My One Day In History - 0600-2359

My One Day In History - 0600-2359

• Paul Mason
• 17 Oct 06, 07:38 AM

The British Library is encouraging us all to blog about our daily experience today. If you want to have a go, click here. It's being done to promote "history" and you are supposed to include stuff about how history has affected your day. It will all be useful in 2207 they say. Since most of us are not lucky enough, like Samuel Pepys, to be able to write "got up, drank my morning draught, went to France to bring about the restoration of the Stuart monarchy, got drunk, snogged the housemaid…" it could be a tall order. However I am about to give it a go. For the entertainment and enlightenment of Newsnight viewers I will be updating this regularly throughout the day. If your blog intersects with mine - ie you see me on the bus, or I am unlucky enough to be put on telly tonight - put me in as a keyword, and Newsnight. Here goes….

0559: Woke up to DAB radio coming on. Today Programme with Jim Naughtie and Carolyn Quinn. Main story - Bush's advisers say he should call in Syria and Iran to help rule Iraq. But don't they already run most of it through allied militias anyway? Lie in bed with my wife listening to the news. At 0615 I have to pay attention as it's the business slot: very financially literate and detailed discussion of Macquarie Bank's strategy of buying infrastructure assets. And the BBC governors want us all investigated for doing too much "consumer" and "fat cat" stories - not at 0615!

My wife gets up first as she's going to the gym. I get out of bed around 0645 and make put the kettle on. I start sweeping sand into the bricks on our new patio which I laid over the weekend. My wife makes a pot of tea (Tesco Finest) and we drink it in the garden, me in my dressing gown (do you really want this much detail 2207???) The moon starts as a silver sliver against a misty sky but about five to 7 the sky in the east lights up pink and the sky goes blue. I look up again and the moon has disappeared over the rooftops. She goes off to work at 0715; I make toast and another cup of tea, this time just using the bag, and then I'm at my computer.

0735: Sit down at the computer which I leave on standby, but with the monitor switched off overnight. Log in. Get my personal emails (from POP server to Outlook on my PC): three overnight - a Google Alert on China news, a "new friend" request on MySpace; spam inviting me to invest in Texahoma Energy. Log in to BBC Webmail - a remote access version of work email that you have to usa an RAS SecurID tag to get into. type my login name, password, personal pin code then a six digit code generated by the tag. Only four emails overnight: (i) same Google China alert, (ii) a Spam alert from the server telling me it has intercepted 22 messages. I give you the top five…

Pablo Luna (walkermayzys@col.. Prescription free top med brand$ 10/16/06 3:35 AM
Scott M Bassett (imhotep@eng.. Re: Can you help me? Need Zyloprim . 10/16/06 5:02 AM
Thomas Salinas (westbayahfq@.. CIAlis (TADALAFIL) =-= $uper VIAgr@ 10/16/06 5:25 AM
Jana Gee (blake@embeddedwire.. Re: Check out for H0T NEWS! 10/16/06 5:55 AM
Sushil Higham (arlenelowder@.. Re: VmlAGRA 10/16/06 6:13 AM

…an email from Lehman Brothers research team called Daily Global Relative Value. It get this every day and its vaguely Marxist title cheers me up.It's a PDF, which I don't read and a kind of quiz for analysts to take part in. The question today is: "Which factor is most likely to induce “Goldilocks†to flee? (Please Open Report to Vote) A) Geopolitical risk B) Stubbornly elevated inflation C) Decline in corporate profitability D) Issuer-specific event E) Liquidity stall F) Aging business cycle." This is about the so-called Goldilocks economy - neither too hot (inflation) nor too cold (recession). Like I said, here at the beeb we are always concentrating on consumer stories and fat cats.

The final overnight email has been from a business consultancy called Yankee Group inviting me to a seminar in New York about "The Impact of Ubiquity on Networks, Service Delivery and Business models". On current budgets I won't be going.

Round about 0800 the post van arrives and rings my doorbell. I go down to collect a special delivery parcel containing the next three chapters of my book with corrections from my book editor. As the previous three chapters are still uncorrected and it's all due in a week's time, this is unwelcome. On the doorstep I say good morning to my neighbour, Caroline, a jazz sax player who is getttng ready to take her daughter to nursery in the time honoured urban bohemian fashion of a push bike: they are both wearing helmets. The postie calls me mate.

