No scare tactics, no lecture. Move the sliders, get a straight-up score for what your habits actually add up to, then dare a mate to check theirs.
The plot twist most people miss: cutting back doesn't cut your risk by the same amount. Doing it half the year isn't "half the risk" of year-round, the gap is way smaller than that. And mixing smoking or vaping with drinking doesn't just add the two risks together, it multiplies them.
1 standard drink = 14g pure alcohol (beer, wine, or a shot of spirits. The type doesn't matter much; the ethanol does).
These aren't smoking or drinking, but they move your baseline risk. Leave them be to keep the number about your habits only.
How your combined risk compares to simply adding the two separate risks together.
Solid: your pattern. Dashed: same daily amounts, all year.
It's a relative risk: how much smoking, vaping, drinking (and any details you add) multiply your odds versus someone otherwise like you who doesn't. It is not your total or absolute risk, and it can't say whether you personally will get sick.
What it deliberately leaves out:
This is an educational model built from published population studies, not a diagnosis, a prediction, or medical advice. If anything here worries you, talk to a doctor.
That's roughly how long after your last cigarette your heart rate and blood pressure start dropping back toward normal. Your body doesn't wait around to start fixing things.
US Surgeon GeneralNicotine hits your brain in about ten seconds, faster than a shot through an IV. That speed is exactly why it grabs hold so hard and won't let go.
National Institute on Drug AbuseHeavy smoking and heavy drinking together push mouth and throat cancer risk to around 35 times someone who does neither. They don't add up, they multiply.
Jun et al., J Korean Med Sci 2024Quit before about 40 and you dodge roughly 90% of the long-term risk of dying early from smoking. When you stop matters way more than most people think.
Jha et al., New England Journal of Medicine 2013There's no amount of alcohol that's been shown to be safe when it comes to cancer risk. Even light, regular drinking nudges the odds up a little.
WHO 2023 · US Surgeon General 2025Vape clouds aren't "just water." The aerosol carries ultrafine particles and trace metals that ride deep into your lungs, which is why the sliders here aren't zero.
National Academies of Sciences, 2018This is Quitting (by Truth Initiative) is built specifically for under-25s quitting vaping or smoking. Free, all over text, zero lectures.
Text DITCHVAPE to 88709 →No tobacco, vape, or alcohol money funds this. Ever. That's the whole point. If it was useful, a one-time tip keeps it online and ad-light.
☕ Support this project →No selling your inputs. No targeted ads based on what you tell it. Display ads here are brand-safe, non-endemic, and category-blocked from alcohol and age-restricted products, configured at the ad-network level, not just promised in copy.
Vaping is modeled with its own dedicated curves, not just a scaled-down cigarette curve, built from two separate evidence bases:
The often-repeated "e-cigarettes are 95% less harmful than smoking" figure traces to a 2014 UK expert-panel opinion exercise (not data-driven), popularized by a 2015 Public Health England report, and criticized in The Lancet for methodological weakness and conflicts of interest. This tool does not use that figure as a modeling input.
For cancers of the upper aerodigestive tract (mouth, throat, voice box, esophagus), alcohol acts partly as a solvent: it helps dissolve carcinogens and makes it easier for them to penetrate the cells lining the mouth and throat. The U.S. National Cancer Institute describes the combined harm at these sites as multiplicative. A 2024 meta-analysis (Jun et al., J Korean Med Sci) measured this directly for cigarettes and alcohol: heavy alcohol combined with heavy smoking produced roughly 35–39× the risk of neither. This tool's multiplicative model reproduces those figures within roughly 1–7%.
For vaping combined with alcohol, no equivalent study exists. This tool extends the same multiplicative mechanism to vaping as a projection, labeled as such wherever it appears.
| Cancer type | Smoking ceiling | Alcohol ceiling (6 drinks/day) | Notes |
|---|
"Smoking ceiling" is the relative risk approached at high cumulative pack-years, taken directly from cited primary sources: the INHANCE pooled dose-response (Wyss, Am J Epidemiol 2013) for larynx, pharynx and oral cavity, Wang (JNCI 2017) for oesophageal squamous cell, and dedicated meta-analyses for the rest (see each row's source). Alcohol dose-response is re-fit to Bagnardi (Br J Cancer 2015). For the shared upper-aerodigestive cancers, smoking and alcohol are combined multiplicatively and multiplied by a synergy factor of 2.0, reflecting the greater-than-multiplicative joint effect measured by the INHANCE consortium (ψ≈2.15); this reproduces the ~35× heavy-smoking-plus-heavy-drinking risk reported by INHANCE and the JKMS 2024 meta-analysis, using cited individual risks rather than an inflated ceiling.
