{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:02:49Z","timestamp":1789790569810,"version":"4.0.1"},"reference-count":18,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Public Health Research"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High sugar-sweetened beverage (SSB) consumption has been linked to the rising prevalence of obesity and non-communicable diseases (NCDs) in South Africa. In April 2018, the country introduced an SSB tax\u2014known as the Health Promotion Levy (HPL)\u2014as a fiscal measure to reduce excessive sugar consumption and curb the rise of overweight, obesity, and NCDs. Although national evidence indicates product reformulation, community-level awareness and perceptions, particularly in low-socioeconomic settings, remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess adults\u2019 awareness, beliefs, and self-reported behaviour changes related to the SSB tax, and to explore nursing practitioners\u2019 understanding, perceptions of its impact on consumer behaviour, and views on their educational role at primary health care (PHC) facilities in Makhanda, Eastern Cape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>A multi-method, cross-sectional design was used. Quantitative data were collected from adults (n = 275) at seven PHC facilities through an interviewer-administered questionnaire. Qualitative data were obtained from semi-structured interviews with nursing practitioners (n = 10) at the same facilities. Data were analysed using descriptive statistics and thematic analysis, and the results were integrated for interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-six percent of adults (n = 264), based on the interviewer-administered questionnaire, were unaware of the SSB tax, while 98% (n = 269) reported no change in consumption since implementation. Nursing practitioners displayed limited awareness of the tax\u2019s rationale and timing but supported taxation as a public health strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SSB tax demonstrates limited perceived impact in this setting. Strengthened community education, awareness campaigns, and improved policy implementation are required to enhance effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/22799036261455674","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:52:48Z","timestamp":1789498368000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Taxation of sugar-sweetened beverages: Perspectives of adults and nursing practitioners in Makhanda, Eastern Cape, South Africa"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1584-3741","authenticated-orcid":false,"given":"Lanine","family":"Herman","sequence":"first","affiliation":[{"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelene","family":"Koen","sequence":"additional","affiliation":[{"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"Noncommunicable diseases","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. Noncommunicable diseases. : World Health Organization, 2025. https:\/\/www.who.int\/health-topics\/noncommunicable-diseases"},{"key":"e_1_3_6_3_2","volume-title":"The role of civil society in tackling noncommunicable diseases","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. The role of civil society in tackling noncommunicable diseases: World Health Organization, 2017."},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.1231"},{"issue":"1","key":"e_1_3_6_5_2","first-page":"1","article-title":"Outcomes of sugar reduction policies, United Kingdom","volume":"27","author":"Hashem KM","year":"2024","unstructured":"Hashem KM, Mialon M, Vandevijvere S, et al. Outcomes of sugar reduction policies, United Kingdom. Public Health Nutr 2024; 27(1): 1\u20139. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11132159\/","journal-title":"Public Health Nutr"},{"key":"e_1_3_6_6_2","first-page":"102195","article-title":"Public health lessons from the French 2012 soda tax and its redesign in 2018","volume":"110","author":"Le Bodo Y","year":"2022","unstructured":"Le Bodo Y, Gojard S, Gojard D. Public health lessons from the French 2012 soda tax and its redesign in 2018. Food Policy 2022; 110: 102195. https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0168851022001002","journal-title":"Food Policy"},{"issue":"2","key":"e_1_3_6_7_2","first-page":"1","article-title":"South Africa's Health Promotion Levy on pricing and consumption of sugary beverages","volume":"25","author":"Ross A","year":"2022","unstructured":"Ross A, Hofman KJ. South Africa's Health Promotion Levy on pricing and consumption of sugary beverages. Public Health Nutr 2022; 25(2): 1\u20139. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9991735\/","journal-title":"Public Health Nutr"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.4103\/jehp.jehp_218_22"},{"issue":"10","key":"e_1_3_6_9_2","first-page":"721","article-title":"South Africa\u2019s Health Promotion Levy: A novel tax to reduce obesity and prevent non-communicable diseases","volume":"109","author":"Myburgh N","year":"2019","unstructured":"Myburgh N. South Africa\u2019s Health Promotion Levy: A novel tax to reduce obesity and prevent non-communicable diseases. South Afr Med J 2019; 109(10): 721\u2013723.","journal-title":"South Afr Med J"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980019001356"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/22799036221129369"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2023-012125"},{"key":"e_1_3_6_13_2","volume-title":"Action for health taxes from policy development to implementation [Internet]","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. Action for health taxes from policy development to implementation [Internet]: World Health Organization, 2024. https:\/\/uniatf.who.int\/docs\/librariesprovider22\/default-document-library\/sbb-taxes.pdf?download=true&sfvrsn=9ef2fd69_1"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s42466-020-00059-z"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-022-01370-5"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017002695"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(20)30304-1"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu12061878"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0105287"}],"container-title":["Journal of Public Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/22799036261455674","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/22799036261455674","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/22799036261455674","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:17:31Z","timestamp":1789787851000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/22799036261455674"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/22799036261455674"],"URL":"https:\/\/doi.org\/10.1177\/22799036261455674","relation":{},"ISSN":["2279-9036","2279-9036"],"issn-type":[{"value":"2279-9036","type":"print"},{"value":"2279-9036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"22799036261455674"}}