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John,   Thanks for your question.   This is not an easy question to answer.  From a smoking point of view, you are not in the same ball park as a daily smoker, who goes through 1 - 2 packs per day.  But you certainly are at higher risk than a non-smoker.  When trying to live a healthier lifestyle, people should minimize risks that are beyond their control, such as high cholesterol due to genetic factors, and eliminate risks that are in their control such as smoking.    Doctors can talk about risks and quantitate the amount of cigarettes used by smokers, but no one can predict the actual risk to a specific individual.  We've all heard the stories of people living well into their 90's who have smoked heavily for years, and we've heard stories of people getting lung cancer in their thirties and forties who were light smokers.  And, yes, people who never smoked also develop lung cancer.  Lung cancer is one issue and chronic lung disease is another issue.  Every one tolerates and reacts to tobacco in a unique way.  There is no way to predict how a person's lungs will react: no reaction; mild lung disease; severe lung disease; cancer.  In addition to lung disease, the risk for developing cancer in other sites also rises tremendously - oral, esophageal and stomach, bladder, and voicebox.    As far as where you fit in compared to a pack a day smoker, it's not just a matter of doing the math.  The risk of one pack a week is not 1/7th of a pack a day smoker.  Once you smoke, your risk rises tremendously and you're probably closer to half the risk as a pack a day smoker.   The other issue discussed in your posted question is your alcohol intake.  Drinking "heavily" twice a week also poses some risk.  Though not on the level of an alcoholic, drinking excess quantities of alcohol twice a week does affect liver function, and alcohol combined with tobacco is even more toxic on the lining of the stomach.    I hope this information has been helpful.  I am not attempting to "lecture" to you, but just inform you that risk is a relative thing, with very gray edges.  The best risk is no risk.    Best wishes.   Martin Cane, M.D.