BMJ Publishing Group, Journal of Epidemiology and Community Health, 8(64), p. 696-704
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Objective: To explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. Design: Structured interviews using Multi-criteria Mapping, a computer based decision support tool. Subjects/Setting: 189 interviewees, drawn from 21 different stakeholder categories in institutionally matched groups across nine members of the EU. Measurements: A four step approach was taken, i.e. selecting options, defining criteria, scoring options quantitatively and weighting the criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. Results: Taxation and subsidies were not favourably received, because they were considered difficult to implement. However, representatives of large commercial retail chains and public health professionals were most in favour of taxation, whilst representatives of public sector catering and nutritional/obesity advisory experts gave the most positive ratings to subsidies, and the trade unions rated both options more favourably than other stakeholder groups. In contrast, both options received their lowest scores from representatives of the farming industry, town and transport planners, the food processing industry and the advertising industry. Public health professionals were the stakeholders most frequently gaving the highest scores (3/9 countries), both for taxation (Italy, Spain and France) and for subsidies (Spain, France and Poland). Finland produced the greatest number of interviewees rating both fiscal options favourably. Conclusions: A decision to apply economic measures such as taxes/subsidies in the EU represents one possibly viable course of action, as part of an integrated and coherent public policy aimed at combating obesity. ; Supported by New and Emerging Science and Technology (NEST) research programme, financed by the 6th Framework Programme for research and technological development of the European Commission (contract no.508913).