One of the challenges public health officials face in reducing diet-related disease is the relatively easy and inexpensive access to sugar-sweetened beverages globally. To help address this burden, public health organizations like the World Health Organization and American Heart Association have recommended that governments tax sugar-sweetened beverages. Now, new research from the Food is Medicine Institute at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University shows that this policy is being adopted at an accelerating pace around the globe, with 64 countries passing sugar-sweetened beverage taxes for health purposes between 1990 and 2024, covering 3.5 billion people worldwide.
Leading the way are countries in South Asia, 50% of which have adopted sugar-sweetened beverage taxes, followed closely by countries in Southeast and East Asia at nearly 48%. Overall, globally, researchers found 29% of high-income countries have adopted such taxes. In contrast, countries with the lowest adoption rates were in Central Eastern Europe and Central Asia, at 17%. The study appears June 8 in The Lancet Global Health.
The reasons for this variable adoption have so far not been clear. In this first analysis of its kind, researchers found that a country's burdens of type 2 diabetes and obesity, but not rates of sugary drink consumption, were drivers of adopting taxes.
"Surprisingly, the consumption rates of sugar-sweetened beverages had no significant relationship with whether a country chose to tax them, suggesting these decisions are driven more by disease burdens," said the study's first author Lizbeth Moreno Loaeza, who led the work while a postdoctoral scholar at the Friedman School and is now at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City. "We also found that countries with higher social and health development are less likely to adopt these taxes, regardless of their economic wealth. This may be because they generally possess more robust health systems and experience lower rates of diet-related diseases."
The study drew on multiple global datasets from 1990 to 2024 across 183 countries, including the Global Dietary Database, Global Burden of Disease Study, Non-Communicable Disease Risk Factor Collaboration, and World Bank data, to identify characteristics of sugar-sweetened beverage taxes implemented for health purposes and the factors associated with their adoption. Tax characteristics were identified using data from the World Bank, World Health Organization, and University of North Carolina. For the total of 64 countries that passed these taxes in the time period, the researchers' analysis showed tax rates ranged from 1% to 34% by country and 5% to 17% across world regions, with the highest median rates in the Middle East and North Africa. Most countries taxed sugary drinks based on either price or volume. Only a small fraction tied the tax to sugar content, an approach the researchers say may be most effective because it pushes beverage companies to reduce sugar in their products.
Notably, despite the public health rationale behind these policies, the researchers found that only 13% of countries directed the revenue toward health programs, a missed opportunity for doubling the public benefits.
In a 2025 study in the journal Nature Medicine , Tufts University and Global Dietary Database researchers estimated that sugar-sweetened beverages contribute to 2.2 million new diabetes cases and 1.2 million new cardiovascular disease cases globally each year, emphasizing the urgent public health need for policies that reduce their consumption.
"We know these taxes work, and we now have a much clearer picture of how they are being adopted and what drives countries to do so," said the study's senior author Dariush Mozaffarian , a cardiologist and director of the Food is Medicine Institute. "Nearly half of the world's population now lives under a national sugar-sweetened beverage tax, but we found that the rates of many of these taxes remain relatively low, and that dozens of other countries, including the United States, have not passed national taxes.
"These findings highlight opportunities to continue to advance nutrition and well-being through sensible policies, like soda taxes, around the world," added Mozaffarian.
Research reported in this article was supported by the National Institutes of Health's National Heart, Lung, and Blood Institute under award number R01HL115189. Complete information on authors, methodology and conflicts of interest is available in the published paper.
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