| Product | Cancer multiplier | Cardiovascular model |
|---|---|---|
| Regular / light / menthol cigarettes | 1.0× | Standard cigarette dose-response curve |
| IQOS / heated tobacco | 0.85× | Standard cigarette curve, scaled 0.85× (FDA: exposure-reduction claim allowed, disease-risk claim barred) |
| Vaping (e-cigarettes) | ~0.10× (projected) | Dedicated curve anchored to pooled meta-analytic e-cig CVD odds ratios (~1.3-1.5) |
Alcohol's relationship to cardiovascular disease is genuinely contested science: some studies suggest lower risk at moderate intake, and more recent reviews dispute this. Rather than take a side, this tool models heart disease and stroke from tobacco/vaping only.
These are independent of smoking and alcohol and default to no effect. BMI uses per-cancer and cardiovascular relative risks per 5 kg/m² from Renehan et al. (Lancet 2008); note it drives oesophageal adenocarcinoma, so it is deliberately not applied to the squamous-cell oesophageal risk modelled here. Blood pressure raises heart and stroke risk only, per the Prospective Studies Collaboration (Lewington, Lancet 2002). Family history applies a modest generic first-degree-relative multiplier (breast/colorectal/lung and CHD metas). HPV is handled as a separate parallel pathway for throat (oropharyngeal) cancer, added rather than multiplied, because HPV-positive oropharyngeal cancer is a largely distinct disease from the smoking/alcohol-driven kind (D'Souza, NEJM 2007). Age is not offered as an input because it sets the absolute baseline the whole model multiplies, rather than acting as a modifier.
These numbers were cross-checked against the field's gold-standard reviews, not just individual studies. The cancer-site list matches the sites the IARC Monographs (Vol 100E, 2012) and the US Surgeon General (2014) grade as causally caused by smoking, and lung risk reaching an odds ratio above 50 at the heaviest exposure in IARC's data means the heavy-smoker ceiling used here is, if anything, conservative. The alcohol dose-response reproduces Bagnardi 2015 exactly and matches the "no safe level" position of GBD 2016 (Lancet 2018) and the WCRF/AICR Continuous Update Project — which is why a light-drinking effect is kept for breast, mouth/throat and oesophagus (where risk begins below one drink a day) but switched off for sites with no significant low-dose signal. The smoking-plus-alcohol synergy factor (2.0) sits just inside the INHANCE consortium's measured ψ of 2.15 (95% CI 1.53–3.04), and its larynx heavy-plus-heavy figure (~37×) matches this tool. Nothing in that review required a change to the numbers here.
Consensus syntheses (the backbone): IARC Monographs Vol 100E, Personal Habits and Indoor Combustions — tobacco & alcohol, 2012 · U.S. Surgeon General, The Health Consequences of Smoking 2014 and Smoking Cessation 2020 · GBD 2016 Alcohol Collaborators, Lancet 2018 (the "no safe level" analysis) · World Cancer Research Fund / AICR Continuous Update Project (alcohol; body fatness and cancer) · National Academies of Sciences, Public Health Consequences of E-Cigarettes, 2018 · U.S. National Toxicology Program, Report on Carcinogens (15th ed.).
Quantitative anchors: Bagnardi V et al., Br J Cancer 2015 (alcohol dose-response) · Hashibe M et al. — INHANCE, Cancer Epidemiol Biomarkers Prev 2009 (smoking×alcohol synergy) · Wyss A et al. — INHANCE, Am J Epidemiol 2013 · Gandini S et al., Int J Cancer 2008 · Wang QL et al., JNCI 2017 · Freedman ND et al., JAMA 2011 · Bosetti C et al. — PanC4, Ann Oncol 2012 · Hackshaw A et al., BMJ 2018 (cigarette cardiovascular) · Renehan AG et al., Lancet 2008 (BMI) · Prospective Studies Collaboration — Lewington S et al., Lancet 2002/2007 (blood pressure, cholesterol) · D'Souza G et al., NEJM 2007 (HPV) · Marron M et al. — INHANCE, Int J Epidemiol 2010 (cessation) · e-cigarette cardiovascular meta-analyses, 2024–2025 · CDC EVALI reports, 2019–2020 · Jun S et al., J Korean Med Sci 2024 · FDA Modified Risk Tobacco Product orders for IQOS. Per-cancer sources are listed in the table above, each flagged strong / moderate / weak.