Public support for policies to create a healthier food environment in Aotearoa New Zealand: findings from a national survey

The food and beverages (hereafter “food”) we consume affect our risk for developing many types of cancer, including cancers of the oesophagus, stomach, colon, liver, pancreas, gallbladder, breast, ovary, kidney, thyroid, blood and brain.^1,2 In 2023 it was estimated that dietary risks caused over 8% of cancer deaths, and excess body weight caused over 6% of cancer deaths in Aotearoa New Zealand.³ In addition, these food-related risk factors contribute significantly to health loss and deaths from other common non-communicable diseases, including heart disease and diabetes.^3,4 Diet-related disease is disproportionately experienced by Māori and Pacific people and those living in socio-economically deprived communities, contributing to persistent and avoidable health inequities in diet-related disease incidence and mortality in Aotearoa New Zealand.^5–7 As our population continues to grow and age, total health loss and deaths from food-related risk factors will continue to increase, along with costs to the economy and our health system.^8–10

An estimated 30–50% of cancer cases can be prevented globally, including many caused by dietary factors.¹¹ Dietary intakes in a population are unlikely to change without changes to the food environment.¹² Unfortunately, Aotearoa New Zealand does not have a comprehensive food strategy, and utilises limited policies, well out of step with international evidence. In Aotearoa New Zealand, the cost of a healthy diet is outside the reach of many families.¹³ Unhealthy foods and sugary drinks are widely available, heavily marketed and often cheaper than healthier options, contributing to an obesogenic food environment.^14–16 Children and adolescents are routinely exposed to pervasive marketing of unhealthy foods and sugary drinks across traditional and digital media.^17,18

Population-based efforts to prevent cancer and/or diet-related disease, such as policies limiting marketing, availability and affordability of unhealthy food, reduce people’s exposure to food-related risk factors, especially when combined with efforts to increase the availability and affordability of healthy foods.^11,19,20 Long term, these factors can drive both individual dietary patterns and wider societal norms in relation to food. Yet, there is much that remains to be done to create a healthy food environment in Aotearoa New Zealand. Key to implementation, as in any democracy, is the extent of public support. Previous surveys of public support for policies promoting healthy food environments are several years old, and public views may have shifted.^21,22

The current research aimed to improve understanding of public support for key evidence-based policies to create a healthier food environment in Aotearoa New Zealand (as recommended by the World Health Organization [WHO] and World Cancer Research Fund).^19,20 As this is an election year, an analysis of policy support by political party voting intention was included.

Methods

The methods are explained in full in the associated methodology article and only essential details are presented here.²³ In brief, this is a cross-sectional, self-administered online survey study.

Participants were aged 18 years and over, residing in Aotearoa New Zealand. Recruitment was undertaken through an established commercial online research panel. Sampling targets for the initial sample were set using population benchmarks for age, gender and ethnicity derived from the 2023 New Zealand Census, with additional samples recruiting Māori and Pacific people. This approach was intended to support both national estimates and equity-focussed comparisons. Data collection occurred over a 6-week period in November and December 2025. The instrument comprised predominantly closed-ended items addressing public views across multiple areas of cancer policy, including 11 questions specifically related to healthy food environments (Appendix A). For the present paper, analyses were restricted to these 11 survey items relating to healthy food environments and socio-demographic characteristics of participants. Support for or opposition to policies was determined using a six-point scale (strongly support, support, slightly support, slightly oppose, oppose, strongly oppose), with an additional opt-out option (do not want to answer). The scale excluded a neutral option, both in order to discourage this as a default response and because we believe that true neutrality would be very rare in the context.

To ensure sample results represent the national adult population in terms of age groups, gender and Māori ethnicity, total (design and poststratification) weights were calculated using Census data. All analyses report actual frequencies and, for all food-related items, survey weighted percentages. Given an effective sample size of 1,161 after weighting, this provided a worst-case 95% margin of error for a total population percentage estimate of ±2.9%. Results are presented for the total population and separately by age groups, gender, prioritised ethnicity and voting intention.

Ethical approval

Ethical approval processes and Māori consultation procedures are detailed in the methodology publication.²³ Ethical approval was granted by the University of Otago Human Ethics Committee (25/1184).

Results

Results are summarised in Tables 1–2. Demographic differences are reported when present. Further stratified analyses are reported in the Appendix Tables (Appendix B).

