Overwhelming and cross-party public support for robust tobacco control measures to achieve a Smokefree Aotearoa New Zealand: findings from a national survey

Tobacco use remains a leading cause of preventable disease and premature mortality in Aotearoa New Zealand, accounting for more than one in five of all cancer deaths¹ and contributing substantially to global burdens of disease.² Tobacco smoking is causally linked to multiple cancers, as well as cardiovascular and respiratory diseases.^3,4 Because of long latency between exposure and disease onset, current cancer incidence largely reflects historical smoking patterns.⁴

Harms from tobacco in Aotearoa New Zealand are inequitably distributed. Māori experience substantially higher smoking-attributable morbidity and mortality than non-Māori, reflecting the enduring impacts of colonisation, structural disadvantage and the historical and ongoing exploitation of Indigenous communities by the tobacco industry.^5,6 Pacific people also experience disproportionate tobacco-related harm, and smoking is increasingly concentrated in communities experiencing disadvantage.⁷

Under Te Tiriti o Waitangi, the Crown has obligations to actively protect Māori health, ensure equity and enable tino rangatiratanga for Māori in health decision making. Tobacco control policy in Aotearoa New Zealand is therefore not only concerned with enhancing population health and minimising health inequities, but also with honouring Te Tiriti. Māori leadership has been central to articulating a tobacco “endgame”,⁸ including the Tupeka Kore vision and the Smokefree Aotearoa goal of reducing smoking prevalence and tobacco availability to minimal levels by 2025. The latter originated in the 2010 Māori Affairs Select Committee inquiry into the tobacco industry and was adopted in the subsequent government response.^9,10

Aotearoa New Zealand has implemented a comprehensive tobacco control programme aligned with the World Health Organization Framework Convention on Tobacco Control,¹¹ including smokefree indoor environments, restrictions on advertising and promotion, health warnings, price and tax measures and cessation support.¹² However, recent national data indicate that progress in reducing smoking prevalence has stalled, suggesting that further reductions will likely require stronger, system-level measures beyond business-as-usual approaches.^7,13

The 2020–2023 Labour-led Government introduced a Smokefree Aotearoa 2025 Action Plan,¹⁴ and in 2023 passed legislation¹⁵ introducing three world-leading endgame tobacco control measures: mandated reduction in nicotine content of smoked tobacco products to make them non-addictive (“denicotinisation policy”); a 90% reduction in tobacco retailer numbers to restrict the availability of cigarettes and other tobacco products; and prohibition of sale of tobacco products to people born after 1 January 2009 (“tobacco-free generation policy”). Modelling indicated that these measures, particularly denicotinisation, would substantially reduce smoking prevalence and Māori/non-Māori smoking prevalence and health inequities.¹⁶

Rapid increases in adolescent and youth vaping after 2020 created considerable public concern,¹⁷ prompting the Labour- and National-led governments to introduce measures including a ban on disposable vapes and nicotine strength limits to reduce uptake of vaping among young people.

Robust tobacco control and vaping regulation policies attract strong supportive advocacy but are often highly contested, notably due to co-ordinated tobacco industry activities. The former is demonstrated by ongoing calls for further action to strengthen regulatory approaches; for example, by restricting the accessibility and affordability of vapes to young people.¹⁸ The fragility and contested nature of tobacco control policy was graphically illustrated in Aotearoa New Zealand when, despite concerted opposition, notably from the health sector, the incoming National Party–led Coalition repealed the three key measures from the Smokefree Aotearoa 2025 Action Plan in February 2024.¹⁹ This episode underscored the importance of governance mechanisms that protect public health policymaking from commercial interference.²⁰

Public support is an important component of policy justification and a critical determinant of the political feasibility, implementation and durability of public policy.²¹ Assessing public support is therefore essential to inform public health advocacy, evidence‑based policymaking and regulation aimed at reducing tobacco-related harm and advancing health equity. International evidence, including from Aotearoa New Zealand, demonstrates public support for many tobacco endgame policies, with the strongest support consistently observed for a denicotinisation policy for smoked tobacco, where support commonly exceeds 70% in the general population.²² Although support for endgame policies is lower among people who smoke, it remains substantial, particularly among those who express a desire to quit or regret smoking.^23,24 In Aotearoa New Zealand, repeal of the 2022 Smokefree legislation occurred despite evidence of substantial public support for the three key policies.²⁵ However, there is limited current (post-repeal) research assessing support for key tobacco control policy options in Aotearoa New Zealand.

