Centre for Health Research and Education (CHRE)

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The Centre for Health Research and Education (CHRE) states that it is “A health research and education company run by medical doctors in service of public health” and its aim is “bridging the policy & practice gap”.1 CHRE receives grants from the Foundation for a Smoke Free World (FSFW), an organisation wholly funded by Philip Morris International (PMI).2345

Background

According to the CHRE website, the company is based in Hampshire, UK, at the University of Southampton Science Park.678 It was registered as a private limited company with UK Companies House in August 2018, with the registered business address in Chandlers Ford, Hampshire.29

In 2020, CHRE’s website stated its goal as “preventing Cancer through research and evidence based policy and practice interventions” and it identifies its priorities as smoking cessation and obesity prevention. The cessation resources on its website recommend Nicotine Replacement Therapies (NRT) and e-cigarettes.10

As of 2020, its website stated that “CHRE does not receive any funds from tobacco, pharmaceutical or e-cigarette companies”.11

It also stated that:

“If there are research and evidence gaps regarding “unhealthy” behaviours, those gaps need to be plugged by all the stakeholder groups that have a vested interest in improving public health in the context of those behaviours. We are committed in advocating for and enabling such research, shaping policy, and help bridge the divide between policy and practice.”
[original text in bold]12

The CHRE website was updated in 2021.13

Relationship with the tobacco industry

According to his LinkedIn profile, CHRE Medical Director Dr. Sudhanshu Patwardhan worked for British American Tobacco (BAT) from 2005 until February 2019, and became one of the two directors of CHRE in February 2019.14 According to UK Companies House records he was appointed Director of CHRE in August 2018 (see below for more details).15 A conflict of interest statement on a 2021 journal paper about nicotine pouches highlighted S. Patwardhan’s prior work with BAT subsidiary Nicoventures and also that co-author Karl Fagerström “currently receives consulting fees from Swedish Match [a manufacturer of nicotine pouches] and has received fees in the past from tobacco companies to assist their development of less-risky tobacco products.”16

CHRE received project funding from the Foundation for a Smoke-Free World in 2019, 2020, 2021 and 2022 (see below).2345

Activities

On the centre’s “Projects” webpage it states that it is “working with local partners in South Asia to build capacity among healthcare professionals in tobacco de-addicton [sic] and national health programmes for TB, cancer prevention and Maternal and Child Health.”17 Other CHRE material states that they have projects in India and Bangladesh.18

The Projects webpage includes a logo for a “Tobacco Research and Cessation Network” (TRC-NET) but there is no further information on CHRE’s website about this network.17 The logo is also included on web pages and materials for CHRE’s summits on cessation and mental health (see below). FSFW’s July 2020 country report on India featured an expert endorsement from Dr. Gaurav Kale, stating that he represented the “Maharashtra Secretariat” of TRC-Net.19 The report was also endorsed by Sudhanshu Patwardhan and Dr. Pooja Patwardhan.19

In 2020, it appeared that CHRE was exploring the feasibility of establishing a network for tobacco research and cessation in India, with funding from FSFW (see below). An article by director Sudhanshu Patwardhan, published in July 2020, states that “ the authors are involved in preparing a systematic training programme for HCPs [Healthcare Professionals] to upskill them using global best practice applied to locally available cessation treatments.”20 It goes on to say that this work will involve the creation of “nationally relevant cessation protocols and guidelines, including those for smokeless tobacco products” (defined elsewhere in the paper as oral tobacco).20 After piloting and validation, the intention is for the programme to be rolled out across India, and shared with neighbouring countries in South Asia.20 The article refers to findings from the authors’ research in India, and they note that this is not yet published.

The planned programme does not appear to be restricted to using standard Nicotine Replacement Therapy (NRT) but mentions the use of other newer nicotine and tobacco products including e-cigarettes (also known as electronic nicotine delivery systems, or ENDS) and nicotine pouches, stating that:

“Regarding alternative nicotine products, manufacturers need to work with policymakers to create and comply with regulatory frameworks that ensure consumer safety and quality assurance and prevent youth uptake. This is particularly true in the case of e-cigarettes and nicotine pouches, both product categories with a promising role in smoking cessation due to their harm reduction potential.”20

A law was passed in India in 2019 banning the manufacture, sale and promotion of e-cigarettes.21

In December 2023 The Times newspaper published an article that described how CHRE helped promote e-cigarettes in the UK.22

See below for details of publications and other outputs.

