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The only way to back up everything (ringtones, system settings, homescreens, apps and all their settings...everything) is with a nandroid backup (root required). Do a google search for "Koush bootstrap." He has his own site. The app is easy to use. You can also do a youtube serach for the same phrase and watch a short video of someone making a backup.
Originally Posted by Lonman06
Titanium is still very useful though, as you can use it to restore apps and their settings if you flash a new ROM, which will wipe all your apps and data (most ROMs need to perform a full wipe when installed). Afterwords, many of your apps will automatically redownload, but a few don't, and the ones that do no longer have your settings. A weather app would be a example of this. Titanium can be used to selectively restore those app settings without you having to re-enter data. The nandroid backup is really for restoring from a total crash, or if you install a new ROM and decide you like it a few hours later, you can use your nandroid backup to get everything back the way it was.
El Poblano is right...do some research so that you're comfortable with all this. It's not rocket science, but some understanding is beneficial.