摘要：Objectives. To evaluate legal and administrative feasibility of a federal “junk” food (including sugar-sweetened beverages [SSBs]) tax to improve diet. Methods. To assess food definitions and administration models, we systematically searched (1) PubMed (through May 15, 2017) for articles defining foods subject to taxes, and legal and legislative databases as well as online for (2) US federal, state, and tribal junk food tax bills and laws (January 1, 2012–February 28, 2017); SSB taxes (January 1, 2014–February 28, 2017); and international junk food tax laws (as of February 28, 2017); and (3) federal taxing mechanisms and administrative methods (as of February 28, 2017). Results. Articles recommend taxing foods by product category, broad nutrient criteria, specific nutrients or calories, or a combination. US junk food tax bills (n = 6) and laws (n = 3), international junk food laws (n = 2), and US SSB taxes (n = 10) support taxing foods using category-based (n = 8), nutrient-based (n = 1), or combination (n = 12) approaches. Federal taxing mechanisms (particularly manufacturer excise taxes on alcohol) and administrative methods provide informative models. Conclusions. From legal and administrative perspectives, a federal junk food tax appears feasible based on product categories or combination category-plus-nutrient approaches, using a manufacturer excise tax, with additional support for sugar and graduated tax strategies. Poor diet is a leading risk factor for cardiovascular disease, type 2 diabetes, and obesity. 1 One evidence-based strategy to improve diet is the enactment of policies to alter the price of food and beverages: disincentives (taxes) for unhealthy food and incentives (subsidies) for healthier food. 2,3 Whereas local taxes on sugar-sweetened beverages (SSBs) are rapidly growing in popularity and political acceptance, these do not have the broad effects that a national tax might have. In addition, substantial disease burden results from other dietary factors, including processed meats and ultra-processed foods high in starch, added sugars, salt, and trans fat. 4 However, federal SSB or unhealthy “junk” food taxes have not yet gained substantial political traction in the United States. Besides concerns over regressivity and healthy food access, barriers include key unanswered policy questions, such as the complexity involved in defining the food to be taxed and the appropriate taxing mechanisms for implementation. Previous research has examined the typology of beverage tax options, 3,5 global food tax policy architecture, 6 and compiled US state definitions of food, 7 but no study to our knowledge has evaluated the legal and administrative mechanisms to define and implement a US federal junk food tax to improve diet quality. To address these gaps in knowledge, we evaluated the legal and administrative feasibility of federal taxes on junk food based on the scientific literature, contemporary legislative experiences from the United States and other countries on defining targeted foods, US federal taxing and administrative mechanisms, and potential differences by tax purpose and type.
