Any time I want to cut something in Photoshop out of its background, I try using selections [and channels, and re-leveled copies of channels, to refine my selections]. If that fails, I break out the Graphire.
Freehand drawing works best with the tablet, and I use it whenever I draw. Retouching photos is a bit easier with the pen, but it's not necessary, and I often leave it unconnected unless the work is becoming too difficult to manage with a mouse.
When I storyboard with a client, I bring the tablet and do quick written notes and thumbnail sketches on top of images, right there on my MacBook Pro.
When I'm drawing in Anime Studio Pro [formerly Moho], I always use the tablet. It's pressure-sensitive pen gives me control over the thickness of a line as I draw it. Saves loads of time.
It's the size of a mousepad, and since I didn't spend much time in art school, I'm comfortable drawing small -- I have always been one to doodle sketches in the margins, and I'm used to drawing small.
If you are more comfortable drawing large, get a larger tablet. IMO, that's the most important choice to consider: large tablet, or small?
I found that the Intuos line of tablets offer features I don't care about [tilt sensitivity, or the ability to swap pens, pens I wouldn't be buying anyway, so screw that, and higher pressure sensitivity -- the Graphire is already so highly sensitive that I don't feel deprived].
I almost never use the pen as a mouse. In my experience, it causes too much hand and wrist pain, over long hours of use, to keep using it as a mouse because:
- it's so sensitive that it's easy to accidentally click or drag the wrong thing, resulting in extra work to undo the damage;
- double-clicking anything just starts to hurt after a while;
- it comes with a mouse, so I just grab that for things that are more comfortable with a mouse.