The Workshop of the PromoKids Network in Bergen 12 June 2019. Knut-Inge Klepp.

1. Food taxation in the Nordic Countries –
From fiscal to health motivated taxes – what can we
learn from the Norwegian experience
Knut-Inge Klepp
The Norwegian Institute of Public Health
2nd Workshop of the Nordic PromoKids Network, Bergen, June 12, 2019
18.06.2019

2. FHI -
This public inquiry (NOU)was set up to conduct a
comprehensive assessment of the current
special taxes on chocolate and sugar
confectionery and non-alcoholic beverages,
including the health effect of the fees and the
consequences for the industry and the tax
authorities
It was also asked to assess whether the fees can
and should be designed so that they to a greater
extent take into account health and nutritional
concerns
18.06.2019
Special taxes on chocolate and sugar confectionery and
non-alcoholic beverages

3. FHI -
Chocolate and confectionery tax
The special tax on chocolate and
sugar confectionery has existed
since 1922
Chocolate and sugar confectionery
was seen as luxury products well
suited for taxation
It was also pointed to potential
overuse of such products
Tax on non-alcoholic beverages
The tax on non-alcoholic beverages was introduced in
1924, then as a tax on carbonated beverages
The fee was justified by the state's need for income,
that the goods were not necessities and could be
characterized as luxury goods
The fee has been changed a number of times and
extended to include non-carbonated beverages
The tax includes beverages with added to sugar or
sweeteners
Drinks containing only natural sugar are not charged18.06.2019
Historical background

4. FHI -
The sugar taxes have been adjusted on
several occasions
As part of the budget settlement in the
autumn of 2017, the Storting decided to
increase these special taxes
As of January 1, 2018, the tax on chocolate
and sugar confectionery was set up by 82.9
% (from NOK 20.19 per kg to NOK 36.92)
This increase was reversed as of January 1,
2019
The tax on non-alcoholic beverages
increased by 42.2 % (from NOK. 3.34 per
liter for kr. 4.75)
18.06.2019
Tax increase as of 2018

5. FHI -
The EEA unites the EU Member States and
the three EEA EFTA States (Iceland,
Liechtenstein, and Norway) into an Internal
Market governed by the same basic rules
These rules aim to enable goods, services,
capital, and persons to move freely about
the EEA in an open and competitive
environment, a concept referred to as the
four freedoms
18.06.2019
The European Economic Area (EEA)

6. FHI -FHI - 18.06.2019
Cross-border trade
Tax differences between Sweden and Norway and total cross border trade

7. FHI -
Chocolate and confectionery consumption in Norway;
kg/person/year
Hdir 2018

8. FHI -
Soft drink consumption in Norway; litre/person/year
Hdir 2018

9. FHI - 18.06.2019
Proportion of the population with a reported sugar
intake above 5 % and 10 % of their total energy intake
Over 5 E% tilsatt sukker Over 10 E% tilsatt sukker
Kostholds-
undersøkelse År Aldersgruppe Alle
Gutter/
menn
Jenter/
kvinner Alle Gutter/ menn
Jenter/
kvinner
Spekost 2 2007 12 mnd 26 28 24 9 9 8
Småbarnskost 2 2007 24 mnd 60 60 59 16 15 16
Ungkost 3 2016 4-åringer 77 77 78 32 30 33
Ungkost 3 2015 9-åringer 89 87 90 58 54 62
Ungkost 3 2015 13-åringer 87 86 88 57 55 59
Norkost 2010/2011 Voksne 60 57 63 23 24 23
Universitetet i Oslo; upubliserte data

10. FHI - 18.06.2019

11. FHI -
Consumption price index (CPI) for food groups 1998-
2015

12. FHI -
WHO Guideline –
Sugars intake for adults and children
Recommendations
WHO recommends a reduced intake of free sugars throughout the lifecourse (strong
recommendation)
In both adults and children, WHO recommends reducing the intake of free sugars to less
than 10% of total energy intake (strong recommendation)
WHO suggests a further reduction of the intake of free sugars to below 5% of total energy
intake (conditional recommendation)
18.06.2019

13. FHI -
Dietary goals:
Limit consumption of processed foods high in
fat, starches or sugars – including ‘fast foods’;
many pre-prepared dishes, snacks, bakery
foods and desserts; and confectionery (candy)
Do not consume sugar sweetened drinks. Drink
mostly water and unsweetened drinks
Strong evidence
18.06.2019
World Cancer Research Fund –
Diet, Nutrition, Physical Activity and Cancer: a Global Perspective
Limit ‘fast foods’ Limit sugar sweetened drinks
WCRFI, 2018

14. FHI -
WHAT IS ALREADY KNOWN ON THIS TOPIC
Studies have suggested an association between the use of non-sugar sweeteners and
health outcomes (such as body weight, diabetes, cancer, and oral health)
However, evidence for health effects due to the use of non-sugar sweeteners is
conflicting
Existing reviews on non-sugar sweeteners and health outcomes have limitations in
scope and currency
WHAT THIS STUDY ADDS
In this comprehensive systematic review, a broad range of health outcomes were
investigated to determine a possible association with non-sugar sweetener use in a
generally healthy population
There was no compelling evidence to indicate important health benefits of non-sugar
sweetener use on a range of health outcomes
Potential harms from the consumption of non-sugar sweeteners could not be excluded
18.06.2019
Non-sugar sweeteners – systematic review of the
evidence
BMJ 2019;364:k4718

