Results our systematic review of the scienti fi c

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trative feasibility. RESULTS Our systematic review of the scienti fi c literature, US and international food tax bills and laws, and federal taxing mechanisms provided data and models to assess the legal and administrative feasibility of a federal junk food tax. Scienti fi c Literature Review Of 63 unique articles identi fi ed, 13 met inclusion criteria (Figure A). Of these, 4 recommended a tax based on product cate- gory 6,8,13,14 ; 4 on broad nutrition criteria (i.e., using more than 1 nutrient cutoff) 15 18 ; 2 on combined category and broad 19 or speci fi c nutrient (saturated fat) criteria 20 ; 1 on the speci fi c nutrient sugar 21 ; 1 on calories 22 ; and 1 on both broad nutrition criteria and speci fi c nutrient (sugar) approaches. 23 Three publi- cations evaluated junk food taxes based on salt, sugar, and fat, and all 3 favored targeting sugar 15,21,23 (Table A, available as a supple- ment to the online version of this article at http://www.ajph.org). Similarapproacheswerealsore ectedinthe gray literature. For example, the Streamlined Sales and Use Tax Agreement, adopted in 24 states to simplify sales tax collection, modeled taxing food by product categories (e.g., soft drinks, candy). 24 WHO favors a broad nutri- tioncriteriatax, 3 whereastheUrban Brookings Tax Policy Center favors a speci fi c nutrient approach that targets sugar. 25 The scienti fi c literature also recommended a graduated taxation strategy, by which the tax increases as the nutritional quality of the food decreases. Speci fi cally, Epstein et al. recommended that the price of food should be graduated to re ect its nutritional con- tent, 16 and the Urban Brookings Tax Policy Center recommended that the tax increase as the sugar content increases. 25 In summary, the scienti fi c literature rec- ommended 4 main methods to classify foods to be taxed: by (1) product category, (2) broad nutrition criteria, (3) speci fi c nutrients or calories, and (4) a combination of these ap- proaches. None of the literature discussed taxing foods according to level of processing, although many articles assumed or posited that taxed foods would be processed. 17,26,27 Additionally, some literature recommended a graduated taxation strategy. Bills and Laws Legislative data provided complementary empirical evidence on US and international junkfoodtaxesandUSSSBtaxes.IntheUnited States,8statesand1tribalgovernmentproposed or enacted junk food tax bills (n=6) and laws (n=3) during the study period; there were no federal junk food tax bills or laws (Table 1). AJPH LAW & ETHICS 204 Public Health Law Peer Reviewed Pomeranz et al. AJPH February 2018, Vol 108, No. 2
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Three bills, Texas s tax, and Maine s law taxed products according to category alone, with Maine s law additionally using a pro- cessing component to identify 1 category of taxable foods (i.e., processed nuts and seeds).
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