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Sin Taxes, Paternalism, and Justifiability to All:

Can Paternalistic Taxes Be Justified on a Public
Reason-Sensitive Account?

Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

1. Introduction

“Sin taxes,” or, more generally, “sumptuary taxes,” are fiscal instruments
meant to lessen the consumption of specific products (such as high calorie foods
and drinks, tobacco, etc.) the use of which is (truly or allegedly) undesirable, for
example, in terms of health effects. Sin taxes utilize a combination of the indi-
viduals’ economic incentives and budgetary restraints to move their behaviour
in a desired direction—by increasing the price of unhealthy goods, and hence
making the unhealthy option less attractive (yielding less “value for money”),
and thereby reduce individuals’ propensity to excessive consumption of unheal-
thy products.1
In this paper, we wish to focus on a specific justification of sin taxes,
namely a paternalistic rationale: a sin tax is justified for you because (or rather
insofar) it is good for you. Moreover, our focus is on foods and drinks, although
we will involve tobacco as well, since this is one of the most widespread, and
arguably successful, areas for paternalist sin taxes. Presumably, in the light of
rising rates of obesity and overweight, more countries will consider using taxa-
tion as a tool to alter patterns of consumption of these products. This calls for
closer investigation of the relevant ethical and economic aspects, and the paper
is an attempt to contribute to that endeavour.
Our main question is the following: given a broadly “public reason” view of
justifiability (to be specified below), where justifiability to all is an important
desideratum,2 if not a downright necessary condition for the legitimacy of a
given policy, can sin taxes ever be justifiable? Our answer, which is perhaps
prima facie surprising, is that they can be, but that given a public reason view of
justifiability the scope of justifiable sin taxes may be quite narrow. Moreover,
close scrutiny of likely and actual impact on individuals or socioeconomic status
groups is needed to justify sin taxes.
The paper proceeds as follows. First, we spell out our understanding of
paternalism and six taxes. Then, in section 3, we turn to the concept of public
reason and justification. We argue that distribution plays—or ought to play—an
important role for public reason accounts, and hence for the question of the pos-
sible public justification of sin taxes. Having argued for the relevance of

JOURNAL of SOCIAL PHILOSOPHY, Vol. 47 No. 1, Spring 2016, 55–69.

C 2016 Wiley Periodicals, Inc.
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56 Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

distributions, we turn our attention to distributive concerns in section 4. In sec-

tion 5, we review existing empirical studies on the impact of sin taxes, with a
particular view to the taxes’ health effects and economic impacts in various
groups, and hence whether those groups carrying the economic burden of the
taxes are also those who obtain the health benefits. In section 6, we try to show
how (modest) paternalistic sin taxes may be reconciled with public reason-
sensitive accounts, but we also point out the difficulties with such reconciliation.

2. Six Taxes and Paternalism

Being taxes, it is often next to impossible to be sure whether the political

background for sin taxes is primarily fiscal or whether the intention really is to
lessen consumption, and the two issues are most often closely intertwined. We
largely ignore this complication and focus on what one might call the paternalis-
tic element in sin taxes: On the premise that consumption of some product is
“bad for the citizen,” and since (some) citizens do not freely abstain from the
use of the product, and it would be better for them if they did so, a sin tax is a
paternalistic move to make it harder for those citizens to consume the product;
and this is justified, paternalistically, because it is better for themselves.
Others may, through their consumption of tobacco or alcohol, create undesir-
able effects for others, for example, second-hand smoke, or accidents or violence
due to alcohol. According to most models of legitimacy, these undesirable
“externality” effects constitute at least prima facie or pro tanto reasons to regu-
late consumption, but since paternalism must address the person regulated (or
otherwise interfered with), and not those standing to benefit from the regulation,
the protection of third parties’ interests is neither necessary nor sufficient for
some policy to be paternalistic. While protection of third parties surely comprise
much of the reasoning or justification behind at least some forms of sin taxes
(again, taxes on tobacco/second hand smoking) and alcohol (traffic and work-
place security spring to mind), we ignore such reasons for sin taxes in the follow-
ing, and focus on the purely paternalistic motive: a sin tax is a tax (meant to be)
good for you. Potential benefits here are most likely (intended to be) health bene-
fits. By lessening consumption of high calorie foods and beverages, one is less
likely to become obese3 and to face the increased risks of the various diseases
commonly associated with obesity. Other, more indirect benefits might be
obtained: even if one does not benefit directly in terms of avoidance of “life style
diseases,” then if societal health care costs are lower due to other agents benefit-
ting from the sin tax in terms of avoiding health problems, and these lower soci-
etal costs mean that the ones developing life style diseases can obtain better
health care, or obtain health care at a lower price, then one is, at least potentially,
benefitted by the sin tax. But the main point is to give sin taxes a strictly paternal-
istic justification, so then it must be shown that those on whom the sin tax is
imposed are at least ceteris paribus enjoying a benefit of the sin tax; it is truly for
their own good, and not merely for the benefit of some other party.
 Sin Taxes, Paternalism, and Justifiability to All 57

