To systematically identify and review food taxation policy changes in Pacific Island Countries and Territories (PICTs).

Food taxation polices, regarding excise taxes and tariffs applied from 2000 to 2020 in twenty-two PICTs, and their key characteristics were reviewed. The search was conducted using databases, government legal repositories and broad-based search engines. Identified documents for screening included legislation, reports, academic literature, news articles and grey literature. Key informants were contacted from each PICT to retrieve further data and confirm results. Results were analysed by narrative synthesis.

Noncommunicable diseases (NCD) are the leading cause of premature death in PICTs and in many jurisdictions globally. An NCD crisis has been declared in the Pacific, and food taxation policy has been recommended to address the dietary risk factors associated with. Progress is unclear.

Of the twenty-two PICTs included in the study, fourteen had food taxation policies and five introduced excise taxes. Processed foods, sugar and salt were the main target of excise taxes. A total of eighty-four food taxation policy changes were identified across all food groups. There was a total of 279 taxes identified by food group, of which 85 % were tariffs and 15 % were excise taxes. Individual tax rates varied substantially. The predominant tax design was ad valorem, and this was followed by volumetric.

A quarter of PICTs have introduced food excise taxes from 2000 to 2020. Further excise taxes, specifically tiered or nutrient-specific designs, could be introduced and more systematically applied to a broader range of unhealthy foods.

To evaluate the impact of changes in import tariffs on sweetened beverages.

Interrupted time series analysis was used to examine sweetened beverage tariff increases of 40–60 % in 2008 and to 75 % in 2012, and an approximately 11 % decrease in 2014 when an excise tax replaced the tariff. Post-tax trends were compared with a counterfactual modelled on the pre-tax trend for: quarterly price of an indicator beverage, monthly beverage import volumes (both 2001–2017) and quarterly sales volumes (2012–2017). In a controlled analysis, taxed beverage imports were compared with a sugary snacks control.

Cook Islands.

NA.

In the first year, after the 2008 tariff increase the price of the selected indicator soft drink increased by 7·3 % (95 % CI 6·3 %, 8·3 %) but after the 2012 tariff increase it decreased by 13·9 % (95 % CI –14·9 %, –12·8 %). At the same time, the import volumes of taxed beverages decreased by 13·2 % (95 % CI –38·1 %, 17·8 %) and 2·9 % (95 % CI –41·6 %, 72·5 %), respectively, and decreased by 24·8 % (95 % CI –36·9, –9·8) and 10·2 % (95 % CI –37·1, 37·5) in the controlled analysis. After the 2014 tax decrease, the price of the indicator soft drink decreased by 23·6 % (95 % CI –26·0 %, –21·1 %), sweetened beverage imports increased by 4·5 % (95 % CI –39·5 %, 156·0 %) and sales of full-sugar soft drinks increased by 31 % (95 % CI –21 %, 243 %).

The increased import tariffs on sweetened beverages appeared to be effective for reducing import volumes, but this was partly reversed by the reduced tax/tariff in 2014.