15. FHI -
Charges that increase the retail price by 20 % or
more lead to more than a proportional reduction in
the consumption of sugary drinks and contribute to
improved nutrition and reduced obesity, obesity and
NCD (WHO, 2016)
To reduce over-consumption of sugars and halt the
epidemic of obesity and diabetes, countries need
comprehensive action plans that combine taxation,
restriction of marketing of sugary products to
children, and education (WHO, 2017)
Recommended taxes on sugary products

16. FHI -FHI -
The WHO Country Capacity Survey, the Second Global Nutrition Policy Review and ongoing monitoring
through the GINA database have tracked the status of implementation of recommendations from the
Second International Conference on Nutrition and the Ending Childhood Obesity implementation plan:
• 59 countries have established a tax on sugar-sweetened beverages
• 46 countries have mandatory regulations on marketing to children
• 55 countries have established front-of-pack labelling (eight of them with mandatory regulations)
• 28 countries have regulations on the inappropriate marketing of complementary food
• 87 countries have school food standards
• 28 countries have banned food and drink vending machines in schools and
• 27 countries are taking action to ban the use of industrially produced trans-fats
18.06.2019
Outcome of the Second International Conference on Nutrition
Report by the Director-General

17. The Rise and Fall of the Danish Soft Drink Tax: An
observational study
Soft drink taxes in Denmark (DKK/liter) Average reported price per month
Schmacker & Smed; upubliserte data; januar 2019

18. The Rise and Fall of the Danish Soft Drink Tax
Purchased quantity per capita per
month
Main findings:
• The average volume of taxed beverages
purchased was 14.8 percent lower than the
year before the tax increase (price elasticity
of 1.15 on average)
• Comparing the results for households living
closer to the border with those that only
have access to the border via a toll bridge we
find a non-significant difference in responses
which suggest that our main results are not
driven by an increase in under-reporting due
to cross-border shopping
• One year after the tax repeal in January 2014
soft drink purchases are 30.1 percent larger
than one year before the first tax cut in July
2013 (price elasticity of 1.23)
Schmacker & Smed; upubliserte data; januar 2019

19. FHI -FHI -
At the third High-level Meeting of the United
Nations General Assembly on the Prevention
and Control of Non-communicable Diseases
(New York, September 2018), Heads of State
and Government committed to, inter alia:
promote and implement policy, legislative
and regulatory measures, including fiscal
measures as appropriate, aiming at
minimizing the impact of the main risk
factors for noncommunicable diseases, and
promote healthy diets and lifestyles
18.06.2019
UN High Level Meeting 3 on NCDs in New York
27 September 2018
Statement from Prime Minister Solberg:
“The WHO has identified the evidence-
based interventions that are most
effective for turning the tide. WHO
recommends increase taxes on tobacco,
alcohol and products of high sugar as
cost-effective measures for combating
NCDs. These are not always popular
measures, I can underline to that, but
they are necessary ones”

20. FHI - 18.06.2019
The Task Force on Fiscal Policy for Health
Bent Høie, Minister of Health and Care

21. FHI -
The committee members agreed that (if there is
to be) a tax on chocolate and sugar
confectionery and on non-alcoholic beverages,
these should primarily have a health and not a
fiscal motivation
A health-based fee should be differentiated
New fees should be notified to the EFTA
Surveillance Authority (ESA)
18.06.2019
NOU report - conclusions

22. FHI -FHI -
The committee's majority believe that a health-based and differentiated fee should be
introduced for non-alcoholic beverages
Two members (lawyers) believe that such a fee should only include non-alcoholic
beverages that are added to sugar
Four members (public health & health economy) believe that a health-based fee should
also include non-alcoholic beverages with artificial sweeteners, but at a lower rate
Four members representing the industry believe in principle that there should not be a tax
on non-alcoholic beverages (alternatively a model predictable for the business sector, such
as the Irish beverage fee)
The Committee recommends that any new fees be notified to the EFTA Surveillance
Authority (ESA)
18.06.2019
NOU report - conclusions

23. FHI -FHI -
Illegal financial support (ulovlig statsstøtte). Complaints have ben filed to the EFTA Surveillance
Authority (ESA). (Risk 10-year back payment)
Unfair trade conditions and lead to increased cross-border trade – first of all to Sweden (including
private internet import)
Norwegian jobs are being threatened (both in retail and in production facilities)
Complicated to limit and delimit what products that should be taxed
Question the relevance of the international public health literature for a Norwegian setting
Other policy measures, including voluntary public – private partnership and educational efforts,
are more effective and appropriate
18.06.2019
Food industry/business perspective
The Norwegian ‘sugar taxes’ represents:

24. FHI -FHI -
The sugar consumption is high in Norway, as is the consumption of chocolate and sweets –
particularly among children
Reduced price on soft drinks and chocolate/sweets will lead to an increased consumption
of these products – inconsistent with national and international recommendations
The effectiveness of taxes as a measure for reducing the consumption of sugary products is
well established – including their ability to reduce inequality in eating habits
Artificially sweetened products could have a lower tax rate than products with added sugar
18.06.2019
Public Health Perspective

25. FHI -FHI -
The NOU is on a public hearing with a deadline of June 12, 2019
The government will present their future plans regarding these taxes when presenting the
national budget for 2020 in October 2019
The design of ‘new and health motivated’ taxes is expected to take quite some time, be
contested by private sector, having to be notified to the EFTA Surveillance Authority (ESA),
and probably end up in court!
Thank you!
18.06.2019
Current status & way forward
The report was submitted to the minister of finance on April 10, 2019