I'm having the same issue, but only on my computer at work and not on the MBP or 24" iMac at home, (same config: SL 10.6.2, iTunes 9.0.2). Seems to only happen if iTunes is already launched. Last song played, or first song in music library will automatically start, sometimes in the middle of the night, sometimes during the day. Playback will pause if i go to itunes and press pause. I don't need to shut down iTunes entirely. It's been happening for a while - at least 6 months. And there does not seem to be a common thread with all the others who have posted here. I am using YouControlTunes for playback on the menubar, but that does not seem to be the issue since i am using it at home as well. It does seem to be happening less frequently than other people have said. Three times in the last 48 hours, but nothing for a few weeks before that. Oh, and the bluetooth fixes and itunes helper delete does not solve the problem. Interesting though yesterday i left itunes on while browsing the store, and it started playing 30 second clips from an "essentials" playlist. First time that has happened.