Neal D. Freedman, Ph.D., M.P.H.

Senior Investigator

Metabolic Epidemiology Branch


9609 Medical Center Drive
Room SG/6E432
Rockville, MD 20850


Research Topics

Dr. Freedman's research focuses on common, potentially modifiable, exposures of public health significance, including tobacco, alcohol, and cannabis. In his work, he tracks usage trends, examines disease risks and burden, investigates underlying mechanisms, and develops new resources. Over the past few years, his research has expanded to include studies of COVID-19 and as part of the HHS response, he led development of COVID-19 SeroHub, a data repository and visualization tool for seroprevalence studies in collaboration with colleagues from CDC and NIAID.

Tobacco Products in Cancer and Disease

It has long been known that tobacco causes many different types of cancer. Yet, the tobacco epidemic has changed substantially over the past 50 years. Thankfully, with concerted tobacco cessation and prevention efforts, the prevalence of smoking has decreased in the United States. Still, more than 14 percent of Americans continue to smoke cigarettes, and an estimated 1.3 billion people use tobacco products worldwide.

Although the health effects of daily cigarette smoking are well established, the health effects of non-cigarette tobacco products including cigar, pipe, and smokeless tobacco and emerging products such as e-cigarettes, heated tobacco, nicotine pouches, and waterpipe are far less characterized. The health risks of low-intensity and some-day use are also poorly understood, as are the risks of using multiple products (dual-use). We conduct studies to provide these needed estimates to inform public health and tobacco regulation. In this work, we use a combination of classical, descriptive, and molecular approaches to describe trends in tobacco use, examine associations with disease in large epidemiologic studies, and measure biomarkers of exposure and effect.

"New Study Describes Mortality Risk Associated with Cigarette-, Cigar-, or Pipe-only Use"
"Nondaily and Low-intensity Smoking Associated with Increased Risk of Death"
"Exploring E-cigarette Use Among U.S. Adults"

Trends in U.S. Premature Mortality

Despite enormous investments in biomedical research and advances in tobacco control and public health, progress in the U.S. has stalled in stark contrast to peer countries. There are also substantial disparities in U.S. mortality rates by race/ethnicity, socio-economic status, and geographic location. We aim to understand the causes of worsening mortality rates in the U.S., identify health disparities, and develop accessible tools to convey these data and inform the public.

"Study Finds Premature Death Rates Diverge in the United States by Race and Ethnicity"
Patterns in “Deaths of Despair” Vary by Geography and Demographics
COVID-19 Mortality Tracker
NCI Study Highlights the COVID-19 Pandemic’s Disproportionate Impact on Black, American Indian/Alaska Native, and Latino Individuals


Dr. Freedman received his Ph.D. in biomedical sciences from the University of California, San Francisco in 2004 and an M.P.H. from the Harvard School of Public Health in 2005. He subsequently joined the Division of Cancer Epidemiology and Genetics as a Cancer Prevention Fellow, becoming a tenure-track investigator in 2009. Dr. Freedman was awarded scientific tenure by NIH in 2015, and is DCEG's principal investigator for the Prostate, Lung, Colon, and Ovary (PLCO) Cohort Study.

Selected Publications

  1. Shiels MS, Chernyavskiy P, Anderson WF, Best AF, Haozous EA, Hartge P, Rosenberg PS, Thomas D, Freedman ND, Berrington de Gonzalez A. Trends in premature mortality in the USA by sex, race, and ethnicity from 1999 to 2014: an analysis of death certificate data. Lancet. 2017;389(10073):1043-1054.
  2. Loftfield E, Cornelis MC, Caporaso N, Yu K, Sinha R, Freedman N. Association of Coffee Drinking With Mortality by Genetic Variation in Caffeine Metabolism: Findings From the UK Biobank. JAMA Intern Med. 2018;178(8):1086-1097.
  3. Christensen CH, Rostron B, Cosgrove C, Altekruse SF, Hartman AM, Gibson JT, Apelberg B, Inoue-Choi M, Freedman ND. Association of Cigarette, Cigar, and Pipe Use With Mortality Risk in the US Population. JAMA Intern Med. 2018;178(4):469-476.
  4. Spillane S, Shiels MS, Best AF, Haozous EA, Withrow DR, Chen Y, Berrington de González A, Freedman ND. Trends in Alcohol-Induced Deaths in the United States, 2000-2016. JAMA Netw Open. 2020;3(2):e1921451.
  5. Inoue-Choi M, Christensen CH, Rostron BL, Cosgrove CM, Reyes-Guzman C, Apelberg B, Freedman ND. Dose-Response Association of Low-Intensity and Nondaily Smoking With Mortality in the United States. JAMA Netw Open. 2020;3(6):e206436.

Related Scientific Focus Areas

This page was last updated on Monday, April 4, 2022