I mean “should” be used. One of the thing that always surprise me about ADS is how much tension is used from the start. Thats not the purpose - rather its function is to extended healing or constant stretching (specifically for tunica stretching as ligs require more force). As you get use to the general idea - the force could be increased when you reached certain stage or resistant point. This increase in force could be minimized with heavier hanging every other day.
When I say you have to wear this all the time - I mean all the time and should become part of daily routine (like putting on a watch). Remember, I never did heavy hanging (moderate force yes) and this worked for me - quite a bit, albeat over a longer period. Think of it this way - hang a 5oz weight on your earlobe for 6 months to a year. At certain stage, your lobe will be stretched and reach a resistant point (ever seen hug lobe with giant ring in it?). Once resistant point is reached - increase the force for next stage. Again, this resistant could be alleviated by supplementing with heavier hanging - which at that point is extended healing only.
I also do think that deconditioning should be carefully considered. Unless you are a heavy PE’er - the lack of gain is due to not enough PE’ing, not because you did too much. Again, this is just an observation and my opinion, but 1-3 hours per day is not enough. I could be wrong as everyone is different.
Lastly, in regard to erect gain. I do think that concentrating on the tunica is important in this aspect as stretching of the cellular structure seem to be only way to make gains on erect length. The lig stretching is fine to get the burried stuff out - giving you a appearance of longer length, but not a true gain. Again, I could be wrong.