3. Public Reason and Justifiability to All

Some might believe that taking the cue from the point of view of public
reason—with its emphasis on “justifiability to all”—begs the question against
paternalistic sin taxes. However, different conceptualizations of “public reason”
operate with different levels of idealization: some build in many presumptions
(moral and epistemic) about the parties that are assumed to take part in the process
of justification and are thus highly idealized conceptions of public reason (e.g.,
Rawls); whereas other conceptions try to make do with as little idealization as pos-
sible. And it is true that on very sparse idealizations (where the parties to whom
some policy must be justified are almost identical to their “real counterparts”),
paternalist policies would almost certainly be ruled out because it is always imagi-
nable that some parties would prefer no policy to some. However, we do not want
to rule out paternalist policies by definition, so we assume some level of idealiza-
tion where paternalist policies might be acceptable (or nonrejectable) to all, but
where the theory is still recognizable as a bona fide public reason account.
“Public reason” accounts are, broadly speaking, Rawlsian or post-Rawlsian
attempts to reconcile individual freedom with the exercise of political power under
conditions of disagreement and pluralism. For some readers, the contours of the
project(s) commonly associated with public reason are well known, but here is our
take on it. In fairly free societies, the citizenry will disagree deeply about most
political matters. Their disagreement is both moral and factual. Due to the
“burdens of judgement” (Rawls 1993), citizens will disagree about religious, philo-
sophical, and moral doctrines. However, reasonable citizens (we might say the
idealized counterparts of many citizens) will acknowledge that much of this dis-
agreement is reasonable, and will endeavour to propose only rules and laws and so
on that are, somehow, compatible with this disagreement. They will abstain from
supporting principles, rules, and so on that are controversial, “unendorsable” by
some other reasonable citizens. Hence Rawls’s famous “liberal principle of legit-
imacy”: “[O]ur exercise of political power is proper and hence justifiable only
when it is exercised in accordance with a constitution the essentials of which all
citizens may reasonably be expected to endorse in the light of principles and ideals
acceptable to them as reasonable and rational” (Rawls 1993, 217).
As spelled out by Quong,4 in order for a public reason account to be distinc-
tive, it must steer a middle course between two other ideas about justification.
On the one hand, it cannot (simply put) appeal to the truth of any comprehensive
or controversial moral doctrine. Citizens disagree, and disagree reasonably,
about the truth of moral doctrines. On the other hand, being itself a moral, pre-
scriptive account, it cannot simply appeal to already given consensus in the citi-
zenry. A public reason account is not a consent model. So, various conceptions
of public reason could be placed on a continuum between two extremes: the
more idealized the parties assumed in the account, the closer the account veers
toward some conception of truth or “true political morality”; the less idealized,
the closer it is to actual consent of actual citizens.
58 Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

Rawls is of course most famous for his proposal of a distributive scheme of

a highly egalitarian character (the “difference principle”), whereby goods and
burdens are to be arranged in the way most beneficial for the worst-off represen-
tative group. Moreover, as a consequence of the commitment to public reason
and the liberal principle of legitimacy, the state should be (broadly speaking)
neutral as concerns conceptions of the good.5 In other words, conceptions or
concerns of the right are legitimate political material, as it were, while concep-
tions or concerns of the good are not. However, it might be averred that this
underestimates the diversity or pluralism of contemporary (liberal) societies:
first, why assume a consensus among reasonable citizens on a highly controver-
sial egalitarian doctrine like justice as fairness and its strong commitment to
redistribution? Reasonable citizens might be supposed to support a host of other
distributive concerns, including responsibility-, desert-, or entitlement-sensitive
theories, that at least potentially run afoul of the egalitarian component of justice
as fairness. And second, why believe that reasonable citizens will agree to the
priority of the right over the good?
This has lead other theorists of public reason, for instance Gaus (see, e.g.,
Gaus 2011) to propose less narrow, or less idealized conceptions of public rea-
son, to model public reason in a way less alien to actual citizens of liberal
democracies. Since Rawls’s is the better known model, we assume some knowl-
edge of its details, and spell out some of the relevant features of Gaus’s model
to make clear the distinction between them.
Gaus agrees with Rawls on the basic question: “[The aim]. . . is to provide a
general account of social morality that reconciles freedom and the demands of
public order in a society in which individuals, exercising their reason about the
best thing to do, deeply disagree” (Gaus 2011, 2).6 However, very roughly
stated, Gaus believes that Rawls underestimates the disagreement in question
and fails to actually treat reasonable citizens as equal interpreters of morality.
The “reasoners” in Rawls’ original position are shorn of all particular knowl-
edge about their own situation and preferences. While some actual citizens
might be so much aligned with the general Rawlsian account that they would
“recognize” the “reasoning made” by the parties in the original position, many
would probably not. In contrast, the “members of the public” (the “reasoners” in
Gaus’s account) are “idealized counterparts of their actual members of the pub-
lic, but they are not so idealized that their reasoning is inaccessible to their real-
world counterparts” (Gaus 2011, 276). This is a sparse description, but for Gaus
the point is that “we must . . . allow for a great diversity in the reasons the Mem-
bers of the Public bring to bear on [any given] question” (Gaus 2011, 277),
because otherwise we abstract away from the problem that public reason was
meant to solve in the first place: the challenge of deep and pervasive disagree-
ment in liberal societies.
To return to the question of paternalistic sin taxes: seen in the light of public
reason, the justifiability of a sin tax is conditional on it is being endorsable, or
nonrejectable by all reasonable citizens/members of the public. Because
 Sin Taxes, Paternalism, and Justifiability to All 59

