Move over, cigarettes. Trans fats, step aside. The battle to better our health is zeroing in on a new target: soda.

“I believe soda is the next tobacco,” said Barry Popkin, director of the University of North Carolina’s Interdisciplinary Obesity Center and author of “The World Is Fat,” published this year. Soda drinkers haven’t achieved pariah status like smokers before them, but proposed sugar taxes and social pressure to be healthy can put a damper on doing the Dew — and even some in the growing ranks of diet pop drinkers are feeling soda shame.

According to Popkin, Americans are consuming up to 300 more calories per day now than they were 25 to 30 years ago, and two-thirds of that increase is from caloric beverages like soft drinks, sports drinks, energy drinks, fruit juice and milk.

While milk has important vitamins and minerals, the sugary beverages “have no health benefits,” Popkin said. And studies show people who drink caloric beverages don’t compensate by cutting out other food, so the calories add up, he said.

An article in the April 30 issue of the New England Journal of Medicine put it bluntly: Sugar-sweetened beverages “may be the single largest driver of the obesity epidemic,” it said.

The article, co-authored by Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale, and New York City Health Commissioner Dr. Thomas Frieden, makes a case for taxing sugary drinks to curb consumption. A proposal in New York last year to impose a 1-cent-per-ounce tax on sugared beverages could be expected to reduce consumption by 13 percent, or two servings per person per week, according to the article.

A federal tax on sugary beverages is one of many proposals Congress is considering as it debates how to pay for a $1.2 trillion overhaul of the health care system, according to a report in The Wall Street Journal. The Congressional Budget Office estimated that a tax of 3 cents per 12-ounce serving of sweetened drink would generate $24 billion over four years.

The possibility of a soda tax angers some soda-loving Marylanders.

“The government will try to tax anything,” said Josh Rubin, 21 of Annapolis. “I don’t think they are taxing things for people’s health. They are doing it to make money, not help people.”

Two states — Maine and New York — tried to impose large soft drink taxes in the past year but have not succeeded.

Tracey Halliday, spokeswoman for the American Beverage Association, a trade group, said proposed taxes on sugary beverages are “a pure money grab” and unfairly discriminate against one product. She batted away soda’s comparison to tobacco, “a known carcinogen.” Halliday said, “People are not buying it.”

Health-conscious consumers are, however, increasingly turning away from regular soft drinks in favor of diet alternatives.

The regular soft drink market lost 15.6 million adult drinkers from 2003 to 2008, while diet soda gained 7.8 million drinkers, according to Mintel, a Chicago-based market research firm. People also are increasingly drinking bottled water, energy drinks and sports drinks, Mintel found.

Weight maintenance and concern about the risks of high fructose corn syrup were the biggest reasons cited for moving away from full-calorie soda.

Still, even diet-soda drinkers are feeling pressure. Dayna Tropeano, 19, of Towson admits to a three-Diet Coke-a-day addiction that she was recently able to kick.

“I actually gave up soda because it makes me feel bloated,” she said.

Diet sweeteners have come under fire for conditioning people to want more sweets, and some have been linked to cancer, but Popkin said there has been no established literature proving that diet sweeteners are harmful or cause weight gain. Researchers with the Framingham Heart Study published a study two years ago that found people who drink one or more sodas per day — diet or regular — are nearly 50 percent more likely than non-soda drinkers to develop risk factors for heart disease, but the study author said that could be because people who drink soda also tend to eat more and exercise less.

To Popkin, sugary drinks are the culprit, leading to weight gain and increasing the risk for diabetes.
Still, for many, any health and tax concerns don’t matter.

“It doesn’t bother me,” said Rebecca Goldberg, 22, of Federal Hill. “If I really want soda, I’ll pay the extra money.”

RedEye and Melissa Sorger, special to b

What would it take for you to give up soda?

