Sugar, tobacco, and alcohol taxes to achieve the SDGs

Robert Marten, Sowmya Kadandale, John Butler, Victor M Aguayo, Svetlana Axelrod, Nicholas Banatvala, Douglas Bettcher, Luisa Brumana, Kent Buse, Sally Casswell, Katie Dain, Amanda Glassman, David L Heymann, Ilona Kickbusch, Patricio V Marquez, Anders Nordström, Jeremias Paul Jr, Stefan Peterson, Johanna Ralston, Kumanan Rasanathan, Srinath Reddy, Richard D Smith, Agnès Soucat, Kristina Sperkova, Francis Thompson, Douglas Webb The Lancet, 2018; Read the full article online

The Sugar, Tobacco and Alcohol Taxes (STAX) Group have published a new Lancet Comment  calling for a more integrated approach and action on sugar, tobacco and alcohol taxes to achieve the Sustainable Development Goals.

Key messages

  • More than a decade after the adoption of the WHO Framework Convention on Tobacco Control, there is compelling evidence that raising tobacco prices substantially through taxation is the single most effective way to reduce tobacco use and save lives. 
  • Alcohol taxation is a cost-effective way to reduce alcohol consumption and harm. 
  • With growing evidence, sugar taxes are a fiscal too that can be used to promote health and nutrition.


  • Mexico's sugar tax reduced sugar-sweetened beverage sales by 5% in the first year, with an almost 10% further reduction in the second year. 
  • Tobacco taxes in South Africa contributed to tobacco consumption decreases of about 40% between 1993 and 2003.
  • When Finland reduced taxes on alcohol in 2003, alcohol-related mortality increased by 16% among men and by 31% among women. As part of a broader public health approach to promote a life-course approach to prevention and to address commercial determinants of health, it is now time for governments to adopt sugar, tobacco, and alcohol taxes (STAX).

Further benefits

STAX not only contribute to improving health and saving lives, but they can also raise resources. For example Thailand's Health Promotion Act of 2001 established a tax on tobacco and alcohol, which now contributes about US$120 million annually for domestic health promotion efforts. In 2012, the Philippines raised taxes on tobacco and alcohol and are using the revenues to supplement efforts towards universal health coverage (UHC). After 3 years of implementation, $3·9 billion in additional revenues were collected, 80% of which was used to finance the extension of health insurance to the poorest 40% of Filipinos.

"Building on evidence, accumulated country experience, and the legacy of previous social movements, health professionals and civil society should unite a broad coalition and call on governments to enact a more synergistic STAX approach."

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