paternalistic sin taxes tend to be regressive (see below), they would ceteris pari-
bus count against Rawlsian egalitarian concerns. However, it is conceivable that
(i) there are ample off-setting redistributive components of the optimal Rawlsian
distribution package, and (ii) a paternalistic sin tax improves overall economic
efficiency, creating more room for general taxation to the benefit of the worst
off. Hence, given one accepts justice as fairness as a public reason account, we
have already answered our main question: public reason-sensitive accounts are,
in principle, compatible with sin taxes.
However, as is clear now, not all public reason accounts proceed in a Rawl-
sian way. Here, sin taxes are instructive to tease out some of the differences. If
we simply asked members of the (real) public about whether or not they endorse
a given sin tax, we would almost always end up in a situation where some citi-
zen(s) cannot or will not endorse a sin tax, and hence, such a policy in unjustifi-
able. But what about their idealized counterparts, the members of the public?
What reasons can they, legitimately, bring to bear on the question?
It is clear that Gaus’s account,7 and public reason accounts in general, do
not appeal solely to self-interest.8 Hence, the very fact that a sin tax makes it
costlier for a person to satisfy his or her preferences is not a decisive or suffi-
cient reason for rejectability, even if that person does not stand to benefit from
the tax in any way. However, policies imposed coercively on citizens can be
rejectable on any plausible account of public reason if (i) some citizen stands
only to be burdened and not benefitted by the policy, (ii) that policy is not other-
wise and independently morally justified by appeals to protection of basic inter-
ests (e.g., some citizen might be only burdened and not benefitted by a law
against violence; however, the law protects other citizens basic interests), and
(iii) the burden is non-negligible, or (iv) there is some relevant alternative policy
which burdens the citizen less and burdens no one more. And it is not implausi-
ble that some citizens would be in such a situation, due to a paternalistic sin tax:
they are burdened, the burden is non-negligible, the tax does not protect some
other citizen’s basic interests (or there is some alternative doing so that is less
burdensome). But how are we to steer a course between (i) the idea that a rule
does not promote the interest of some citizen is not sufficient to say that the rule
is not justified or justifiable, and (ii) the idea that the fact that a rule (policy) is
burdensome can be a legitimate reason for rejecting that rule?
Throughout The Order of Public Reason, Gaus’s focus is mainly on “the eligi-
ble set” of legitimate polices, not on the singularly “correct” policy (see Gaus
2011, 321ff). The specific reasoning behind this need not detain us here; the idea
is, roughly, that for some policies (rules) or areas of concern, members of the pub-
lic can converge on a set of policies consisting of rules they would all prefer over
the absence of any policy regulating that area. Stated in these terms, the key ques-
tion is whether a particular proposal of a sin tax falls in the eligible set: is it among
the policies (regulating that area) that all would prefer over no policy at all?
Again, this might not seem to get us off the ground: surely, a citizen whose
interests are only set back from a particular sin tax (i.e., he or she is not
60 Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

benefitted in health or economic terms, and he or she is burdened by the tax)

