I never use it, and I rebind the key over to the other side of my keyboard because I'd rather use that key for something useful. I use Bullet Time when I'm overwhelmed which isn't very often. I miss the breath mod for sniping, I would use that.
I don't use VATS for pretty much all the reasons Tricky outlined, it's just not challenging or rewarding to me and I don't like having control taken away from me. It's like quicktime events, I intensely dislike those too.
