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The airbrush came free with my intuos 3 as I bought the special edition version. I don't think i'd have ever used the airbrush otherwise.
It is a niche product- if you're a traditional airbrush user then you will want one, but if you aren't then there's little point in you purchasing this as the standard pen can do everything this can do and feels more natural for every day use.
Build quality is great like all wacom products. Comfort is good, but you have to hold it in quite an unusual way to be able to use the scroll wheel- search the internet for a tutorial on how to hold it.
Using it as a digital airbrush is it's intended use, but it also works great as a pressure sensitive pen with a second user input- by setting brush size to pen pressure, and opacity to the scroll wheel you can mimic the effect of a real airbrush, where the level would control the ink/air ratio and the distance from surface would control size (i.e. further away=bigger, so more pressure=smaller brush). But if you set it so pen pressure is the 'right' way around (more pressure=bigger brush) then you can use it as a standard pen and then set something else, such as colour, or opacity, to the scroll wheel- letting you draw as normal and then make small adjustments with your thumb- a very useful feature but not essential- and at around £70 for the pen, it could be a bad investment if you don't use it.
I sold my airbursh because I didn't use it much, but after writing this review I do miss it a little bit, so I might grab another one.