They are not "snake oil", properly set up they will improve your mileage. I ran one, can't remember the brand, for 3.5 years mounted on the rear of my Leer Shell on an F-150 SCab towing a 22' 5,600# TT. It worked very well gaining me 1.5 to 2 additional mpg. This paid the $350 purchase price back in a year.
As noted I believe the key to my success was the fact that it was mounted at the rear of the truck, closing the gap with the front of the trailer. It only took a couple of minutes to mount and was very secure with no additional wind noise. Of course, I only ran it when towing.
We logged about 15,000 miles a year with this setup and I never had a negative experience and the mileage improvement was amazingly consistent {I always ran with my Scan Guage documenting/supplementing my pump calculations.}
Here is a shot taken at Quartzsite 8 years ago:
Moderator edit to re-size picture to forum recommended limit of 640px maximum width.
:C