There are very accurate manometers out there!
If you want a specific pressure, there are vacuum regulators, some good, some bad. In my experience, I know that the vacuum pump in my hood pulls a vacuum of ~1 torr, so I try to adjust to that and it works for most things. I don't have a regulator so I just go with 1 torr for everything on my line.
If I need to get to ~50 torr, I use a different vacuum pump that has a (crappy) regulator on it. A good aspirator will get to about 30 torr. One bad thing about water aspirators is that the pressure they can achieve varies depending on the temperature of the water, which can change as the motor runs. Annoying for long distillations!