A clear political divide has emerged over how far the next Government should go to tackle tobacco, alcohol and unhealthy food, with parties on the political left showing the strongest support for tougher public health measures.
A new Health Coalition Aotearoa election policy survey shows the Green Party, Te Pāti Māori and Labour providing the strongest backing for evidence-based prevention policies aimed at reducing avoidable illness, easing pressure on the health system and protecting government decision-making from industry influence.
The findings have particular significance for Māori, with tobacco, alcohol, obesity and unhealthy diets collectively responsible for a substantial burden of preventable death and disability and those harms falling disproportionately on Māori and Pacific communities.
Health Coalition Aotearoa says these risk factors contribute to around a quarter of healthy years of life lost to preventable death and disability — amounting to more than 350,000 disability-adjusted life-years every year.
Tobacco endgame wins strongest backing
Among the policies attracting the widest support was the reinstatement of New Zealand’s tobacco endgame legislation.
The previous Smokefree legislation included measures to dramatically reduce the number of tobacco retailers, lower nicotine levels in cigarettes and progressively prevent younger generations from legally purchasing smoked tobacco.
Those measures were repealed by the National-led Government after it took office.
Health Coalition Aotearoa’s survey indicates restoring tobacco endgame measures is one of the prevention policies with the strongest support among responding political parties.
For Māori, smoking remains an important equity issue because tobacco-related illness and mortality have historically fallen disproportionately on whānau Māori.
School lunches also emerge as election issue
Restoring the Healthy School Lunches Programme to what Health Coalition Aotearoa describes as an optimum design was another policy attracting significant support.
School lunches have become an increasingly contested political issue following changes introduced by the current Government.
Supporters of universal and expanded school food programmes argue they can improve nutrition, reduce pressure on household budgets and ensure children are able to learn without hunger becoming another barrier in the classroom.
The issue carries particular relevance during a cost-of-living crisis in which many whānau are facing increasing pressure from food, housing, electricity and other household expenses.
National and NZ First don’t respond
However, voters have been left without direct answers from two of the country’s major political parties.
National and New Zealand First did not complete the Health Coalition Aotearoa survey.
Neither party attended the organisation’s Political Forum on Prevention at Parliament in August.
Health Coalition Aotearoa co-chair Professor Boyd Swinburn says the organisation wanted to identify areas where political parties could find common ground so effective prevention policies could survive changes of government rather than being repeatedly introduced and removed depending on which parties hold power.
ACT was the only party on the political right to complete the survey.
Its response showed support for some tobacco-control measures and policies dealing with conflicts of interest, but opposition to most of the other prevention proposals put forward.
The Opportunity Party was not included in the survey but has subsequently released Healthy People and Clean Up Politics policies that Health Coalition Aotearoa says closely align with a number of its priorities.
Who gets a seat at the policymaking table?
The survey also moves beyond tobacco, alcohol and food to ask a bigger question about who influences public policy.
The Greens, Te Pāti Māori and Labour showed broad support for stronger lobbying rules, better management of conflicts of interest and increased transparency around government decision-making.
Health Coalition Aotearoa wants stronger protections against undue commercial influence when governments develop policies affecting products capable of causing significant health harm.
That includes scrutiny of the relationship between policymakers and industries involved in tobacco, alcohol and unhealthy food.
The organisation argues prevention policies should primarily be driven by public health evidence rather than the commercial interests of industries affected by regulation.
Alcohol and taxes prove harder political sell
There was less political enthusiasm for some of the more controversial measures.
Health Coalition Aotearoa co-chair Jason Alexander says parties were more reluctant to support taxes targeting unhealthy commodities, while support was also weaker for significant alcohol law reform and embedding Te Tiriti within relevant legislation.
That is despite the coalition arguing there is substantial evidence that pricing, taxation and regulatory measures can reduce consumption and improve health outcomes.
Alcohol harm remains particularly significant for Māori because the consequences extend beyond individual consumption and can intersect with injury, violence, mental health, whānau wellbeing and pressure on health and social services.
Prevention versus treatment
The survey raises a much larger question as Election 2026 approaches.
Political parties are promising billions of dollars for hospitals, doctors, medicines and frontline health services.
But Health Coalition Aotearoa is challenging them to explain what they will do to prevent people becoming sick in the first place.
Reducing smoking, alcohol harm and unhealthy diets could potentially prevent thousands of people requiring treatment while reducing long-term pressure on an already stretched health system.
For Māori, prevention is also an equity issue.
When preventable disease disproportionately affects Māori communities, policies capable of reducing that disease burden can have an equally disproportionate benefit.
That means the election health debate is about more than hospital waiting lists, GP appointments and how many doctors New Zealand can recruit.
It is also about whether the next Government is prepared to confront some of the commercial and social drivers putting people into those waiting rooms in the first place.
And on that question, Election 2026 is revealing a significant political divide.
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