At 0800 I stop writing this and start looking at the websites of the newspapers to see if there's anything I might need to cover. More blogging due mid-morning.

11000 UPDATE: Not much in the papers. More on muslims: now the backlash against Labour's PR offensive has started (in the Telegraph, and on Newsnight last night). Veiled women pictures everywhere. Only article I bothered to read was this one, which was excellent. Being a daily news journo with access to the wires you tend to know what's going to be in the papers before you read them, so you mainly look for interesting comment or exclusives everyone else has missed.

I've spent about 2.5 hours correcting a chapter of my book (about the rise of syndicalism after the London docks strike of 1889, so definitely "touched by history" today), and half an hour talking to somebody in the NHS about a story I am working on: I may put more details in the "for posterity" version of this, but it was off the record so nothing here. Until just now I was still in my pyjamas - one of the luxuries of having a job where you know you may still be at work at midnight is to take a leisurely run at the morning until 1000.

Had a short conversation with today's output editor of Newsnight, Robbie Gibb. He tells me there is a six minute slot we need to fill tonight and that Peter Barron, the actual supreme leader of Newsnight, is keen on the story about Hinckley Point's boiler pipes turning dodgy. As I write this I am awaiting a call out of the eleven o'clock meeting. Let me explain: the output editors of the BBC News bulletins all go to a meeting at 0915: they compare notes but if you are the Newsnight editor you are also prone to hiding various exclusives and angles. After that they communicate with their minions. Then at 1030 in Newsnight's case there is a cramped meeting in the editor's office: Robbie and Peter go through what they are thinking and the desk producers - mainly people in their 20s and 30s - pitch stories. These are the people who will drive the news desk all day, not the onscreen reporters. We communicate by email and mobile phone, pitching stories, dissing others and depending on our mood volunteering to fill the six minutes not already allocated. It looks like I am in line to do something.

I've showered (green Dove soap, Aveda Black Malva shampoo) and dressed (jeans, old shirt) and am now going to chase down HSS Tool Hire who are supposed to be picking up a Wacker Plate and Brick Cutter from me - which is one of the reasons I am still working at home at 1100. 25 work emails since the last check, mainly useful. No more home emails. I've spent the last three hours in my study, not leaving my desk, but with a sub-audible Radio Four on on the next room which, as always during the daytime, seems to be about hedgehogs and women's problems.

Right, historians of the future, read this: I phoned the HSS call centre and gave them my order number. After only 30 seconds of muzak (actually a commercial radio-style ad for HSS) they told me the driver is on his way and will pick the stuff up in 20 minutes. Whatever you read about call centres and customer service in the 21st century, it's not true: hiring stuff, and even buying stuff is a doddle now - even at the roughnecked end of commerce, the building trade. The stuff I hired worked, did what it was supposed to do, did not injure me, was delivered on time (albeit by men with a marked reluctance to carry anything). Even the fact that I am supposed to be trained to work a vibration plate was not an obstacle to getting it delivered.

1151: The HSS man actually helped me carry both machines through the house to the truck. I suppose just in case in the year 2207 it is still an issue I will mention the detail that he was black; the postman was white, I am white, all my neighbours are white. The wacker plate was a Honda: when I asked him what make it was he looked at me gone out as if to say - why, you're not thinking of buying one are you!

I have just got a personal email from my local community organisation inviting me to an over-50s tea dance: Quadrille dancing with Elsa Perez. It is not funny - in four years time I will be able to go! It is 12 noon now and time to do something that does not involve Microsoft Word or Typepad.

1220: Nipped out for a quick lunch at my local Portugese greasy spoon. Took a call from someone pitching me a "survey based" story about gambling habits. Steak covered in "pizzaola" sauce with fresh veg cut up and boiled to taste like tinned veg. All in all a mistake - their cakes are good, as are their breakfasts, but I am on a diet. Sadly even the veg will not count towards the five portions my wife polices me to eat each day. In the cafe are: a builder in shorts; two office worker couples, all smoking; some burly plain cothes law enforcement types (my area of south London is home to many offshoots of NCIS and the Met). The counter mobbed by builders in hi-vis buying sandwiches. All four of the extended Madieran family behind the counter working very fast to keep up. The owner takes time to have a few words with me as he brings me the steak.