An act of G-d.
John Lewis 23, Columbia

A substitute like wine for the price of coke, like $1.50 a cup.
Ashley Wilson 19, Towson

Trade soda for beer, definitely nothing will make me give that up.
Anna Hugo 25, Olney

Soda is a hard thing to quit. I tried giving it up for Lent. It lasted, but only so long. I’ve switched from regular to diet back to regular again. As hard as it would be, I think I would have to quit drinking first and foremost.
Chris Nasatka 36, Nottingham

If it was rotting my teeth.
Kelsey Wilhour 21, Eldersburg

I have a sick addiction to Code Red. I would [rather] give up candy/sweets than give up my liquid crack!
Rae Ricketts 20, Abingdon

If I saw a dramatic change in my weight without it.
Abby Tavik 21, Baltimore

A really good shopping spree at the mall.
Ally Curran 21, Annapolis

I’d actually give soda up before most other things. Giving up coffee? THAT’S the hard one.
bcslaski via Twitter

I would give up cursing before I gave up soda. Sorry, but that feeling of CO2 going down my throat is more addictive than cigarettes.
myklstarr via Twitter

The sweet ‘n lowdown

Diet soft drinks have the sweetness without the calories of their classic counterparts, thanks to artificial sweeteners that are many times sweeter than regular sugar and therefore used in much smaller doses. Here’s a breakdown of the artificial sweeteners approved by the Food and Drug Administration, plus the new natural sweetener stevia, now available in some foods.

The Basics:

Acesulfame-potassium
Brand names: Sweet One, Sunett
Found in: Diet Sprite, Coke Zero, SoBe Lean Green Tea (usually in conjunction with another sweetener)
Sweetness: 200 times sweeter than sugar
Year discovered: 1967
Year FDA approved: 1988

Health concerns:

FDA says studies show no carcinogenic effects, but critics say there hasn’t been enough research. The Center for Science in the Public Interest, a consumer advocacy group, advises consumers to avoid this sweetener, citing possible cancer and thyroid risks.

The Basics:

Aspartame
Brand names: NutraSweet, Equal
Found in: Diet Coke, Diet Pepsi, Diet Sprite, sugar-free Jell-O
Sweetness: 180-220 times sweeter than sugar
Year discovered: 1965
Year FDA approved: 1981

Health concerns:
Some researchers have raised concerns about links to brain cancer, leukemia and lymphomas, but the FDA and international food safety commissions say reviews of the many studies and clinical trials on aspartame show there’s no link to any cancers. CSPI recommends avoiding aspartame, citing possible health risks.

The Basics:

Saccharin
Brand names: Sweet’N Low, Sweet Twin, Necta Sweet
Found in: Tab
Sweetness: 200 times sweeter than sugar
Year discovered: 1879
Year FDA approved: Was considered GRAS (generally recognized as safe) when the government began requiring pre-market approval of food additives in 1958.

Health concerns:

Studies linked saccharin to bladder cancer in rats, and the FDA in 1977 recommended it be banned. Instead, Congress required all products containing saccharin to carry a warning label. But human studies showed no consistent cancer link, so in 2000 saccharin was de-listed as a carcinogen and the warning label requirement was repealed. CSPI says to avoid saccharin.
The Basics:
Sucralose
Brand names: Splenda
Found in: Diet Rite, SoBe Lean Green Tea, sugar-free Oreos, lower-sugar Quaker instant oatmeal
Sweetness: 600 times sweeter than sugar
Year discovered: 1976
Year FDA approved: 1998

Health concerns:
Made with real sugar and chlorine, studies have found no links to cancer, according to the FDA. CSPI says it appears to be safe, but warns that it often is used in conjunction with acesulfame-potassium.

The Basics:

Neotame
Found in: Detour low-sugar energy bar
Sweetness: 7,000 to 13,000 times sweeter than sugar
Year discovered: 1965
Year FDA approved: 2002

Health concerns:

FDA says there are no adverse effects when ingested at levels used in foods. CSPI says it appears to be safe.

The Basics:

Stevia
Brand names: Truvia, PureVia
Found in: Sprite Green, Glaceau Vitamin Water 10, SoBe Lifewater, Trop50
Sweetness: 300 times sweeter than sugar
Year discovered: French researchers isolated the plant’s sweetness in 1931; had been used for centuries in Central and South Americas.
Year FDA approved: Rebaudioside A (or rebiana), a highly purified component of the stevia plant, was accepted as GRAS for use in food in December 2008.

Health concerns:

Derived from a plant, this calorie-free natural sweetener has been used in Japan and elsewhere in Asia and Latin America for decades. Rat studies have shown reduced sperm count, infertility, smaller offspring and DNA mutation. CSPI urges caution, saying stevia needs to be better tested.

Sources: Food and Drug Administration, National Cancer Institute, Center for Science in the Public Interest REDEYE

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