To address this gap, we report findings from a nationwide, cross-sectional online survey assessing support for evidence-based cancer-related policies in Aotearoa New Zealand. This report focusses on describing public support overall and by voting intention for key tobacco control and vaping regulation policies. These policies included the repealed tobacco endgame measures from the Smokefree Aotearoa action plan, two measures that have been proposed to help reduce youth vaping uptake¹⁸ and other key tobacco control measures proposed internationally. The latter includes raising the age of legal sale of tobacco products to 21 years (“T21 policy”),²⁶ introducing levies on tobacco companies to limit their profitability and provide funding to address the adverse health and environmental impacts of smoking,²⁷ and ending the sale of smoked tobacco products altogether.²⁸

Methods

Full methodological details are published in the study methodology paper published elsewhere in this journal.²⁹ Briefly, adults aged ≥18 years were recruited via a large commercial online panel using quota sampling to achieve national representativeness by age, gender and ethnicity, with additional targets for Māori and Pacific people.

Data were collected in November–December 2025 using a structured questionnaire comprising predominantly closed-ended items covering cancer prevention, early detection, treatment and supportive care and related policy domains.

Respondents were asked to indicate their level of support or opposition to measures including reducing nicotine content in cigarettes and tobacco products to non-addictive levels, restricting retail availability of tobacco and vaping products, creating a tobacco-free generation by prohibiting tobacco sales to those born after 2008 (corresponds to individuals born on or after 1 January 2009) and raising the minimum legal age of sale for tobacco, vaping and other nicotine products to 21 years. The survey also examined support for the introduction of an excise tax on vaping products to reduce affordability for children, and government levies on tobacco companies to recover healthcare and environmental costs associated with tobacco use. Finally, we assessed support for a complete ban on the sale of smoked tobacco products and asked respondents whether they agreed with the Government’s decision to repeal legislation that introduced the three world-leading tobacco control measures. Following initial recruitment, wording of the repeal question was amended to improve clarity, resulting in exclusion of the first 107 responses from analyses of that item.

Policy items were measured using a six-point scale ranging from strongly support to strongly oppose, with a do not want to answer option, while views on the repeal were captured using agree, disagree and unsure response options. The survey instrument is available in the Appendix of the methods paper in this series,²⁹ with specific tobacco questions provided in Appendix A of the current paper.

We used design and poststratification weights to align the sample with 2023 New Zealand Census population benchmarks for age groups, gender and Māori ethnicity. Analyses provided estimates of support among the total population, and by age group, gender, prioritised ethnicity and voting intention (Appendix B). Based on the effective sample size of 1,161 after weighting, the approximate worst-case margin of error for a total population percentage is ±2.9%.

Ethical approval

Ethical approval was granted by the University of Otago Human Ethics Committee (25/1184) and Māori consultation procedures are described in the methodology paper.²⁹

Results

Results are summarised in Table 1 (detailed levels of support by policy) and Table 2 (total support for each policy by voting intention). Additional stratified analyses are reported in the Appendix tables (Appendix B).

There was substantial or overwhelming support for all nine of the tobacco and vaping policies (Table 1). Total support (strongly support/support/slightly support combined) varied between 77.0% and 85.0% for eight of the policies. The exception was stopping the sale of tobacco products altogether, which was supported by a slightly lower proportion (70.0%) of participants. Strongly support varied between 37.3% and 52.0% and was greater than total opposition (strongly oppose/oppose/slightly oppose combined) for each of the nine policies (range 12.4–27.5%).

Support for the policies by age group, gender and prioritised ethnicity mostly did not vary substantially (see Appendix tables). The exceptions were that support for most policies was lowest in the 18–20-year-old age group and highest in people aged 65 or older, and support was somewhat lower for most policies among Māori participants and males. However, there was still substantial majority support for all nine measures among 18–20-year-old, male or Māori participants.

View Table 1–2.

Of particular note, 18–20-year-olds supported both of the measures that would most affect their age group—the tobacco-free generation policy (74.2% total support) and raising the age of legal sale to 21 years (74.8%).

Table 2 shows support by voting intention. There was substantial majority support for all nine measures regardless of voting intention, including among people who intended to vote for parties making up the current Coalition Government (ACT, National, NZ First). For five of the nine measures, support was lowest among people who intended to vote for NZ First. However, there was still majority total support for all nine measures among NZ First voters.

With regards to specific measures, there was very substantial support for all three of the world-leading measures introduced by the previous Labour-led Government that the current Government repealed: reducing nicotine content of cigarettes so they are no longer addictive (84.2% total support), reducing the number of places allowed to sell tobacco products (77.0% total support) and a tobacco-free generation (78.1% total support). Majority support was also present for these measures among ACT, National and NZ First voters: reducing nicotine content of cigarettes (78.6–88.6% total support), reducing the number of places selling tobacco products (64.4–79.2% total support) and a tobacco-free generation (64.8–76.9% total support).