In the cafe I read the FT. Just for posterity I will give you a "reading" of what I saw, postmodernist style: lead story on Macquarie - right story, right line. Big second lead on flotation of Chinese bank - very FT, aimed at its supposed global audience. Phil Stephens comment piece on why generals should not intervene in politics (curious echo of Pepys here!) - my reaction? The voice of a Blair ally quietly making a point. Big comment piece by FT international editor - aargh, indigestible, Big feature on the succession plan at Berelsmann - very interesting. Real original take on a real major business. Most of the rest of it I have seen on the wires already. There are two supplements with the FT - the Companies and Markets section, which I scan and bin, and an advertising led thing which made so little impression on my that I binned it before taking in what it was about.

I have taken a phone call from an NGO activist I was working with to cover a planned backbench revolt by Labour MPs over the Company Law Reform Bill. It now looks like the revolt is fizzling out, as there have been concessions from the government. There will still be a dingdong in parliament later this week between Labour and the Tories over the substantive bill. NGOs disappointed more concessions not wrung out of the front bench.

I stick some washing in the machine, collect my suit from the local dry cleaners and watch the One O'Clock News. The One leads with Iraq Study Group planning escape routes for Bush, and with Blair "presser" - what we call a press conference - which is still going on. Looks like he's having a hard time. I email Robbie to ask if he wants to do the numbers game over NHS job losses tonight. We are now discussing this via email. I write "How many people are really being sacked this year - and why can't Blair or the chief exec answer it? Straight political fist fight off the back of a stats piece." He is thinking about it.

Meanwhile, on another story entirely I am asked by Jasmin the deputy editor to make a call to a key contact who we need to speak to. I make the call. That's the second interesting thing that's happened to day where I can't go into detail. I am beginning to realise it might go on like this all day.

Jasmin is my line manager and deals with my story pitches, whinges and workload: I am due a call with her about the NHS story I was researching earlier, which is not the same as the one Blair is dealing with. Since I have started with this ethnic identity thing, Jasmin is Sikh. Looking at my experiences today through 2207 hindsight, I think it is worth saying that with middle class people, and even to "assimilated" working class people, I find at least in London ethnicity is almost transparent - I genuinely hardly notice who is black, white or Asian. What you do tend to notice more is language and culture: so the Portugese/Madieran cafe's whole identity is wrapped up in who they are; and in London right now you can't move without hearing somebody speaking Polish into a mobile phone.

I am ironing a shirt and getting my suit on ready to go into work. It is exactly 1330

1500: As Erwin Schrodinger might have predicted, writing this blog has now started to affect what is happening to me. Arriving at work I get an email from my first ever girlfriend (we split up 28 years ago) who now works in the comms department of one of the organisations dealing with bad news today and we have a slightly edgy but funny email exchange where she tells me about her day so far, takes the mickey out of me and my patio, and chides me a bit over the way her story is being covered.

I walk in the office, Bush is live on News24 about Guantanamo. Another email informs me we won't do the NHS story today. News24 is now reporting on the blogging project.

On the tube journey here I remember seeing: a builder in a wooly hat with a spirit level longer than he was high; a young couple where the man had a walking stick and they both looked worried; a slightly intense looking woman who was taking up two seats with a giant bag of sewing; an actor type wrapped in a scarf despite the tube being boiling hot; a woman in a track suit carrying a violin case.

Going back a bit, on leaving the house I was dressed in: pink shirt (Aquascutum); blue suit (Kilgour); black shoes (Church's); watch (Zenith); cufflinks (Van den Berg). I know this sounds like an advertorial from GQ magazine but in 2207 they might want to know. Anyway it's the journalists equivalent of body armour and it means nobody is going to jerk you around on the reception desk of a major company should you need to turn up at one in a hurry. In my pockets there are: wallet; SonyEricsson P910i (battered and scratched and minus its stylus); keys; transparent plastic earpiece in case I have to do a live report; about £3 in change; Oystercard with some business cards. I am carrying about £40 in notes and quite a lot of plastic.