will complain and prefer no tax at all rather than some tax regulating the area.
However, Gaus operates with a reversibility constraint: “a person’s advocacy
must not depend on her knowledge that she will only occupy specific roles or
positions” (Gaus 2011, 300). This is perhaps a slightly underdeveloped theme in
public reason thinking, but we take it to imply the following in this context: a
citizen’s belief that she will not be benefitted by some paternalistic sin tax is not
it itself sufficient to show that it is reasonable for her to reject that policy. If, for
example, the basic reason for the rejection is that she believes her health is
robust enough to consume her preferred units of alcohol, while she knows that
other persons would benefit, then, at least, her complaint begins to look dubious
in light of the reversibility constraint. Naturally, we need to be very careful
here. For, conversely, the fact that some other person would benefit by some
rule is not sufficient to show that a complaint against that rule is spurious (that
would mandate all sorts of extremely unfair rules). Parfit’s (2003) discussion of
the distributive implications of Scanlon’s (1998) contractualism is instructive:
according to Parfit’s analysis, while a person might have a legitimate complaint
against rules that are aggregately optimific if the rule would set back that per-
sons interest to a very high degree, huge benefits accruing to many other persons
might justify a rather big individual loss to one or a few persons. A hard and fast
formula is not available here, but the contours of the reasoning are clear enough:
benefits to many may make it unreasonable to reject a rule even if that rule is
harmful to your own interests. And probably, a (non-draconian) sin tax is only
slightly harmful to those who do not stand to benefit (in terms of improved
health or financial situation), but wish to continue consumption. While this may
appear to go against the “spirit” of Gaus’s and other public reason accounts, we
would argue that it is an implication of the reversibility constraint. Given the
assumption that a sufficient number of persons would benefit from a sin tax (due
to improved health status), the mere fact that some person believes that he or
she would only be burdened (and not benefitted) by that sin tax is not sufficient
to show that the sin tax is unreasonable and could reasonably be rejected.
The question now becomes: what do we know about the (distribution of)
benefits and burdens of sin taxes, and what role should distributive concerns
play in the first place given public reason-sensitivity? We turn now to these
questions.

4. The Relevance of Distributive Concerns

In the above, we argued that, on a Rawlsian account, with its emphasis on

egalitarian redistribution, distributions matter, and policies (such as sin taxes)
that can play a positive role in the endeavour to approach, for example, the goals
of the difference principle, can, therefore, be justified. On such public reason
accounts, distributions matter by definition.
 Sin Taxes, Paternalism, and Justifiability to All 61

But given a non-Rawlsian/non-egalitarian account of public reason, it might

seem strange to engage issues of distribution in the present context. Since rea-
sonable disagreement covers not just conceptions of the good, but matters of jus-
tice as well—citizens may sincerely and reasonably disagree over whether
desert, entitlements, utility, equality and so on should play a role in distribu-
tion—it could seem prima facie futile to do so, for no detailed account of redis-
tributive justice can be taken as basic for the discussion. We want to briefly
argue why this is not so: even given reasonable disagreement concerning distrib-
utive theories, reasonable citizens need to know something about the distributive
impact of alternative policies, including the impact of sin taxes.
First, reasonable citizens (or more precisely, members of the public), even if
we accept realistic levels of bounded rationality and limitations of cognition, are
assumed to engage in a fair amount of deliberation when proposing, accepting or
rejecting social rules. Without some idea about the impact of proposed policies,
members of the public cannot deliberate adequately. This in itself is enough to
show that an assessment of the distributive impact of policies is necessary.
Second, “left liberal” theories (like Rawls’s) are committed to substantial
egalitarian values, and egalitarianism of that sort is controversial. However, it
would be to move too quickly to say that “public reason accounts” per se are
inimical to redistributive concerns, and hence that the best available such
accounts are “classic liberal” or “libertarian” (like Gaus’s). Even Gaus’s account
includes redistributive concerns because persons need a minimum of goods to
preserve human agency or “autarchy” (see, e.g., Gaus 2011, 357ff). Hence, a
policy that would contribute to inequality in ways that endangers agency for the
worse off would not be acceptable on Gaus’s account. Furthermore, while it
might plausibly be said that the commitment to the highly specific and demand-
ing ideal of distribution expressed by the difference principle is at odds with the
ideal that public reason should address citizens and their ideals and reasons “as
they are,” it might conversely be averred that any too modest commitment to
(substantial) equality is at odds with the values of public reason, albeit in
another way: briefly put, a core value of public reason is the ideal of
“justifiability to all.” Among many other things, this must mean that institutions,
entrenched privileges, and so on, that foster or sustain inequality must be justifi-
able—notably, justifiable to the worse off. If justice should be our critic, and not
just our mirror, we must be able to justify such inequalities, and sometimes, we
probably cannot and we need to alter institutions in an egalitarian way. Again, it
need not be the case that there is consensus on one theory of just distribution
over another; but some element of (broadly speaking egalitarian) social justice
seems indispensable in the attempt to justify the relevant institutions and so on.
Third, and finally, to live up to the demands of the reversibility constraint,9
it is simply necessary to know something about distributional impact. To assess
whether the complaining party is justified in rejecting a proposed sin tax, we
will need to know whether or not that person could reject the policy given he or
she occupied other positions among those affected.
62 Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

We believe we have offered reasons as to why a public reason-sensitive

account need at least to have an eye on distributions to proceed to an assessment
of the justifiability of a proposed sin tax. Now, we want to engage with some
empirical studies concerning the impact and distribution of sin taxes.

