Sugar-sweetened beverage tax acceptability in the U.S. versus foreign-born population: Results from a large Northern California county

INTRODUCTION: A tax on sugar-sweetened beverages (SSBs) may reduce consumption, but previous studies have found low overall support for a tax. Moreover, little is known about factors related to support for a tax, particularly nativity. The U.S.-born population may be less likely to support a tax given higher SSB consumption than the foreign-born. METHODS: We conducted a random-digit-dial telephone survey of adults in Santa Clara County (2011; N=361), a Northern California county of 1.8 million where 37% of adults are foreign-born.  We assessed the overall level of unconditional support, conditional support if funds were used for obesity prevention, and opposition to a SSB tax. We used multinomial logistic regression to examine associations between nativity and these categories of support. Other variables included sex, age, education, income, and presence of children in the household. RESULTS: Overall, nearly half (46%) of adults supported a SSB tax unconditionally, 21% supported it if funds were used for obesity prevention, and 34% opposed. U.S. born adults were significantly more likely than foreign-born adults to oppose rather than support a tax unconditionally (OR=2.565, p=0.032); there was no difference by nativity for conditional versus unconditional support. There were no associations between other variables and tax acceptability. DISCUSSION: Most adults in a large Northern California county support a SSB tax unconditionally or are supportive if funds were used for obesity prevention. There was less opposition to a tax among foreign-born adults, underscoring the importance of messaging the effectiveness of SSB taxation appropriately and targeting outreach to different groups.