Know Your Number
The real math on smoking, vaping & drinking

Know your
number.

Not scare tactics. Not a lecture. Just what the actual research says your habits add up to. Tap a preset, see your number, share it if you want.

The thing most people get wrong: cutting back doesn't cut your risk by the same amount. Someone drinking + smoking six months a year isn't at "half the risk" of doing it year-round. The gap is way smaller than that. And combining smoking or vaping with drinking doesn't add the risks together, it multiplies them.

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About EVALI: a 2019–2020 outbreak of serious vaping-linked lung injury (2,807 hospitalizations, 68 deaths, per the CDC) was traced almost entirely to vitamin E acetate in illicit THC vape carts, not regulated nicotine e-liquid. Real risk, tied to black-market products specifically, not something that scales with the sliders below.
Tobacco / Vaping

02040
1612
Alcohol
0510

1 standard drink = 14g pure alcohol (beer, wine, or a shot of spirits. The type doesn't matter much; the ethanol does).

1612
Duration
12550
Lifetime cigarettes0
Lifetime drinks0
Lung cancer
1.0×
risk vs. someone who does neither

You

–

Year-round

–

Neither

1.0×
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Synergy: Lung

How your combined risk compares to simply adding the two separate risks together.

Combined risk by cancer type

Sorted highest to lowest, at your current settings.

Risk over time

Solid: your pattern. Dashed: same daily amounts, all year.

Your pattern
Both, year-round
Free resource, not a revenue source

Actually trying to cut back?

Truth Initiative's This is Quitting is the only US quitline built specifically for people under 25 quitting vaping or smoking: free, text-based, no lectures.

Text DITCHVAPE to 88709 →
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This tool runs on no tobacco/vape/alcohol sponsorships, ever. That's a hard line. If it was useful, a one-time tip keeps it online and ad-free.

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What this tool will never do

No tobacco, vape, or alcohol ads. Ever.

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.

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How this is calculated, and where the numbers come from
The vaping model, specifically

Vaping is modeled with its own dedicated curves, not just a scaled-down cigarette curve, built from two separate evidence bases:

  • Cardiovascular risk is calibrated directly to real population studies, not biomarkers. A 2019 analysis of the federally funded PATH study (J Am Heart Assoc) found some-day e-cigarette use carried an adjusted odds ratio of 1.99 for having had a myocardial infarction, and every-day use 2.25, independent of cigarette smoking, with reverse causality ruled out via longitudinal follow-up. A 2025 network meta-analysis of 11 adult population studies found a pooled composite cardiovascular disease odds ratio of 1.31 for e-cigarette use. This tool's vaping heart-disease curve is fit directly through the PATH anchors; stroke is modeled at half that curve's excess, since the one dataset examining vaping and stroke specifically found a weaker, non-significant association (adjusted OR 1.13) than for MI.
  • Cancer risk has no human incidence data yet: e-cigarettes haven't existed long enough for the decades-long latency most cancers require. This tool projects a cancer contribution from biomarker studies instead: NNAL (a tobacco-specific carcinogen metabolite) runs about 85–98% lower in exclusive e-cigarette users than in cigarette smokers across several independent studies. This tool scales vaping's contribution to roughly 10% of an equivalent cigarette's cancer-risk curve: a projection from exposure data, not a validated cancer-risk finding, and labeled as one throughout.
Why this varies so much by device: carbonyl/aldehyde output in e-cigarette aerosol has been measured anywhere from ~100–2,800× lower than cigarette smoke under normal use, to 5–15× higher under high-voltage "dry puff" conditions. This tool models a single central estimate; real risk for any individual device could reasonably fall outside it in either direction.

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.

Why smoking/vaping + drinking multiplies risk instead of adding it

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 types modeled, and which factor drives each one
Cancer typeSmoking ceilingAlcohol ceiling (6 drinks/day)Notes

"Smoking ceiling" is the relative risk approached at high cumulative pack-years for combustible cigarettes. For larynx, pharynx, oral cavity, and esophagus, the ceiling is scaled up from Gandini et al.'s pooled "current smoker" average by ~2.8×, the ratio separating lung cancer's population-average smoker risk from its long-term-heavy-smoker risk. That's what allows the multiplicative combination to match the JKMS heavy+heavy figures above.

Product multipliers
ProductCancer multiplierCardiovascular model
Regular / light / menthol cigarettes1.0×Standard cigarette dose-response curve
IQOS / heated tobacco0.85×Standard cigarette curve, scaled 0.85× (FDA: exposure-reduction claim allowed, disease-risk claim barred)
Vaping (e-cigarettes)~0.10× (projected)Dedicated curve calibrated to PATH study odds ratios
Why heart disease and stroke don't include an alcohol effect

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.

Important limitations
  • No study has tracked people who use these substances heavily for part of the year and stop, year after year. This tool approximates that as an averaged dose spread across the year, which is more likely to understate than overstate real risk.
  • EVALI is a real, serious, well-documented acute risk but isn't a graded dose-response relationship, so it's presented separately.
  • This is an educational model built from population averages, not a diagnostic or personalized medical risk assessment.
Sources referenced

National Academies of Sciences, Engineering, and Medicine, Public Health Consequences of E-Cigarettes, 2018 · Bhatta & Glantz, J Am Heart Assoc 2019 · e-cigarette CVD network meta-analysis, 2025 · Plurphanswat, Selya & Rodu, Cureus 2024 · CDC EVALI outbreak reports, 2019–2020 · NNAL biomarker studies, PATH / Cancer Epidemiology Biomarkers & Prevention 2025 · Public Health England 2015 review & The Lancet's critique · Jun S et al., J Korean Med Sci 2024;39(22):e185 · Gandini S et al., Int J Cancer 2008 · Cumberbatch MG et al., Eur Urol 2016 · U.S. Surgeon General's Advisory, Alcohol and Cancer Risk, 2025 · National Cancer Institute Alcohol and Cancer Risk Fact Sheet · Bagnardi V et al., Br J Cancer 2015 · Peters SAE et al., BMJ 2018 · NCI Smoking and Tobacco Control Monograph 13 · FDA Modified Risk Tobacco Product orders for IQOS.