5. Benefits and Costs of Sin Taxes—An Economic View

To assess how cost and benefit effects of sin taxes tend to be distributed (in
particular the extent to which health benefits of sin taxes tend to occur to the
same groups that face the economic burden of such taxes, and hence whether
empirical research supports sin taxes on paternalistic grounds), we review the
empirical literature on such effects. Economists and public health scientists have
studied the effects of price changes on consumption, especially in the fields of
tobacco and foods.
Most of the studies show that individuals in low-income groups will face a
relatively large economic cost in that case, because a relatively large share of
their consumption budget is allocated to foods and beverages rich in sugar and
fat.
We could also suspect that low-income individuals would be more
restricted by their budget than high-income individuals, and hence that price
sensitivity in consumption response (of both taxed and untaxed commodities)
would be relatively large for low-income individuals. Some empirical studies
support this suspicion for foods (e.g., Smed, Jensen, and Denver 2007) or for
tobacco (Baltagi and Levin 1986; Townsend, Roderick, and Cooper 1994).
These empirical results on price sensitivity suggest that sin taxes on food or
tobacco may be health-promoting for the individual—and more health-promot-
ing among low-income groups. This can be further amplified: if low-income
individuals a priori are assumed to have a higher intake of (for example) sugar
and fat than high-income individuals (which has been found in many studies of
dietary behavior [Darmon and Drewnowski 2008]), then a significant price
change may imply a shift from high-risk to low-risk dietary behavior.
Many of these studies within foods find that the price sensitivity of con-
sumption depends on the character of the good, including how substitutable it is
with other goods. If the good with increased price (e.g., due to a sugar or fat tax)
can be substituted with other goods, there will be an effect of the price increase
on the consumption of these other goods as well, and this substitution effect
may interfere with the direct health effect of the price change. Taking the intake
of saturated fats or sugar as examples, a substantial improvement of dietary pat-
terns (on average) would require reductions in the consumption of these
nutrients of about 25% in most European countries (Elmadfa 2009). If such a
reduction should be achieved solely by means of a tax, this would mean that the
tax would probably have to increase the product prices quite dramatically, and
with such dramatic price increases, potential substitution effects should also be
taken into account. As such potential substitution effects will reflect a wide
 Sin Taxes, Paternalism, and Justifiability to All 63

range of different patterns in diets and meals, there is no clear and general evi-
dence for the direction and magnitude of these effects, and hence for whether a
tax on a single dietary item would increase or decrease individuals’ healthiness
from an overall physical health perspective10 (again abstracting from, e.g., emo-
tional or psychological health effects, the inclusion of which would make the
benefit pattern even more unclear).
In contrast to selective food taxes, a tobacco tax should be expected to
imply relatively little potential for substitution, because the availability of
straightforward substitutes is limited, and hence the direct positive effect of a
tobacco tax on health could be expected to dominate, although a relatively dra-
matic price increase may be necessary to obtain significant health
improvements.
Hence, whether sin taxes are supportive or in conflict with equality con-
cerns appear to be an empirical question, and the answer is context-dependent.
A systematic review of simulation studies by Eyles, Ni Mhurchu, Nghiem,
and Blakely (2012) found that overall, pricing policies resulted in improved diets
and health benefits for lower socioeconomic groups. This finding was supported by
a vast majority of the studies, where about one quarter estimated that pricing poli-
cies would result in greater health benefits for lower socioeconomic groups com-
pared with higher socioeconomic groups, and would thus have the potential to
reduce health inequalities directly. Several of the reviewed studies estimated that
relative impacts would be similar across socioeconomic groups, which translates
into a greater absolute impact in lower socioeconomic groups, given that lower
socioeconomic groups usually have higher noncommunicable disease burden. A
few studies had estimated poorer health outcomes for lower socioeconomic groups.
Several of the reviewed studies noted that such taxes would be regressive, meaning
that the financial burden predominantly lies on the lowest income groups.
Briggs et al. (2013) found that a tax on sugar-sweetened drinks in the
United Kingdom would increase the weekly spending most in low-income
groups, and that the potential health gains (represented by reduction in energy
intake and estimated obesity rates) were relatively largest in both the high- and
low-income groups—and lowest in the middle-income group. Nnoaham, Sacks,
Rayner, Mytton, and Gray (2009) investigated the potential effects of alternative
taxation/subsidization schemes, including a saturated fat tax and an unhealthy
food tax. Like other studies, they found that the percentage impact on food
expenditure and real income were largest in the lowest income quintiles, but that
the two tax scenarios had negative public health effects—especially the fat tax
scheme—due to unintended effects on the consumption of other dietary compo-
nents, primarily a lower consumption of fruits and vegetables.
At the end of the day, neither economic nor health status or impact can be
our “currency.” Ultimately, what must be our measure is individual well-being,
or at the very least some proxy for well-being that is closer to it (such as oppor-
tunities, capabilities, or resources more generally) than health or money, but
which comprises both statistically expected impact on health and impact on
64 Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

