very important to focus on patient- and practitioner-centred approaches, which take into account aspects such as lived experience, and the cost of living crisis, to ensure that public health policies, such as SDIL, do not exacerbate inequalities.

Finally, it is extremely crucial to ensure that we remain focused on the key objective, which is reformulation and sugar reduction and not revenue generation. Whilst the SDIL would generate revenue, the overall goal is for a reduction in sugar consumption, and improved oral (and general) health.

Editor’s note: this article was submitted by an external party and has been edited according to FDI’s editorial guidelines. The views expressed are those of the original author.