I'd wager very few pickup owners tow anything- around here they are all mall crawlers.
But OTOH, probably 90% of the miles on it are driving around "to the mall" or work.
Could I rent a truck every time I needed one? Probably, but it would probably cost me another $1k+ a year or so, be massively inconvenient, etc.
OTOH, a lot can probably be done to improve the efficiency of normal trucks being used in commuter situations. Hybrid/etc style vehicles are probably just fine for my use case, since I already have the baby motor in it. Is it a bit slower/etc when I'm towing, sure, but it gets the job done.