financial prosperity. For example, it might be the case that some policy like a fat
tax would bring benefits to an individual in health terms due to lessened con-
sumption of fatty foods, but that it would still impose such high opportunity
costs on the individual (foregone opportunity to consume strongly preferred
goods) that, ultimately, that individual fares less well in terms of well-being. A
clear cut way of assessing the total impact on individuals’ well-being is not
readily available; but the absence of such a method does not make the problem
go away.
The above-mentioned economic studies on distributional impacts of health-
motivated food and beverage taxation hence show somewhat mixed results in
terms of the cost/utility distribution across income classes, but they in general
suggest that redistributive effects between low- and high-income consumers do
not appear to be dramatic. Thus, in general the studies do not undermine a pater-
nalistic rationale for sin taxes. Whereas the studies tend to agree on the regres-
sive income effects of such taxes, the evidence for a social/income class pattern
in relative health benefits is more mixed—although relative health effects in the
low-income groups tend to be at least as good as in the other income groups.

6. Discussion

The above review of empirical studies suggests that individuals from low-
income groups tend to be burdened the most, but also to obtain at least as large
health benefits as individuals from higher income groups, if taxes on unhealthy
products are introduced or increased. Hence, this empirical evidence does not
suggest serious redistribution from low-income to high-income groups, and does
not rule out the paternalistic rationale for such sin taxes. Nevertheless, more
moral considerations need to be included.
As we have hinted in the above, one problem with the paternalistic justifica-
tion is that it can target the wrong audience, as it were. To simplify, assume that
a population consists of two groups: the well-off prudent and the worse-off
imprudent. If, or to the extent that, a sin tax effectively lessens consumption of
some unhealthy product only for the well-off (and thereby benefits them), and
only brings more economic hardship to the worse-off since they persist in their
use of the product, but for a higher price, then surely the paternalistic justifica-
tion is ineffective vis-a-vis the worse-off. It seems that the policy is reasonably
rejectable as seen from their point of view: they are only burdened, and the ones
that benefit are already better off.
Given our overview of the existing literature and data on the subject in the
above, one cannot say that paternalist sin taxes misfire in the way described
here—at least if we (unjustifiably, as we have noted) focus on health impact
alone, and if we focus on groups. The literature and data do not point unilater-
ally in a direction such that the worse or worst off do not benefit from paternalist
policies, or benefit disproportionately less than other groups.
 Sin Taxes, Paternalism, and Justifiability to All 65

However, moving the focus from groups to individuals, the paternalist

rationale might very well misfire for any given individual, irrespective of that
individual’s socioeconomic status. We have assumed from the start a public rea-
son point of view stressing justifiability to each affected individual. If a paternal-
ist policy does in fact not benefit an individual, but only imposes burdens on
her—burdens that would not exist in the absence of the policy, or would be less
if it did not exist—then it can be quite hard to see how such a policy could be
justified to her. True, as Scanlon has noted, and as we have already spelled out,
one cannot reject a principle merely by appealing to the fact that it is burden-
some: if every alternative is (much) more burdensome on someone else, then the
fact that some policy is a burden to me does not amount to a legitimate ground
for rejecting the policy (Scanlon 1998.) Hence, the fact that some policy only
burdens, but does not benefit, some person should not be counted as a sufficient
ground for rejecting that policy. However, great care must be taken when we
construct cases involving (potential or actual) burdens. To illustrate: when it
comes to public health policies—where health is at stake—it is almost always
possible to construct a case in which someone is very badly burdened by the
absence of some policy. Take something as banal as sugar. Surely, a lax pol-
icy—a “no-taxes-imposed-policy” as regards sugar—can easily be construed as
imposing a very great burden on the few sugar addicts that almost literally gorge
themselves to death on sugar. But the same goes for driving cars. Surely, a “no-
ban-on-cars” policy will inevitably lead to the deaths of some—a very heavy
burden. But still, it seems reasonable to say that individuals have a legitimate
complaint—that they can reasonably reject—a policy that completely bans car
driving, even if this imposes much heavier burdens on someone else. In sum,
Scanlon’s formula does not get us much closer, at least not prima facie. As con-
cerns sin taxes, it should not be rejected straight away that some individuals,
who otherwise do not infringe on other persons’ rights, do have a legitimate
complaint against policies that only impose burdens, and no benefits, on them. If
justification needs to address any affected individual, and a paternalist principle
burdens that individual without bringing any comparable benefit, then that indi-
vidual does have an at least prima facie legitimate complaint against that princi-
ple or the policies that flow from it. Sin taxes might give rise to such legitimate
complaints, especially if the burdened person is already worse off as compared
to those who benefit. Here, we believe that (roughly) egalitarian distributive
concerns should play a rather important role for public reason-sensitive
accounts, even if fully fledged egalitarian commitments (in the vein of Rawls) is
held to be too demanding and controversial. It seems reasonable to assume the
following: assuming that a paternalist sin tax is, roughly speaking “cost-
effective,” much then depends on the distributive pattern of the tax. To simplify:
compare the complaints of two consumers in two different alternatives that both
will not be benefitted by some sin tax (to repeat: they will gain no benefits to
their health, and since they prefer to consume the product targeted by the tax in
question, they will be worse off economically due to the tax), well-off consumer
66 Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

