In the K-12 district for which I work, there have ~600 staff (teachers/non-teachers), ~7800 student users and about 3000 workstations + notebooks. We're a Windows (XP for educational software product requirements) shop and run AD. In the past two years we've reigned in administrative users [even I, the sysadmin, run as a limited user on my workstation] and implemented a fairly detailed SRP White Listing. These two changes alone greatly reduced not only issues with crap-ware infections, but greatly reduced technician support time requirements.
The vast majority of our users [excluding the students who can no longer run proxy software] Do. Not. Fucking. Hate. Us. You would be surprised how happy people are when their computers "just work" and don't require cleaning/futzing every couple weeks.