Overwhelmingly, most of the population (an estimated 79.5%) thinks politicians should do more to create a healthy food environment, (including 42.7% “a lot more”). Support was considerably higher among younger people (83.4–87.6% for 18–49-year-olds compared with 66.3% for those aged 65+), and substantial across all ethnic groups (74.5–85.7%). Intending voters across all political parties want greater political action to create a healthy food environment, with desire for more action very high among those intending to vote for the Green Party (97.2%), Labour (85.8%), Te Pāti Māori (78.9%) and NZ First (74.2%), and lower (while remaining a majority) among those intending to vote for National (66.8%) and ACT (53.2%).

A clear majority of Aotearoa New Zealanders support each of the 10 proposed food policies (see Table 1). In addition, our results indicate majority support for all policies, regardless of voting intention (Table 2). “Government action to reduce the cost of healthy food” had the most support (88.6% overall support; 53.4% strong support), including substantial cross-party support among voters for current parliamentary parties (76.1–94.9%). Women showed higher support for this policy than men (91.3% versus 85.8% overall support). Over two-thirds of the population (70.6%) support a law setting limits for the amounts of sugar, fat and salt in food products, with support higher among older age groups (63.9% for 18–20-year-olds compared with 76.1% for 50–64-year-olds and 74.2% for those aged 65+), and a clear majority support across voters (57.9–77.8%). A sugary drinks tax is supported by more than two-thirds of the population (an estimated 67.4%). Support increased to 75.6% if the tax is used to make healthy foods more available/affordable, including strong cross-party support (66.8–86.7%). Older people were more supportive of sugary drinks taxes than younger.

Nearly two-thirds of the population (an estimated 62.2%) support banning marketing of unhealthy food, increasing to 66.3% for banning unhealthy food sponsorship at events attended by under-18-year-olds, 66.5% for banning unhealthy food ads in public places and 72.8% for government support to help sports/community groups stop using junk food sponsors. By voting intention, support was mostly similar for the marketing-related policies. Support for banning unhealthy food sponsorship at events had similar support across the current parliamentary parties (61.3–69.5%) as did no advertising of unhealthy foods in public places (66.5–68.4%, with the exception of ACT 59.0%). Banning marketing of unhealthy foods also had majority support across current parliamentary parties, but with a bit more variation (ranging from 55.9% among ACT voters to 67.7% among Green Party voters).

Of the population, an estimated 79.0% agree that “The junk food and sugary drinks industry should not be involved in developing government policies (local and national) that create healthy food environments” (36.3% strong support). Overall support for this policy was higher among older ages (88.5% for those aged 65+ compared with 67.1% for 18–20-year-olds). Further, there was substantial cross-party support among voters that the junk food/sugary drinks industry should not be involved in policymaking to create a healthy food environment (70.9–90.3%).

Government action to reduce the cost of healthy food, no industry involvement in healthy food environment policy, and taxes on sugary drinks (with funds used to make healthy foods more available/affordable) were the top three most-supported policies overall, as well as being the top three for most of the political parties. Green Party voters had the highest or near-highest percentage support for each of the 10 policies (67.7–94.9%). On the other end of the political spectrum, the majority of ACT voters were in support of all policies, though consistently at or near the lowest percentage support for almost all the policies (50.2–79.0%). Supporters of the two main political parties (Labour and National) showed similar levels of support for most policies with one main exception (Taxes on sugary drinks if the money was spent on making healthy foods more available/affordable: Labour 80.4%, National 68.2%).

View Table 1–2.

Discussion

There is a strong public appetite among Aotearoa New Zealanders for politicians to do more to create a healthy food environment, with almost four in five agreeing. This support is cross-party, with the majority of intending voters for all political parties agreeing. There is also strong public support for specific policies to improve the food environment, with majority support (62.2–88.6%) indicated for the policies asked about in the survey. These results support the findings of earlier research,²² indicating there is sustained support for these types of policies to promote a healthy food environment in Aotearoa New Zealand.