A and worse-off consumer B. The burden they would bear would be the same in
absolute terms, but since B is relatively worse off than A, B’s relative burden is
higher. In A’s alternative, the tax will, ceteris paribus, benefit the worse off,
while in B’s alternative benefits will mostly accrue to the better off. It seems not
unreasonable to say that B’s complaint is more serious than A’s.
That is not to say neither that A’s complaint cannot be serious enough, nor
that B’s is always serious enough to reject the proposed sin tax. If the tax in ques-
tion seriously threatens the good of A, there is a reasonable complaint to be made
(Gaus 2011, 301f); conversely, if B is only superficially (although not negligibly)
negatively affected and there are large gains to aggregated welfare at stake, then,
at some hard-to-specify point, B’s complaint will seem unreasonable.
A further problem arises once we make the full shift from “health” to well-
being, or impact on persons’ well-being.11 The data presented in the above point
in the direction that paternalistic sin taxes could, at least ceteris paribus,
improve the health status of the lower socioeconomic strata, but also (trivially)
mean that the economic burden imposed on them weighs heavier. The first sup-
ports the justifiability of paternalistic sin taxes, whereas the second weakens that
justification. However, once we recognize that neither health nor money is our
ultimate currency for moral evaluations, several further factors need to be taken
into account. Individual well-being consists of many elements on any plausible
conceptualization of well-being: hedonic pleasure, social, and cultural well-
being (e.g., the enjoyment of a particular, perhaps unhealthy meal or snack in
certain social settings) and probably many more.12 True, a paternalistic (nondra-
conic) tax on, for example, sugar and fat, does not make it impossible for people
to consume lokum (Turkish delight) or ras malai (the Indian dessert), but it does
make it more costly to consume such products.
Some further issues relevant for the overall assessment of whether a paternal-
ist sin tax is justified in the light of its contribution to individual well-being are
well known from the public health ethics debate. For instance, it is conceivable
that more focus on fat or sugar might contribute negatively in terms of welfare
because (some) individuals will begin to conceive themselves as ill or at risk of
becoming ill (Verweij 1998) because fat and sugar are singled out as “dangerous.”
Furthermore, such policies could contribute to the already existing stigmatization
of obese and overweight persons (Puhl and Heuer 2010). Because paternalistic pol-
icies are justified in terms of contribution to well-being, such issues should not be
set aside in an all things considered assessment of their justifiability.

7. Summary and Conclusion

Sin taxes, or sumptuary taxes, are instruments meant to reduce the consump-
tion of some product, normally for the reason that (over-) consumption of the prod-
uct is unhealthy. The most reasonable justification for such a policy (setting aside
utilitarian concerns, at least) is that “it is good for you”; which means basically a
paternalist justification. From the economic point of view, the price sensitivity of
 Sin Taxes, Paternalism, and Justifiability to All 67

