The politics of health taxes: Understanding the power and influence of the food and alcohol industries in New Zealand

Abstract

Background and Aims: The consumption of ultra-processed foods and alcohol are key risk factors for noncommunicable diseases (NCDs)—the leading cause of death and disability globally. Evidence-informed policies and interventions to reduce these risk factors are urgently required. However, around the globe, governments attempting to adopt such population-level policies face significant industry opposition. This thesis explores how industry actors stymie policy action at the national level, specifically, the role of commercial interests in the non-adoption of ultra-processed food (UPF) taxes and alcohol pricing policy over a 20-year period in New Zealand. Methods: I employed process tracing methods involving analysis of documents and semi-structured interviews. Source materials were websites, industry trade journals, news articles, policy documents and information obtained through Official Information Act requests. I conducted 19 interviews with political elites directly involved in decision-making processes related to the two policy domains and an iterative qualitative analysis was guided by a business power framework which considers the structural, instrumental and ideational dimensions of power. Findings: The food industry’s sources of instrumental power, including institutionalised collaboration, strong cohesion through a single trade association and substantial access to media helped to keep UPF taxes off the agenda throughout the period of study. The alcohol industry, represented by sectoral trade associations, was less successful in keeping pricing off the agenda. Still, its power—partly derived from informal ties to politicians and officials—was still sufficient to prevent major policy change. The alcohol industry’s structural power also played a role. An important finding of this research is that power operates via anticipated reactions. Industry’s instrumental power was enhanced by ideational power in both policy domains. Conclusions: Pricing policy inaction was the result of opposition by industry actors with substantial resources, the risk aversion of vote-maximising politicians who wanted to avoid conflict with industry actors, and exclusionary processes which marginalised public health actors and ideas. These findings have important implications for our understanding of the mechanisms by which public health may be subverted by commercial interests.