Funded by the Foundation for a Smoke-Free World

CHRE received project funding from the Foundation for a Smoke-Free World in 2019 and 2020.23 Information published on the FSFW website, stated that the project aim was the “Development of insights on UK’s remaining smokers and their healthcare advisers’ needs and wants to help achieve smoking cessation; identification of priority interventions needed to achieve maximal and broadest impact of smoking cessation in the UK.”23 (Note that in 2020, the FSFW website stated that the aims were  to “Synthesize and formulate lessons learned from countries with ANDS availability which have seen drastic drops in number of smokers” [ANDS, not defined here: Alternative Nicotine Delivery Systems]; and the “identification of observable smoker characteristics that are linked to cessation success”.24 However, as of 2021 this text appeared in the entry for Ernst and Young.23)

According to the FSFW’s 2020 tax return, CHRE was awarded a total of US$3,449,956 between 2019 and 2021.34 As of 27 May 2021, there was no information about FSFW funding on the CHRE website. In 2022 CHRE was awarded US$3,584,019 by FSFW, the majority of which was for its work in India (see below).5

In November 2019, CHRE was awarded a grant of US$450,115 (GB£348,570) to fund a “Smoke-free UK landscaping project – reaching the ‘hardcore’ of smokers and supporting quitting”, according to the FSFW’s 2019 tax return.2 The tax return also stated that the aim of the funding was to “Achieve and sustain smokefree at UK’s Priory Group Mental Health Hospitals”.2

The Priory Group is a private healthcare company that provides services to the UK National Health Service (NHS) and was listed as a co-sponsor of CHRE’s 2019 and 2020 mental health summits (see below).25 A Director of Priory Group gave a presentation on smoking cessation and mental health at CHRE’s summit in September 2019.26 Searches of the Priory Group website in May 2020 for mentions of CHRE produced no results until a blog post was published on 31 May, on World No Tobacco Day.27 This stated that “At Priory Group, we have been working with experts from Centre for Health Research and Education (CHRE) to upskill and empower our staff to provide support to patients for quitting smoking successfully.”27 It quoted Dr. Rick Driscoll, Visiting Consultant at Priory Hospital Bristol and Expert Adviser to the CHRE, and said that Priory had been working with CHRE since 2019 “to support all willing smoker patients in their quitting journey”.27

CHRE declared the FSFW grant on an event listing for its 2020 “Smoke-Free Mental Health Summit”.28  The text, in small type at the bottom of the page (see Figure 1), stated that “FSFW has no role in determining the agenda, content or programme of the project including the Summits.” 28 The event was listed as a “report or publication” sponsored by FSFW.29 It was postponed due to the Covid-19 pandemic; as of July 2020, it was not clear whether or when the event

Figure 1: Screenshot of CHRE event web page with reference to the FSFW grant.28

Although it was not clear if he was due to speak at the 2020 summit, Sudhanshu Patwardhan, Medical Director of CHRE, spoke at the 2019 event (see below).

Funded for research in India

In July 2020, information on grants uploaded to the FSFW website showed that CHRE was also awarded a grant in January 2020 for “Evaluating the feasibility and establishment of a multi-center network for tobacco research and cessation in India”. This included scoping work and “Development of a coherent and bold vision” by July 2020.30 The 2021 FSFW tax return indicated that CHRE had been paid US$1,527,783 that year for “Capacity building to reduce tobacco related death and disease in India”.4 and in 2022 CHRE received an additional US$1,196,504 from FSFW to “Build and strengthen tobacco harm reduction and cessation knowledge and capacity in India”, as well as a further US$2,037,044 for the capacity building project.5

Since the grants were awarded, the directors of CHRE have discussed cessation in India in various articles and webcasts (see below for details). The two directors of CHRE are also listed as directors of a private company registered in Pune, India. (see below)

Key staff

CHRE’s website did not have a page listing staff, as of July 2020. According to Companies House, its two directors and sole shareholders are Sudhanshu Ramesh Patwardhan and Pooja Sudhanshu Patwardhan.3132