There is now a lot of business news happening but it will struggle to get on Newsnight because there are other big stories around: Tata bids for Corus; US PPI down…

1630: Following the second big editors meeting of the day, Newsnight is now going to cover the NHS job losses story and I am now working flat out on preparing somethign I have to record at 8pm. My producer Mark is hard at work scrounging tapes of Tony Blair from other frantic producers. SO there you go, it's as quick and decisive as "now we're at war with Eurasia" once the bosses decide something. More to follow…

1830: It is now half past six and I am deep in the detail of scripting graphics abotu NHS job losses, wading through party breifings and Treasury responses about who's saying what over the NHS. There is such a mixtur eof on and off record stuff in my inbox that I am not even going to go there. In the middle of it all I got a cal from another longterm contact offering me an exclusive on a political story. I know it all sounds like Walter Mitty - but basically since about 1530 I have gone into multitasking mode. Physically I am sitting at my desk and mainly talking to people (Labour, Tories, NHS Employers, Unison) via emissaries. I have ordered Sweet & Sour Chicken Balls from the takeaway: my other half will not be pleased at my fresh vegetable and fruit intake - it amounts to a solitary Cox's Orange Pippin I ate this morning. Set against that is the Twix I bought and ate as soon as I found out I had to do tonight's story - that hour between three and four pm is the journalistic equivalent to the hour when the secret police come and take people away into night and fog….

Right now, outside, it is dark. The big thing on Newsnight tonight is an exclusive story about the activities of the Janjawid militia in Sudan. At 1900 I will be interviewing somebody from the unions and then at 2000 I will record some of my piece for tonight. Then I'll go and edit it, eating the Chinese food somewhere inbetween. My car home is booked for 2300 and my first appointment tomorrow is 0815. I hope that technology has cut the TV correspondent's working day a bit by 2207 - in fact if you bear in mind that the way we work adumbrates the way most people will work in future, with work seeping into life and life into work, the whole concept of work hours will break down.

2215: They have not broken down yet however. It is ten fifteen and I am sitting in a small dark room with two other blokes: producer Mark Lobel and VT editor Clive Edwards…we are cutting together a piece which is part me standing in the studio, part me tracking over rushes, part footage of Tony Blair and David Nicholson, CEO of the NHS, trying to explain why they can't give an exact figure for the number of job losses in the NHS. Its all done except for an information graphic, which is being done by someone else. We have just watched the ten o'clock news cover the latest carnage in Iraq and it occurs to me that this is the third or fourth year of sitting in a dark room with other journalists late at night watching pictures of Iraq and quietly shaking our heads. The second story on the Ten O'Clock News is about, er, fat cat salaries.

Moving swiftly on, I am now psyching myself up to go and do a live top to my piece in the studio with Jeremy Paxman. See you on the airwaves.

2220: I get to the studio to record the top of the programme which involves just standing in a place. Paxman ribs me about this blog - implying that I should not be getting up at 6am. We have a conversation the conclusion of which is that both our lives would be better if we got more sleep. I spend the next 20 minutes in the "Green Room" with programme guests watching the more important stuff a the top of the programme and then, near the end, I am guided to the set to do my live bit. UNfortunately the 30 seconds allocated for me to slip onto the set and start speaking is too short, or goes too quickly, and I am not guided to the required spot so I start speaking in a kind of no-man's land. it is all over, like dentistry, before you know you have started. Had a long discussion with Anei our makeup woman about how to mend an ADSL router that has been struck by lightning - she was shocked that you could just go out and buy a new one, and did not have to rely on BT replacing the one that's broken.

I queued as usual to get my cab at BBC reception and Derek, the man on the desk who looks out for me, got it sorted. The cab took the usual dog-leg journey down through Chelsea to the embankment then along to Vauxhall bridge. This is a great journey to take in silence late at night with the river breeze in your face, in the back of a decent car. I have learned to use it to relax.

