The Soft Drinks Industry Levy and childhood hospital admissions for asthma in England

Sugar sweetened beverage consumption has been suggested as a risk factor for asthma symptoms in children. We examined whether the UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, was associated with changes in National Health Service hospital admission rates for asthma in children. We conducted interrupted time series analyses (2012 - 2020) to measure changes in monthly incidence rates of hospital admissions for asthma. Sub-analysis was by age-group (5-9, 10-14, 15-18 years) and neighbourhood deprivation quintiles. Estimated changes were relative to counterfactual scenarios where SDIL was neither announced, nor implemented. Compared to the counterfactual scenario there was an overall relative reduction in incidence rates of hospital admissions of 20.9% (95%CI: 29.6-12.2), 22 months post-SDIL. Reductions were similar across age-groups and deprivation quintiles with relative reductions of 24.3% (95%CI: 29.6-12.2) in children aged 10-14 years, and reductions of 23.2% (95%CI 33.4-13.1) in children living in the middle deprivation quintile. These findings provide evidence that the implementation of a tax intended to reduce childhood obesity in the UK preceded a potentially significant collateral public health benefit in the form of reduced hospital admissions for childhood asthma. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This project was funded by the NIHR Public Health Research programme (grant Nos 16/49/01 and 16/130/01) to MW. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health and Social Care, UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Data was acquired through a data sharing agreement with NHS digital for which conditions of use apply. Requests for data must be made directly to NHS digital and cannot be granted by the authors. Data were provided to us in an aggregated and anonymised state and ethical approval was therefore not required for analysis of this data I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data was acquired through a data sharing agreement with NHS digital for which conditions of use apply. Requests for data must be made directly to NHS digital and cannot be granted by the authors.