Sudhanshu Patwardhan is named as Medical Director.14 His role has been described as including responsibility for Policy.33 According to his LinkedIn profile, he worked for British American Tobacco (BAT) for nearly 14 years. From 2005 to 2008, he held scientific roles. From 2008 to 2013, he was responsible for “Corporate and Regulatory Affairs” where he “Strategically led the business to make the first global acquisition by a FTSE 10 company in the electronic cigarettes category, to bring scale and global availability of reduced risk alternatives for smokers who would not or could not quit smoking”.14 BAT’s first e-cigarette acquisition was Vype in 2012. In 2013, he then went on to work in BAT’s newer nicotine products company Nicoventures, on the “global nicotine KOL ecosystem to facilitate smoking cessation and serve public health”14 (The term KOL stands for “Key Opinion Leaders”). During this time, his job title was Senior International Engagement Manager.3435

On a BAT webpage, in connection to its 2008 Sustainability Report, Sudhanshu Patwardhan described his role as BAT’s “interface with the medical and public health communities” and stated that:36

“One of the biggest challenges we face is our limited freedom to finance external research because of restrictions on third parties receiving funds from the tobacco industry. It’s frustrating that, unlike other multinational companies, we are unable to collaborate freely with academic centres of excellence to drive science and innovation. We are actively seeking constructive solutions to overcome this challenge”.36

He left BAT in February 2019.14

Sudhanshu Patwardhan is listed as a mentor for the Tobacco Harm Reduction Scholarship programme run by Knowledge Action Change (KAC), which is also funded by FSFW.237

He was listed as a speaker at the Global Forum on Nicotine (organised by K-A-C) in 2016,38 and in 2018.3940 He has also attended the tobacco industry event the Global Tobacco and Nicotine Forum (GTNF), previously called the Global Tobacco and Networking Forum.

In September 2020, he was listed as key speaker and co-organiser at an event funded by FSFW called “15 Years of Framework Convention on Tobacco Control”, which ended on 1st October 2020.41 See Events below for further details. Sudhanshu Patwardhan was described as “guest editor” of the associated special edition of journal Drugs and Alcohol Today.4243

Pooja Patwardhan’s role is Clinical Director of CHRE.28 As of June 2020, her LinkedIn profile states that she is a “Medical Doctor: Self-employed” but contains no further information.44 She has been registered as a General Practitioner (GP) with the UK General Medical Council (GMC) since 2011, is licensed to practice in the UK, and is on the GP register (a requirement to be employed as a GP in the UK).45

Sudhanshu Patwardhan has been registered as a (GP) with the GMC since 2013, and is licensed to practice in the UK. As of June 2020 he is not listed on the GP register.46

Sudhanshu Patwardhan and Pooja Patwardhan are named as two of the three directors of a private company registered in Pune, India in August 2019, called the Paarth Centre for Healthy Futures, whose registered address is Utkarsha Hospital in Solapur in the state of Maharashtra.47 The third director is listed as Vikas Vinayak Kirpekar, who is also a director of Utkarsha Hospital Private Ltd.4748

Outputs

Webinars, Podcasts & Radio Interviews

On 29 April 2020, Pooja Patwardhan took part in a podcast on ‘global health perspectives’ hosted by Derek Yach, President of FSFW.4950 The FSFW website states that she has “upskilled and empowered 100s of influencers in UK as well as in India, as part of the mission of creating local champions, to support tobacco users in their quitting journey”.49 It also states that she has been “at the forefront of creating and disseminating “Quit During Covid” message using innovative ways”.49 It is not clear what the term “influencer” here refers to as no further details are given on the website.

In June 2020, around the time of World No Tobacco Day, Pooja Patwardhan was interviewed by several local radio stations in the UK, including two local BBC stations. According to the FSFW website, she talked about quitting tobacco and “national and regional results of the COVID-19 poll”.51 This refers to a poll commissioned by FSFW and conducted by market research company Nielsen, in the UK, Italy, South Africa, India, and the US.52

In August 2020, Sudhanshu Patwardhan was listed as the only guest speaker at a webinar hosted by the Lee Kuan Yew School of Public Policy, Singapore, and chaired by Professor Tikki Pangestu, Visiting Professor at the Lin School of Medicine, National University of Singapore.53 The webinar was titled “FCTC- the policy and practice gap” and aimed to “propose a set of approaches and solutions for realising the public health potential of FCTC”.53 Invitations to the seminar were sent to public health advocates, but by 21 August the event had been cancelled, with no explanation given on the event web page.53 Tikki Pangestu was former Director of Research Policy & Cooperation at the World Health Organization, for over a decade, until he left in 2012.5455 He also took part in a FSFW podcast, in May 2020. 4956