Arrived home at about 2340, poured a glass of port. Talked to my wife, who has seen a fatal cycle accident today and looks a bit shocked. Came to the study to write this, ending Bridget-Jones style with a list of medicines I am about to take: 20mg omeprazole, Gaviscon, Twinings Digestif Tea (1 unit). That's my day: I will post it up on the site and it will be here for posterity, or until the BBC rebrands us, or gets abolished: which will be long before 2207.
This is a part of article My One Day In History - 0600-2359 Taken from "Tadalafil Soft Tabs" Information Blog

Group Therapy Helps Men With Impotence

A new review of existing research suggests that group therapy can help men with erectile dysfunction even if they are already using popular drugs like Viagra. Group therapy could even be a feasible alternative to some treatments for impotence.

While the number of men studied overall was small, the reviewers found that group therapy appeared to be about as successful as suction devices and injections in terms of promoting erections. One analysis showed therapy worked for nearly two-thirds of participants.

The findings spotlight the importance of "integrating sex therapy and other psychological techniques into office practice" to help impotent patients, said lead author Tamara Melnik, professor of psychiatry at the University of São Paulo in Brazil.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Before the days of Viagra and its sibling drugs, many considered erectile dysfunction to be a difficult-to-treat psychological disorder. Now, drugs allow millions of men to achieve normal erections by allowing blood to flow more freely to the penis; the more serious side effects are rare.

However, drugs are not always an automatic cure for men with erectile dysfunction, especially those whose impotence relates to psychological factors.

A 2001 study of 115 impotent men found that psychological factors were responsible for the problems in 43 percent of the men and physical factors were responsible for problems in another 43 percent. In the rest of the men, researchers blamed impotence on a combination of mental and physical factors.

In the new review, Melnik and colleagues examined 11 studies from the last 32 years to compare the value of group therapy to other treatments such as oral drugs, injections and suction devices.

The review studies nearly 400 men: 141 received group therapy, 109 took drugs, 68 took drugs and took part in psychotherapy, 20 used "vacuum" (suction) devices and 59 were in control groups that did not receive any treatment.

Half of the men in the studies were from the United States and the average age of the men was 47.4 years.

By pooling data from five of the studies, the researchers found that 36 of 55 men who took part in group therapy reported successful intercourse compared with 5 of 45 who were on waiting lists and had no treatment, Melnik said.

The researchers also combined data from two similar studies from 2000 and 2005 and found that men who took Viagra in conjunction with group therapy were more likely to report successful intercourse than those who took the drug alone.

The total number of men in the two studies was small just 71.

The review authors did not find much difference in erection success rates between those who tried injections or suction devices and those who took part in group therapy alone.

According to Melnik, the goal of group therapy is to help men gain confidence and reduce anxiety. Most men feel comfortable in the setting of group therapy because they can share their difficulties with other men who have the same problem, Melnik said.

"Most people only wonder about the easiest and most rapid way to reach remission of erectile dysfunction," Melnik said. "Group therapy takes more time than using medication, but in some cases dealing with psychological aspects is fundamental to achieving a successful outcome and maintaining the results."

The review does not examine issues of cost nor how group therapy expenses compare to those of other treatments. The review authors did not look at the availability of group therapy for erectile dysfunction patients.

Hossein Sadeghi-Nejad, M.D., a New Jersey urologist, said psychological factors play a role in some cases of impotence. While drugs like Viagra can help people with erectile dysfunction caused by mental factors, the medications "do not work unless the patient is in the right frame of mind," said Sadeghi-Nejad, director of the Center for Male Reproductive Medicine at Hackensack University Medical Center.

Indeed, while some people assume that Viagra and other drugs cause erections on their own, sexual stimulation is still necessary. Moreover, as generations of psychologists have discovered, mental issues can wreak havoc on a person's sexual thoughts and sensations.

Sadeghi-Nejad added that stress, in particular, could cause problems and reduce the effectiveness of erectile dysfunction drugs.

Melnik T, Soares BGO, Nasselo AG. Psychosocial interventions for erectile dysfunction (Review). Cochrane Database of Systematic Reviews 2007, Issue 3.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

Health Behavior News Service
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This is a part of article Group Therapy Helps Men With Impotence Taken from "Generic Cialis Soft Tabs" Information Blog

Tobacco Education: Emphasizing Impotence as a Consequence of Smoking

Tobacco use is well-known to be a significant health concern. Nevertheless, millions of men and women around the world continue to use tobacco products. Most antitobacco education and advertising efforts have focused on the traditional warnings of lung cancer, heart disease, and pregnancy complications. However, in the last two decades, the link between smoking and impotence has been described by various authors.[1-12] Despite this, impotence is not well recognized by the general public or even by general practice medical providers as a potential consequence of smoking. Pharmacists and other health professions are missing an opportunity to teach smokers about another good reason to kick the habit.

