You know, I'm amazed at how such a seemingly simple item can really evoke some huge "wow" from the recipients. I received a thank you note from our school principal after I had one of the kids give her one after she had told me in an email that she had a rough morning at home. I mailed a black one to a friend with a sympathy card after her MIL died. She said that she's showing everyone & no one has seen them before. I found the tissue packs in the tissue aisle at WalMart. they have some "fancy" ones out now that won't work in these, but the old-fashioned ones still exist.