Well, I guess from the above comments that I should be embarrassed to admit that I have one
First of all, a tank banger isn't going to get the attention of the dive boat ignoring where I am in the water,
though fortunately I haven't had to use it on the surface.
Under water you do not need to depress the button all the way to get the attention of someone. A short partial sounding is like a burp and is no more annoying any other sound.
I rarely use mine, but in Belize we had one DM more interested in scooting way ahead to kill lion fish than pointing things out. The other divers in the group appreciated that I had a means of getting his attention back to stuff we were looking at. Just a short burp of low pitched sound redirected his attention. Yes, a tank banger would have worked but useless on the surface, and I'd have to carry something to bang the tank with.
On another dive someone got way low on air. As I was preparing to share air I gave a more prolonged and louder blast to get the DM's attention that we were going to need to ascend.
I consider the horn to be a low profile safety device.