I came down with Tinnitus a couple of years ago and needed something to knock the edge off any loud sound and the ER-20 plugs are perfect. You will never find me without a pair in my pocket or on my key chain. You can't really use foam in moderately loud situations if you want to hear anything. Over 90+% of needed hearing protection is in the 10-20db or less range. I always wear them in Church, watching TV with my family, loud restaurants, and quite a bit when driving the car (road noise) or running my Rainbow Vacuum. They work well in the movie theater or at a sporting event where the crowd has loud outbursts. The ER-20's last a long time and I can wear them many hours at a time at a time and also adjust how deeply I want to put them in. The great thing is you can still hear people talking to you, but they remove background noise and protect you from sudden sounds. I usually order them in sets of about five and give some away to friends. I would never expose myself to loud music or get in a loud situation and leave myself unprotected again. If only I had these growing up, I would not have Tinnitus today!