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Despite the overwhelming accumulated evidence of the negative effects of nicotine intake, the prevalence of tobacco use is not expected to decline in the near future in several countries. Israel and Portugal both signed the WHO Framework Convention on Tobacco Control (WHO FCTC) and implemented several strategies to achieve Positive Public Health Outcomes (PPHO) (e.g. policy making, legislation). Nevertheless during the past 10 years the number of smokers in Israel has decreased from 28% (in 2000) to about 20.6% (in 2017), while in Portugal, the number of smokers has not changed (2002, 19.2%). However, it has increased for women and adolescents. The goal of PH.PIE project (Public Health Policy Implementation &amp; Evaluation) is to document policy development and implement Health Impact Assessment (HIA) towards a knowledgeable civic society, searching for the real PPHO. Tobacco control is a selective topic because of its high relevance in public health. PH.PIE considers policy making and stakeholder analysis to comprehend HIA of strategic public health issues and PPHO. The tobacco industry during the last 10 years has invaded the market with a comprehensive new approach, built around the concept of harm reduction and turnaround strategies to counteract WHO FCTC principles. This way, public health has apparently lost its grip from its own argumentative discourse, while several stakeholders have positioned themselves in the co-working facelift of nicotine use with smokeless tobacco, electronic cigarettes, and other forms of use that have not been scrutinized in terms of their real potential on public health terms. Harm reduction approaches take the front line, in contrast to smoking cessation efforts as a cornerstone of WHO FCTC. We argue in this paper that health literacy can be critical tool in re-making nicotine addiction in the homo salus upbringing.

european journal of public health

Public health policy implementation and evaluation in portugal and israel (Project PH.PIE): the intersectoral pledge and the case of health literacy for tobacco control in the building of the Homo Salus