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Implementation costs of sugary drink policies in the United States

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Abstract

To support implementation of important public health policies, policymakers need information about implementation costs over time and across stakeholder groups. We assessed implementation costs of two federal sugar-sweetened beverage (SSB) policies of current policy interest and with evidence to support their effects: excise taxes and health warning labels. Our analysis encompassed the entire policy life cycle using the Exploration, Preparation, Implementation, and Sustainment framework. We identified implementation actions using key informant interviews and developed quantitative estimates of implementation costs using published literature and government documents. Results show that implementation costs vary over time and among stakeholders. Explicitly integrating implementation science theory and using mixed methods improved the comprehensiveness of our results. Although this work is specific to federal SSB policies, the process can inform how we understand the costs of many public health policies, providing crucial information for public health policy making.

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Authors and Affiliations

  1. Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA

    Natalie Riva Smith

  2. Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Kristen Hassmiller Lich, Justin G. Trogdon & Leah Frerichs

  3. Department of Nutrition, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA

    Shu Wen Ng

  4. Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA

    Shu Wen Ng & Marissa G. Hall

  5. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Marissa G. Hall

  6. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA

    Marissa G. Hall

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  1. Natalie Riva Smith
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Supplementary Material (Parts 1-11) includes details about the key informant interviews, how we arrived at each point estimate and embedded assumptions, probabilistic components of our calculations, additional notes, and code to replicate the results, and is provided here. Supplementary file1 (PDF 527 kb)

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Smith, N.R., Hassmiller Lich, K., Ng, S.W. et al. Implementation costs of sugary drink policies in the United States. J Public Health Pol 44, 566–587 (2023). https://doi.org/10.1057/s41271-023-00435-4

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