I've pulled a couple of cars around with our Axis (Escape and Focus Electric; this year I'll also be towing my new C-Max) and our Acme Dolly (also with surge brakes).
Tow-haul mode or not you're still pulling an extra 4000lbs + behind the camper so mileage is reduced no getting around that.
Having said that I typically won't notice the car back there unless I turn on the rear-view camera or make a turn sharp enough that the car appears in the rear-view mirror.
When Tow-Haul is on it will hold the lower gears longer and you get the down-shift while going downhill when you tap the brakes (I've used this feature even when not towing; just turn on Tow-Haul and tap the brakes).
Usage of Tow-Haul comes down to if you like to hear the V-10 scream or not; some people don't. The V-10 engine is built to rev (overhead valves) and doesn't mind running all day at 4k RPMs. With Tow-Haul on it will run at a higher RPM due to holding the lower gears longer. Note that it does reduce some gear hunting in some situations simply due to the different shift pattern.
I usually leave Tow-Haul off while driving on flat ground and turn it on while driving through hilly terrain.
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