As a cold war kid, I avoid nuclear confrontation as much as possible - usually by winning the game before it becomes an option. I almost never use them myself. I had to drop a bomb on the last turn of a science victory to earn the Steam achievement. (They are kind of fun.)
Now that I've upped my difficulty level to Emperor, I suspect I will get involved in struggles where nuclear war is unavoidable. It will be interesting, to say the least. I don't mind having no defense against it short of diplomacy; that's fair enough. I am a little concerned that I'm playing against madmen.