Literature regarding smoking and impotence describes various mechanisms for the link. McVary et al.[1] published a comprehensive review in 2001 that examined clinical and scientific studies. The investigators found evidence that impotence can be caused directly by smoking-induced reductions in nitric oxide concentrations, which impair endothelium-dependent relaxation of arteries, and indirectly by smoking-induced atherosclerosis.

The likelihood of impotence or erectile dysfunction (ED) in men who smoke has also been described by various authors. The review by McVary et al.[1] indicated that smoking may increase the risk of moderate or complete impotence by two times that of nonsmokers and that smoking cessation may decrease impotence risk. Austoni et al.[9] found that after adjustment for confounding variables, Italian men who smoked more than 10 cigarettes per day and former smokers had significantly higher risks (odds ratio [OR] 1.4 and 1.3, respectively; both p < 0.0001) for ED. Shiri et al.[11] demonstrated similar but nonsignificant findings in Finnish men: OR 1.4 for smokers (95% CI, 0.9–2.3) and 1.3 for former smokers (95% CI, 0.9–1.9). Polsky et al.[12] found that Canadian men with ED were twice as likely to be former smokers (OR 2.2; 95% CI, 1.2–3.9) but that current smoking did not significantly increase ED risk.

Recently, a U.S. epidemiologic study of 1329 white men (smokers and nonsmokers) showed that 15% reported suffering from impotence.[7] The authors concluded that the relative OR of impotence in smokers or past smokers compared with nonsmokers was significant at 1.46 (95% CI, 1.05–2.02). When adjustments were made for age and for age and comorbidity, the relative OR became nonsignificant at 1.42 (95% CI, 1.00–2.02) and 1.38 (95% CI, 0.97–1.97), respectively. A dose–response relationship suggesting that men with a longer smoking history had a higher likelihood of impotence was also seen. In men with greater than a 29-pack-year history, the relative ORs of impotence were significant at 2.08 (95% CI, 1.41–3.08) compared with 1.34 (95% CI, 0.88–2.07) in those with a 12.6–29.0-pack-year history and 0.92 (95% CI, 0.58–1.46) in those with a 1–12.5-pack-year history. When adjustments were made for age and for age and comorbidity, the relative OR for the greater than 29-pack-year group was reduced but still significant at 1.69 (95% CI, 1.10– 2.58) and 1.60 (95% CI, 1.04–2.46), respectively. Interestingly, when the authors stratified the data by age from current smokers and from men who formerly or never smoked, smokers in their 40s had the greatest relative OR of having impotence (2.74; 95% CI, 0.44–16.89).

Unfortunately, not only does smoking tobacco appear to increase impotence risk, data suggest it also predicts a poor response to popular pharmacologic treatment for impotence. Park et al.[13] found that current smoking was significantly associated with sildenafil failure in men over the age of 60 years suffering from impotence (OR 1.34; 95% CI, 1.04–3.52; p = 0.015). The lack of effect was likely due to the failure of sildenafil to potentiate endogenous nitric oxide-mediated vascular responses—responses that are reduced in smokers.[14] Since all phosphodiesterase inhibitors, such as sildenafil, exert their effect through nitric oxide modulation, this therapeutic failure may be a class effect.Effect of Smoking Cessation on Impotence

Data are mixed regarding the usefulness of smoking cessation in smokers to improve erectile function or reverse ED. Some studies have indicated that men who are former smokers are still more likely to have ED than nonsmokers.[9,11,12] Shiri et al.[11] indicated that recovery from ED is reduced in those currently smoking (adjusted OR 0.6; 95% CI, 0.2–1.4) and in former smokers (adjusted OR 0.7; 95% CI, 0.3–1.3) compared with nonsmokers, but the results were not statistically significant and the overall number of patients in this analysis was low. However, results from a study by Derby et al.[15] suggested that smoking cessation in young adulthood (versus later in life) may be necessary to reduce the risk of ED.