In response to the question asking whether participants agreed with the current Government repealing the law that introduced the three world-leading tobacco control measures, 27.2% agreed, 50.5% disagreed and 22.3% were unsure or did not want to answer. The proportion disagreeing with the repeal was higher than the proportion agreeing with the repeal regardless of voting intention.

Discussion

This study found overwhelming public support and minimal opposition in Aotearoa New Zealand for implementing rigorous tobacco control policy measures. Strong support was evident for the three key measures from the 2021 Smokefree Aotearoa Action Plan that were subsequently repealed by the National-led Coalition Government. Similarly, there were high levels of support for imposing levies on the tobacco industry to recover health and environmental costs resulting from the use of tobacco products, and for raising the age of legal sale to 21 years—a measure that has been implemented at locality, state and federal levels in the United States of America.²⁶ Firm majority support was evident even for the most rigorous policy investigated—ending all smoked tobacco product sales.

The findings align with previous surveys. For example, an assessment of public support for the three key Smokefree Aotearoa Action Plan measures just prior to their repeal found 77% support for denicotinising smoked tobacco products, 68% support for reducing tobacco retailer numbers from 6,000 to 600 and 65% support for the tobacco-free generation policy.²⁵ Levels of support for these policies were even stronger in this survey, demonstrating that there is sustained and even growing public support for robust tobacco control policy measures.

There were mostly similar levels of support across different age groups and ethnicities and by gender. A striking and unanticipated finding was the high level of support for both the tobacco-free generation and T21 policies among people aged 18–20 years, as this group might have been expected to negatively view having their ability to buy tobacco products restricted. However, the findings align with key themes from a qualitative study with young people in Aotearoa New Zealand that found that most young people attribute a low value to being able to purchase tobacco products and valued more highly the societal benefits, such as protection from addiction and future health harms, that a tobacco-free generation policy would introduce.³⁰

The analysis by voting intentions demonstrated cross-partisan support for tobacco control policies, which was strong among supporters of all political parties. This included similarly high levels of support among people who intended to vote for the parties making up the current Coalition Government (albeit slightly lower among NZ First voters). This is particularly salient given the Coalition Government both repealed the Smokefree Aotearoa Action Plan measures and failed to introduce any new tobacco control policies in its own action plan.³¹ This further highlights the lack of democratic mandate for the repeal that occurred in 2024.³² It also reveals a deep disconnect between the current Government’s tobacco control actions and public opinion (including that of its own supporters), and reinforces both the political feasibility and imperative for implementing robust tobacco control policies.

The survey also demonstrated strong support for strengthening the regulation of vaping through two measures aiming to reduce the accessibility and affordability of vaping products for young people.

General strengths and limitations are discussed in the methodology article,²⁹ including the acceptable precision of estimates and the risks of selection and participation biases. A specific strength of the tobacco and vaping policy component of the study is the analysis showing that support for policies was similar by voting intention, despite the very different policy positions of the main political parties.

A minor limitation is that the effective sample size for the question on support for repeal of the Smokefree legislation was reduced due to a wording change, which resulted in the loss of the first 107 responses.²⁹ Additionally, we did not collect information on smoking or vaping behaviours and therefore could not stratify responses by smoking or vaping status. Finally, the tobacco-free generation and mandated denicotinisation policies are conceptually complex and participants may have not understood their detail and nuances. However, both policies were widely discussed when the legislation was introduced and particularly after their proposed repeal, when there was extensive media coverage. In addition, similar levels of support for these policies have been found in other surveys in Aotearoa New Zealand and internationally with a variety of question wordings.^22,24 For example, the EASE survey asked about support for denicotinisation of cigarettes and tobacco in the context of still being able to get nicotine in products other than tobacco products and found similar levels of support among people who smoke or had recently stopped smoking.²⁴ Further research using in-depth qualitative studies will help explore policy understanding and reasons for supporting or opposing these policies, although where this has been done it has generally reinforced the evidence for strong public support.³⁰

Conclusion

In conclusion, this survey demonstrates that the public overwhelmingly supports the implementation of more robust tobacco control interventions to rapidly and equitably reduce smoking prevalence, and that governments have a clear mandate for decisive action. Politicians of all political parties should make introducing strong, effective tobacco control measures a priority and should be held accountable if they fail to do so. Aligning policy with this democratic mandate in order to finally achieve the Smokefree Aotearoa goal for all peoples is an opportunity to greatly improve population health, reduce health inequities, prevent the huge social, environmental and economic costs of tobacco smoking, honour Te Tiriti o Waitangi and protect future generations from the scourge of tobacco.

View Appendix.