Articles

On 7 April 2020, Pooja Patwardhan (PP) published an article in BJGP Open, the journal of the British College of General Practitioners, discussing the risks for smoking rates rising during the COVID-pandemic.57 According to the author’s disclosure: “PP or CHRE have not received any funding from pharmaceutical, electronic cigarette, or tobacco industries.”57 The article was not peer reviewed.57 In July 2020, this paper was listed as an FSFW sponsored publication.29 A correction to the ‘competing interests’ section of this article was subsequently issued by BJGP Open on 19 January 2021. The correction removed the statement “PP or CHRE have not received any funding from pharmaceutical, electronic cigarette, or tobacco industries”, instead saying “CHRE has received grants from Foundation for a Smoke-free World, Inc (FSFW)… FSFW describes itself as a non-profit, independent organisation which is funded by Philip Morris International Global Services, Inc.” and that “PP did not receive specific funding and it has been written in a personal capacity,”.58 Pooja Patwardhan says that the paper was removed from the FSFW website at the author’s request in August 2020.59 It is no longer listed on the site.60

Sudhanhsu Patwardhan published a related blog article on the Royal Society for Public Health (RSPH) website.61 The conflict of interest statement said that “SP or CHRE do not receive any funding from pharmaceutical, electronic cigarette or tobacco industries.”61 Pooja Patwardhan also contributed a news item on the RSPH website where she talks further about the role of GPs and smoking cessation during the Covid-19 pandemic and the material the CHRE has produced for GPs.62 There is no mention of who funds the CHRE in the article or on the infographics produced.

On 26 May 2020, Pooja Patwardhan published a blog post on the same topic in Nicotine Science and Policy, which is produced by Knowledge Action Change.6364. In the blog, Pooja Patwardhan said:

“As a practising GP and a firm believer in preventive medicine, I have been involved in upskilling GPs and other clinicians on smoking cessation around the world. I have seen that when accurate information reaches them in a practice-friendly way from another clinician, they are very receptive and supportive of helping their patients quit smoking and manage cravings using the harm reduction principle.”64

Nicotine Science and Policy offers readers “daily news, research, comment and policy analysis on nicotine containing products, electronic cigarettes and other novel nicotine delivery systems.”65

A short communication paper written by Sudhanshu Patwardhan and Ira Banerjee was published in the Journal of Addiction Science on 8 May 2020 on “Nicotine Withdrawal, the Role of NRT in Hospitalised Smoker Patients and its Implications for Covid-19”.66 The paper stated that Ira Banerjee was Communications Manager at CHRE, and that neither the authors nor the centre received funding from tobacco companies.

On 4 June a paper about cessation in mental health settings written by Pooja Patwardhan and Richard Driscoll (Visiting Consultant at Bristol Priory Hospital and CHRE) was published on the e-journal website ecancer medical science.67 The conflict of interest statement said that “PP or CHRE have not received any funding from pharmaceutical, electronic cigarette or tobacco industries”. The funding statement said that “CHRE has received a grant for a project in Smokefree Mental Health from The Foundation for Smokefree World”. This paper was listed as an FSFW sponsored publication.29

On 1 July 2020, Pooja Patwardhan published an article with Marewa Glover, on smoking among minority groups including those with mental health conditions.68 This paper was also listed as an FSFW publication and jointly credited to CHRE and COREISS.29
CHRE’s FSFW funding was not disclosed in the article until February 2021, seven months after publication. When the funding was declared an “Expression of Concern” statement was also added by the publisher, emerald insight, “to inform readers that credible concerns have been raised regarding the editorial process for this article”.69 In correspondence with TobaccoTactics, Pooja Patwardhan has said that “This funding statement was omitted by the publishers during the publication process”.70

Glover is the director of COREISS, a private registered company based in New Zealand established with funding from FSFW. For more information see our page on COREISS.