A small, prospective study by Guay et al.[16] indicated that smoking cessation significantly decreases the risk of ED. This study evaluated acute changes in smoking status in 10 smokers (ages 32–62 years) using the RigiScan portable home monitor (Dacomed/Urohealth, Minneapolis, MN), which measures penile tumescence and rigidity. At the time of the study, all patients were smoking at least one pack of cigarettes per day and had smoked for at least 30 pack-years. Men were monitored for two nights: one when they smoked and one when they did not smoke for 24 hours. In addition, four men were monitored after smoking cessation (using nicotine patches) for one month. Results of the study showed that after not smoking for 24 hours, the men had a statistically significant improvement in penile tumescence and rigidity (p < 0.05 for all measures). In addition, sustained improvement in ED was found in the four men who were monitored after one month of nicotine replacement and smoking cessation, indicating that nicotine may not be the only mediator of ED from smoking.

A long-term prospective study evaluating whether smoking cessation can improve ED in smokers was recently published. Pourmand et al.[17] evaluated smokers ages 30–60 years who requested nicotine replacement therapy (NRT) for smoking cessation and who also complained of ED starting at least five years after starting to smoke. Of the 2837 smokers, 22.5% (n = 637) reported having ED and 54.3% (n = 346) of those with ED had no other risk factors for ED besides smoking. Those patients without other ED risk factors were followed for one year after stopping NRT. They were then classified as current smokers (those who continued to smoke) or as former smokers (those who stopped smoking with NRT). Results indicated there was a relatively significant correlation between pack-years of smoking and ED status in all patients (Spearman's correlation coefficient, 0.533). At follow-up, there were 118 former smokers and 163 current smokers. The ED status improved by at least one grade in 30 (25%) of the former smokers but in none of the current smokers. Moreover, more current smokers had deterioration in their erectile function: 3 (2.5%) former smokers versus 11 (7%) current smokers. Overall, former smokers tended to have a significantly better ED status after follow-up compared with current smokers (p = 0.09).

In addition to potentially benefiting the health and erectile status of men with ED, smoking cessation may also affect their treatment for ED. Park et al.[13] suggested that stopping or reducing the consumption of cigarettes may ensure better efficacy with sildenafil for the treatment of ED.Tobacco Education and Advertising Regarding Impotence

Two U.S. states and some countries have strived to increase the public's knowledge of the detrimental effects of tobacco on erectile function in an attempt to reduce smoking. In the late 1990s, the California Department of Health Services introduced a one-year marketing campaign targeting the link between smoking and impotence.[18] Newspaper headlines read "The Marlboro Man needs Viagra" and "What Viagra may give, tobacco taketh away." Hawaii followed suit with the "limp" television campaign geared toward 18–24-yearold men.[19] These campaigns were not the first to target impotence as a reason to stop smoking, but they were the most impressive. Unfortunately, published data describing the effects of these advertising campaigns are not available (Stevens CM, personal communication, 2005 Aug 29). However, a 2006 news release from the California Department of Health Services indicates that smoking rates in California have continued to decline since 1996 and are currently at an all-time low of 14%, 25% less than the rest of the nation.[20]

In 2000, Thailand became the first country to go beyond advertising by placing impotence warnings and pictures on cigarette labeling.[21] Subsequently, Canada and Brazil implemented similar warnings on their cigarette packages.[22,23] Currently, the United Kingdom is considering adding various picture warnings to cigarette packages, some of which say that "smoking may reduce the blood flow and causes impotence."[24] Data regarding the results of cigarette labeling indicate that graphic cigarette warning labels reach their intended audience and serve as an effective population-based smoking-cessation intervention.[22] Unfortunately, U.S. requirements are lagging behind other countries, as cigarette manufacturers are only required to include traditional warnings from the U.S. Surgeon General regarding heart disease, lung cancer, emphysema, and complications with pregnancy.Threat of impotence as a Motivator for Smoking Cessation.