There is overwhelming support for government action to reduce the cost of healthy food (nearly nine in 10 support this with more than half indicating strong support). This is not surprising with the current cost of living crisis. The ever-increasing cost of food, which research has indicated is impacting more on healthy food such as fruit and vegetables, compared with unhealthy options such as sugary processed foods, is making it more difficult to maintain healthy dietary habits.¹⁶ Cost is a known driver of dietary habits, particularly among the less wealthy.²⁴ If the trend of disproportionate price increases for healthy foods continues, it is likely to have long-term detrimental effects on dietary habits at a population level. As more people turn to cheaper unhealthy foods, children grow up with those unhealthy foods as their “norm”, leading to less healthy dietary intake in adulthood.²⁵ Targeted food subsidies are recommended by both the WHO and Te Aho o Te Kahu – Cancer Control Agency as a way to make healthy food more affordable and promote better health outcomes in an equitable way.^11,20 However, identifying the best food subsidy policy design requires careful consideration of local context and consultation with key stakeholders to ensure both overall effectiveness and equitable impact.²⁰

Policies that make unhealthy foods that are high in fat, sugar or salt (HFSS) less affordable can help to curb the trend towards low-cost unhealthy foods, especially when combined with policies that improve the affordability of healthy options. We found over two-thirds supported a sugary drinks tax, compared to 2014 when only 44% supported taxing sugar content in drinks.²¹ With support from over three-quarters of Aotearoa New Zealanders, the sugary drinks tax policy where funds collected are used to make healthy foods more available/affordable is the most supported tax policy option, and offers a potential partial solution to the problem of the increasing divide between the cost of fruit/vegetables and unhealthy processed foods. Removing or even reducing the cost barrier to healthy food purchasing should also improve equity.

Aotearoa New Zealanders’ ability to choose healthy options, already limited by cost, is further impacted by constant exposure to compelling marketing of unhealthy foods. It is critical, particularly in the case of children, to reduce exposure to marketing of unhealthy foods. Such marketing is designed to make these products appear especially appealing and can drive consumers disproportionately towards unhealthy foods. Currently, Aotearoa New Zealand children’s worlds are awash with junk food marketing.¹⁸ When asked if they would do anything about junk food marketing if they were prime minister for a day, over two-thirds of children said they would do something, including getting rid of billboards and big signs, and being honest.²⁶ Support for banning marketing was substantial in the current survey. Almost two-thirds of Aotearoa New Zealanders surveyed support a ban on marketing of unhealthy foods, which is higher than the pre-implementation support for smokefree pubs and bars (56%).²⁷

Finally, there is currently an abundance of HFSS processed food products in our food environment.²⁸ A law setting limits on the amounts of sugar, fat and salt in food products, which saw support from over seven in 10 Aotearoa New Zealanders, would reduce the negative health impacts of these products when they are consumed.

With almost four in five Aotearoa New Zealanders indicating support, the public are clear that the junk food/sugary drinks industry should not be involved in the development of policies to create a healthy food environment. Historically, industry lobbying and influence on government decision making has stalled progress towards a healthy food environment for Aotearoa New Zealanders and contributed to policy inertia.¹² With strong support across the political spectrum of voters, there is a clear mandate for all political parties to stop industry involvement. There is also substantial support for stand-down periods between working for industry and government and clear, enforced rules for lobbyists.²⁹

General strengths and limitations are discussed in the methodology article, including reasonable overall precision of estimates and risks of selection and participation biases, but there are also specific issues for the food policy component of the study. While the food policies explored are effective internationally and recommended by the WHO, there are others that were not able to be included in this survey (to minimise respondent burden). For example, reducing the availability of junk food in the environment around schools and in residential areas that children frequent, and a ban on junk food marketing online.³⁰ Nevertheless, the study indicates a range of possible evidence-based interventions with widespread public support across the political spectrum.

Conclusion

Overall, the message is clear that Aotearoa New Zealanders want politicians to do more to create a healthier food environment, with the cost of healthy food a major concern. They also want an end to food industry interference in policymaking. In addition, there is substantial support for a range of policies (e.g., sugary drinks tax, marketing bans, formulation limits) to improve our food environment. Our health system, which is already under immense pressure, will struggle to cope with ongoing increases in cases of cancer and other non-communicable diseases requiring treatment. Implementation of these policies to create a better food environment will help to reduce the incidence and impact of non-communicable diseases such as cancer, heart disease and diabetes, and provide long-term relief to address the burden on our health system. In addition, these policies should reduce diet-related health inequities (e.g., for people experiencing food insecurity, Māori and Pacific people).

View Appendix.