As part of the effort to reduce cigarette smoking--the single most preventable cause of death in the society--researchers have tried for over half a century to identify effective school-based anti-tobacco education that can discourage tobacco use among children and adolescents. Unfortunately, deaf and hard of hearing young people have been largely excluded from this effort. Prevention messages available to hearing youth are often inaccessible and inadequate, and culturally and linguistically appropriate programming has not been developed. This may leave deaf and hard of hearing young people more vulnerable to a substance that is responsible for about one in five deaths--400,000 each year--in the United States, and over four million deaths across the globe. Children and adolescents that struggle with issues of social acceptance and self-esteem, who experience communication barriers, and who face difficulties when it comes to school performance are at great risk for tobacco use and other risk-taking behaviors. In this article, the authors describe a tobacco prevention curriculum tailored to the needs of deaf and hard of hearing youth. This "Hands Off Tobacco!" curriculum is now being tested in a quasi-experimental non-equivalent control group design involving over 600 deaf and hard of hearing students at four schools in California, New Jersey, and Minnesota.