On 17 July 2020 Sudhanshu Patwardhan published a paper with Jed E. Rose on “Overcoming barriers to disseminate effective smoking cessation treatments globally” (see above).20 The conflict of interest statement declared CHRE’s funding from FSFW for “work in smoking cessation” and stated that it did not receive funding from tobacco companies.20 Co-author Jed Rose (President and CEO of the Rose Research Center) declared funding from tobacco companies and Juul Labs.20 For more information see our page on Jed E. Rose. The authors acknowledged the input of FSFW President (at the time), Derek Yach. (Both July papers were to be presented by the authors at the 2020 FCTC-themed online event funded by FSFW.41 See below for more details.)

Before this, in May 2020, an article by Sudhanshu Patwardhan on the cost of nicotine replacement therapy in India was published on The Economic Times healthworld.com website, co-authored by Professor Amir Ullah Khan from the Indian School of Public Policy.71

In July 2021, CHRE published a report on its website titled: “Reclaiming Stolen Years: A survey report on barriers and opportunities to reduce tobacco related harms in the UK among the two million people with mental health conditions who smoke”.7273 It stated that part of this project was supported by a grant from FSFW and was supported by Ogilvy Consulting.7273 (See Ogilvy Group for more on the company and its relationship to the tobacco industry and FSFW)

In May 2022, Sudhanshu Patwardhan and Karl Fagerstrom co-authored a paper on the harm reduction potential of nicotine pouches.74 The authors stated that they had not received any external funding for the article.74 The declaration of interests stated that CHRE had received grants from FSFW for “some of its smoking cessation projects”, that Patwardhan had previously worked for BAT’s Nicoventures, and that he had no financial interest in nicotine pouches. It stated that Fagerstrom set up Niconovum (now owned by Reynolds/BAT) and was in receipt of consulting fees from Swedish Match.7475 (Swedish Match sells nicotine pouches as well as snus. PMI announced its bid to buy the Swedish company in April 2022. See Philip Morris International for details).

Presentations

Prior to the FSFW grant being awarded, Sudhanshu Patwardhan gave a presentation at CHRE’s smoking cessation summit on 30 September 2019, titled “Smoking Cessation and Mental Health What does the future hold for us?”.76 One presentation slide included an image of Nordic Spirit, a snus-type nicotine pouch made by Japan Tobacco International (JTI).76 It is not known if the product was discussed as a cessation tool at the conference. The same slide contained a graphic representing the Voke nicotine inhaler, a product licensed by the British Medicines & Healthcare products Regulatory Agency (MHRA) as a medicine since 2014.77 Until 2017, BAT had a commercial agreement with Kind Consumer Ltd to commercialise this device, but the product was never marketed directly by the tobacco company. In 2017, the licence was handed back to Kind Consumer, which began selling Voke in 2019.  Sudhanshu Patwardhan was working for Nicoventures during the period Voke was licenced to BAT.14

Partnerships

Sudhanshu Patwardhan stated in his 2019 CHRE summit presentation slide that “CHRE is working with technology and healthcare partners to rapidly test and roll out innovation in smoking cessation”. Its partners were not specified.76

His speaker profile at the 2016 GFN stated that he worked with the British Standards Institute (BSI) steering group “to create the world’s first quality and safety specifications for vapour products” and that he was a “Co-convenor at the European CEN working group on definitions and terminology related to vapour products”.38 He was working for BAT during this period.14

Events

In September 2019, CHRE organised a conference on smoking cessation and mental health in partnership with Priory Health Group.78 Its 2020 Smoke Free Mental Health Summit, funded by FSFW, was postponed due to the Covid-19 pandemic.28

On 5 May 2020, Sudhanshu Patwardhan was hosted for a Twitter chat by the pan-African Centre for Harm Reduction Alternatives (CASA).79 Based in Kenya, CASA’s Chair is Joseph Magero, who has received scholarship funding from the FSFW-funded organisation Knowledge Action Change.80

In September 2020, an event called “15 Years of Framework Convention on Tobacco Control”, hosted by the journal Drugs and Alcohol Today, featured Sudhanshu Patwardhan and Pooja Patwardhan as speakers. The event appeared to be jointly presented by Sudhanshu Patwardhan and journal editor Axel Klein.41  The event website stated that “The 15 Years Conference is supported by the Foundation for a Smoke-Free World. The Foundation played no part in determining the planning or execution of the event.”41 For more information see The Foundation for a Smoke-Free World.

Relevant Links

The Centre for Health Research and Education (CHRE) website

TobaccoTactics Resources

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References

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