European Journal of Nutrition & Food Safety

Background: The UK Government are considering introducing a tax on unhealthy foods to reduce their consumption in order to improve the nation’s health and fund National Health Service (NHS) costs for obesity related co-morbidities and treatments. They suggest that the evidence supporting a food tax needs to be investigated before its implementation [1]. Mytton,Clarke and Rayner [2] state that food taxes may improve public health, however, American research shows that there is no correlation between existing taxes and a reduction in obesity [3]. This study aimed to investigate the attitudes of university students regarding the implementation of a tax on unhealthy foods to improve the nation’s health.
Methods: This research employed an exploratory qualitative methodology based on grounded theory to gain an insight of student attitudes towards a food tax. Convenience sampling was used to recruit twelve university students consisting of eleven female health care profession students, representing nursing, occupational therapy and dietetic cohorts and one male engineering student. Data was collected from two, one hour focus groups which were audio recorded and transcribed verbatim. The six stages of thematic analysis used to analyse the data and identify themes [4]. Ethical approval was granted by the Coventry University Research Ethics Committee.
Findings: The predominant emergent themes were: acceptance of taxes, behaviour changes, accountability and a combination of approaches. Most participants felt that an unhealthy food tax would only be acceptable if the revenue was specifically used to fund the NHS to assist with the costs of obesity and subsidise healthy foods. The overarching perception was that a food tax alone would not reduce the participants’ purchases of unhealthy food due to its desirability. However, it was suggested that if other interventions were used alongside a tax this may bring about behaviour change. 
Discussion: Participants felt that a combination of interventions including education, subsidies, food taxes, clear nutritional labelling, availability of healthier options and appropriate marketing alongside the consideration of low income groups would be required to bring about a change in eating behaviours to address the prevalence of obesity. These findings are consistent with public health expert views [5] and concur with a study conducted with Danish residents [6]. Due to the small sample size of this study generalisation to the wider population is not possible; therefore further research is necessary to provide stronger evidence to evaluate the impact that existing taxes and interventions may have on behaviour change and health outcomes. This will enable policy makers to establish the effectiveness of taxes and other strategies before their implementation in the UK.
Conclusion: This study concluded that a holistic approach may be necessary in order to have an impact on eating behaviours and ultimately obesity.