Some people start because they think it looks cool, while others start because they want to fit in with their friends. Some people start because they think it will help them relax, while others start because they think it will make them look more grown up. Whatever the reason, starting to use tobacco is a decision that can have a big impact on a person's life. Tobacco use is the leading cause of preventable death in the United States, and it is responsible for more than 480,000 deaths each year. Tobacco use is also a major risk factor for a number of other diseases, including cancer, heart disease, and stroke.