consumption depends on the character of the good, and how substitutable it is with
other goods. Empirical studies suggest that price sensitivity in consumption
response is relatively large for low-income individuals, which might yield support
for paternalistic interventions—this, however, tends to be a too simplistic picture
due to substitution effects, which depend on the character of the goods. Individuals
in low-income groups will also face a relatively large economic cost in case of sin
taxes. The net distributional effect of sin taxes is an empirical question, and exist-
ing studies on distributional impacts of health-motivated food and beverage taxa-
tion show somewhat mixed results in terms of the cost/utility distribution across
income classes, but the redistributive effects between low- and high-income con-
sumers do not appear to be dramatic, and hence do not undermine the paternalistic
rationale for such sin taxes in the considered cases.
Some of the normative concerns are partly alleviated by the findings. Some
sin taxes do seem to have beneficent impact on health, and it is not necessarily the
case that the worse off do not benefit from such policies. However, some norma-
tive concerns remain, even on the assumption that sin taxes can be fairly efficient.
(i) If justification (of principles or their concomitant policies) should address the
individuals affected, then the paternalist justification is likely to misfire as regards
at least some persons: they stand not to be benefitted, only burdened. One might
say that this might be simply a negative factor to be weighed against the potential
benefits; however, from the point of view of justification or legitimacy on a public
reason-sensitive account, the paternalist justification—”it is good for you”—does
not apply to those that are only burdened and not benefitted. Other justifications
need to be invoked, and we have argued that the reversibility constraint on pro-
posals and reasonable rejections of proposals at least sometimes can justify policies
to those who are not benefitted. (ii) We have argued that a modest concern for egal-
itarian values is compatible with public reason-sensitive accounts. However, the
regressive character of most forms of sin taxes might constitute a normative prob-
lem when seen against egalitarian values because the worse off are generally rela-
tively more burdened by sin taxes. (iii) When we move from a singular focus on
impact on persons’ health, a string of other factors relevant for well-being comes
to the fore, such as the hedonic and sociocultural value of foods and beverages that
might be termed “unhealthy,” unnecessary worry or misconceptions about one’s
own health, stigmatization, and so on. These negative impacts on individual well-
being also count against the plausibility of the paternalist justification of sin taxes
on foods and drinks. To be justified, paternalist initiatives should be good for well-
being, not just good for health.

Notes
1
Many countries use taxes as a means to regulate tobacco consumption (World Health Organization
2010) or alcohol consumption (World Health Organization 2004). The use of health-motivated
taxes in the food domain is less widespread, but some examples have attracted attention in recent
years. In 2011, Hungary introduced a tax on foods containing “too much” fat, sugar or salt,
68 Morten Ebbe Juul Nielsen and Jørgen Dejgaard Jensen

including crisps, soft drinks, and chocolate bars, with the official aim to improve the health of
the nation (Holt 2011; Villanueva 2011). France introduced a tax on sugary drinks in 2012, as an
instrument to combat the growth in child obesity (Villanueva 2011). Denmark introduced a tax
on saturated fat in foods in 2011, also with an aim to discourage the consumption of foods con-
sidered as unhealthy (the tax was, however, repealed again after only 15 months in action; see
Vallgårda, Holm, and Jensen 2014).
2
“Public reason requires that the moral or political rules that regulate our common life be, in some
sense, justifiable or acceptable to all those persons over whom the rules purport to have authority
(Quong 2015). Note that on this definition justifiability to each is a necessary condition. How-
ever, we extend the use of “public reason” to cover all theories that are at least sensitive to the
ideal of justifiability to all, hence “public reason-sensitive.”
3
We do not wish here to engage in the question whether obesity is in itself a disease; surely, some
obese are healthy, but it might still be the case that statistically, it is prudentially better to avoid
obesity.
4
See Quong (2015).
5
For an instructive discussion of this see Mulhall and Swift (1992), 232ff.
6
Compare: “How is it possible that there may exist over time a stable and just society of free and
equal citizens profoundly divided by reasonable though incompatible religious, philosophical,
and moral doctrines?” (Rawls 1993, xviii).
7
We want to stress that we are aware that Gaus’s account is not the only relevant alternative here.
We believe, however, that it is instructive.
8
“Moral personhood consists in the capacity to care for moral rules in such a way that one recognizes
a compelling reason to abide by the rule even when such conformity does not promote one’s
wants, ends, or goals” (Gaus 2011, 19; see also ibid, 205ff).
9
Admittedly, there is scope for very many different interpretations of what one needs to do in order
to fulfill the commitment to reversibility, but we proceed here on a rough and ready understand-
ing: you would, counterfactually, accept or reject a proposed rule, even if you held any other rel-
evant position.
10
Taking into account the potential for such cross-price effects, it will be possible to design taxation
schemes in ways to overcome such problems and ensure an overall positive health effect of the
tax. Examples could be to combine taxations on different unhealthy food substances (e.g., both
sugar and saturated fat), and/or use the tax revenues from such taxes on lowering the taxes for
healthy foods, such as fruits/vegetables or seafood (Smed et al. 2007; Nnoaham et al. 2009).
11
For a discussion, see Andersen and Nielsen (2015).
12
An anonymous reviewer raised this point for which we are grateful. We are agnostic as to whether
these further factors are instrumentally relevant or whether they constitute some sort of intrinsic
value.

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