A fight over whether or not to put a new tax on soda is bubbling up in the San Francisco Bay Area. In November, voters in San Francisco will consider a tax on sugary drinks. Many health experts say these drinks contribute to diabetes, tooth decay, and being seriously overweight.

Backers of the campaign say a penny-per-ounce tax is needed in San Francisco, to influence people to cut back on drinking sweetened cola, sports drinks and canned teas. This law would apply to nearby Oakland and the tiny city of Albany, too. Supporters of the tax say that people gulp these drinks without thinking. It is easy to take in empty calories, or calories without any nutritional benefits, this way.

Some Claim Soda Tax Will Hurt Small Businesses

Opponents, however, say a "grocery tax" will lead to higher prices on other goods. They claim this will hurt small businesses and customers struggling to survive in one of the country's most expensive places. They also warn that city leaders can use the money however they want, despite talk of putting it toward health programs.

"We work so hard to keep the price low as much as possible, and we work every day to continue to stay in business," said Adel Alghazali. He recently talked to reporters at his produce market in the low-income Mission District of San Francisco.

Just A Few U.S. Cities Have Similar Taxes

Only a couple of other U.S. cities have added this type of tax so far. Voters in Berkeley approved a penny-per-ounce soda tax in 2014. Philadelphia did so in June, taxing diet drinks as well. The American Beverage Association represents soda companies. The group is going to court to prevent the 1.5-cent-per-ounce tax from taking effect in Philadelphia in January.

Bay Area success this fall could tip the national conversation, said Lawrence Gostin. He is a global health law professor at Georgetown University and tax supporter. Voters in Boulder, Colorado, will also decide on a soda tax measure on Election Day.

"Not long ago, it would have been unthinkable to tax soda, and now, not only are we thinking about it, we're doing it," Gostin said.

Expensive Campaign In San Francisco Bay Area

The Bay Area campaign battle is costly. Opponents of the tax are funded largely by the American Beverage Association which has paid for nearly $10 million in television ad time. Meanwhile, former New York City Mayor Michael Bloomberg has given about $1.7 million to the San Francisco campaign in favor of the tax. He gave more than $2 million to the Oakland campaign.

This is San Francisco's second try to create a soda tax. In 2014, a similar proposal failed to get enough votes for a "dedicated" tax. That kind of tax requires that two-thirds of voters approve it. This year, backers went for a "general" tax, which requires a simple majority of voters say "yes" to it. This tax does not have specific demands about how the tax money is spent.

The beverage industry spent more than $9 million to defeat the 2014 measure. It has said in mailers that with a general tax, the money "could be spent on anything."

Opponents Call it A "Grocery Tax"

People who oppose the tax have also called it a "grocery tax." They argue that business owners will be forced to raise prices on other items to spread the cost. This has made supporters of the tax very angry. The tax is on distributors and is not paid by customers who buy the drinks.

Supporters have fought back with their own nonstop ads. The ads make it clear that voters would be approving a small tax on soda, not on everything else at the store. They point out that the tax will improve the health of children and families.

Both sides want the votes of low-income and minority voters. These groups tend to drink more sweetened beverages.

Reaching Out To Certain Communities

Soda tax backers have reached out to voters in historically black and Latino neighborhoods that rejected the tax two years ago. In turn, the beverage industry has enlisted the help of store and restaurant owners in impoverished pockets of the bay area where there are people of many ethnic and racial backgrounds.  

Clem Howard was among campaign volunteers canvassing the Bayview-Hunters Point neighborhood on a hot Saturday. She checked her clipboard as she knocked on doors.

Howard, who is African-American, said her mother was diagnosed with diabetes but still could not give up drinking several cans of cola a day. Diabetes is a disease where the body cannot properly regulate the amount of sugar in the bloodstream. It is connected with obesity, or being extremely overweight. She said her baby sister and brother-in-law are diabetic but still drink soda, even though her brother-in-law lost a toe to the disease.

"So this is very personal for me," Howard said. "That's why I'm out here working so hard, sharing my story and trying to just spread the word about the impact of sugary drinks."

Sugary Drinks Can Pose Health Risks

Roughly 13 percent of African-American and Latino adults are diagnosed with diabetes. Only 7.6 percent of whites get diabetes. This is according to a 2014 report by the Centers for Disease Control and Prevention.

The American Heart Association recommends children consume less than six teaspoons of added sugar a day. A normal-sized can of Coca-Cola is 12-ounces and contains nearly 10 teaspoons of sugar. It has more than four teaspoons more sugar than children should consume in a day.