Just over one in seven adults are smokers, one in five are obese, and over half of adults are overweight.
One in five adults have high blood pressure, which is an important contributing factor to heart disease and stroke.
Just half of all adults do the recommended 30 minutes physical activity a day on five days a week, and 60 per cent of people don't eat the right amount of fruit and vegetables each day.
Massey University Professor Sally Casswell, who reviewed the results, agreed that New Zealanders' perceptions of their state of health were at odds with the statistics.
"I think it really shows that a lot of the things that we know are risk factors for ill health don't necessarily impact on people's subjective health status."
Professor Casswell said that in most people's minds, health meant "energy levels and vitality" rather than being associated with physical activity and eating properly.
To identify people with potential future problems with alcohol, the survey of 12,500 people used a test which asked people such things as whether they suffered from memory loss after a drinking session.
Overall, men are more than twice as likely as women to have hazardous drinking habits. Maori men came off worst at 35 per cent compared with 30 per cent of Pacific men and 27 per cent of European men.
Maori men also topped the table for smoking and cannabis use. Around 33 per cent had used it in the past year, compared with 20 per cent of Europeans.
Professor Casswell said that education programmes were not a quick fix for these problems, because most people were aware of the need to behave in a healthy way.
"It's more about changing the environment people live in."
She cited lifestyles where people are "almost forced" to use their cars because there is no public transport, or a dangerous neighbourhood.
"There is some evidence to suggest that people's access to good-quality fruit and vegetables at a reasonable price does have an effect.
"The other side to that is people's access to and increasing reliance on fast foods.
"The survey results suggest the need for more effort in the area of really promoting healthy environments so people's behaviour becomes healthier."
The study also gives an insight into the number of people hit by major diseases. One in five people 45 or older have been diagnosed with heart disease, while one in 12 of that age group have diabetes.
Professor Casswell said very few of the findings offered any surprises, although there were striking differences in the lifestyles of Asian women compared with European, Maori or Pacific Islanders.
No Asian women reported hazardous drinking patterns, compared with 12 per cent of European women, 18 per cent of Maori women, and 9 per cent of Pacific women.
The survey results were useful in monitoring variables that are key risk factors for ill health, she said.
"If we are not seeing improvements in these measures in the future, then we know we are going to have to put more energy and resources into this and to help people change their behaviour."
The Obesity Action Coalition said the findings were a grim picture.
The health problems reported could be caused or made worse by being overweight and obese.
"New Zealanders need to eat better and be more physically active if they are to avoid getting these degenerative diseases as they age," said executive director Celia Murphy. "The economic and social costs of not acting now are really frightening."
Health Minister Annette King said it was encouraging that so many New Zealanders thought they were healthy, but the results showed "obvious areas for improvement".
The survey is the third by the ministry. The previous two were in 1992/93 and 1996/97.
Ministry of Health:
Provisional Results of the 2002-2003 National Health Survey
[PDF]
Herald Feature: Health
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