NSW Health Minister Ryan Park has identified illicit tobacco as the single biggest preventable health challenge facing the state over the next decade, during the NSW Great Health Debate hosted by the Public Health Association of Australia and the University of Sydney. Park expressed concerns that the government had initially hoped vaping would help smokers quit but is now worried it could lead to another generation becoming addicted to nicotine. He stated that governments, public health officials, and researchers had made significant progress in curbing tobacco rates in the last century, and he does not want to be the minister who sees this progress undone. Park acknowledged that the government has strengthened regulations and is closing down 15 to 20 illegal tobacco stores every week, but admitted there is more work to be done. He emphasized that the proliferation of these stores and the availability of illicit tobacco products keeps him up at night, and he does not want to leave a legacy where insufficient action was taken. During the debate, other health leaders presented their views on preventative healthcare. NSW Greens health spokesperson Dr Amanda Cohn called climate change the number one issue, while shadow minister for health Sarah Mitchell highlighted childhood obesity and declining vaccination rates. Cohn also advocated for a standalone preventative health agency in NSW, similar to those in Victoria and South Australia, to ensure preventative strategies are implemented across the state. Mitchell supported funding preventative health initiatives beyond election cycles but did not endorse a standalone agency. Park expressed doubt that a new agency would be more effective than existing bodies. The debate also covered gambling reform, with strong divisions among participants. Mitchell noted that problem gambling is not black and white, as poker machines are important for regional pubs and clubs' revenue and community engagement. Cohn shared a case of a woman who collapsed in an emergency department due to lack of food and water while gambling, stating that clubs are preying on people with addiction. Park acknowledged the challenge of online gambling and mentioned recent investments in gambling support services. The debate highlighted the complex interplay of health issues facing NSW, with a focus on preventative strategies and the need for coordinated action across government and community sectors.