I use an inflatable for training and sometimes in races. The only annoyance is that if you have the waist strap loose then some models tend to rotate around you and become a bit annoying. If you cinch it tightly, then you get a belly ache.
I inflated mine for practice while on land to make sure that it worked. It did, and you really don't need the CO2 cartridge as I believe all models have a mouth inflatable valve. 3 or 4 big blows, and it's full.
USCG rules require these manual ones to be worn and to have the CO2 cartridge intact. This makes it inconvenient to travel with because you'll need to buy another CO2 cartridge at each race site (you can't fly with the cartridge).
I guess that in really rough waters or on really cold water, I would prefer the security of a light wearable pfd like the Mocke vest that is always bouyant. Plus, you could still swim well while wearing the Mocke vest or one of that type. An inflatable one that's inflated is not as easy to swim with and inflating/deflating while in the water might be somewhat of a hassle.