On the basis of the association between smoking and impotence and data supporting the benefits of smoking cessation on impotence, it seems logical that this topic be included in smoking-cessation programs. Moreover, data support that there is a need for this information to be communicated to smokers, as a majority of men appear to be unaware that smoking increases ED risk. In a survey of Hong Kong men,[25] only 13.9% were aware of the link between impotence and smoking, and only 12% of British smokers were aware in a 1999 survey.[26] Results of a study conducted by Shiri et al.[11] indicated that smokers with ED were more likely to stop smoking than smokers without ED (23% versus 12.6% stopped, respectively), but the results were not statistically significant likely because of the low numbers of patients in the analysis.

Recently, a small survey in the United States investigated the issue of using impotence as a motivator for smoking cessation.[27] Male smokers ages 18 years and older were surveyed at a local health fair in Denver, Colorado, in April 2004. Surveys were voluntary and anonymous. Participants were surveyed to determine if they knew that smoking increases impotence risk and that regular smoking may reduce impotence drug-treatment response and to assess what effect the risk of impotence would have on their decision to continue smoking.

Sixty-two surveys were completed. Most of the men surveyed were middle age (65% ages 41–60 years) and white (76%). Smoking habits were evenly distributed among 6–10, 11–20, and 21–30 cigarettes smoked per day. The majority of men had attempted to quit smoking at least once, with over one quarter attempting six or more times.

Thirty-four men (55%) stated they were aware that smoking tobacco increases impotence risk, and 56% of the surveyed men maintained that they would be "somewhat more likely" or "much more likely" to stop smoking because of the link between smoking and impotence. Of the men who stated they were unaware of the increased risk of impotence due to smoking, 57% stated they would be somewhat more likely or much more likely to stop smoking. Overall, 39%, 37%, and 19% stated the relationship between smoking and impotence had no effect on their decision to continue smoking, made them somewhat more likely to stop smoking, and made them much more likely to stop smoking, respectively. Three men did not respond to this question.

In total, six men (10%) stated they suffered from impotence; of these, one smoked 6–10 cigarettes per day, two smoked 11–20 cigarettes per day, and three smoked 21–30 cigarettes per day. Three of the impotent men stated they were unaware of the link between impotence and smoking, and five stated that the link made them somewhat more likely or much more likely to stop smoking. Only one impotent man stated that impotence would not affect his decision to continue smoking. Thus, 96% of the men (23 of 24) who planned to continue smoking were not impotent. Overall, 23 men (37%) stated they were aware that smoking could potentially reduce the effects of pharmacologic agents (i.e., sildenafil, vardenafil, and tadalafil) used to treat impotence.Implications for Pharmacists

Pharmacists and other health care providers involved in smoking-cessation programs are ideally situated to educate patients about the association between smoking and impotence. A majority of men will likely respond to smoking-cessation education that is focused on impotence risk, especially if they are already impotent. Younger smokers may be more likely to alter their smoking habits on the basis of potential impotence risk rather than remote threats of heart and lung disease. Moreover, health education programs in schools could incorporate impotence into their discussions of tobacco risks to encourage youths to avoid tobacco altogether.Conclusion

The link between smoking and impotence should be used by pharmacists and other health providers to help motivate men to quit smoking.  Printer- Friendly Email This

References

Am J Health-Syst Pharm.  2006;63(24):2509-2512.  ©2006 American Society of Health-System Pharmacists
This is a part of article Tobacco Education: Emphasizing Impotence as a Consequence of Smoking Taken from "Tadalafil Soft Tabs" Information Blog

Impotence Indicates Risk Of Heart Disease

Many people who suffer a heart attack had never had any symptoms of heart disease. Of the roughly 5,000 individuals who die of sudden cardiac arrest in Sweden each year, two thirds had not had any known heart disease. But in men there is one thing that should constitute a advance sign of coming heart problems: impotence.

In some cases, impotence can have neurological, psychiatric, and other causes. But the most common cause, accounting for up to four cases of five, is that the blood circulation in the penis has become so poor that erection is impaired, or no erection can occur at all. And if the circulation in these vessels has been affected by atherosclerosis, then it is highly probable that the same process is under way in the coronary artery in the heart.

In a dissertation from Lund University in Sweden, the physician Rasmus Borgquist has managed to show that this reasoning is correct.

"One of our studies shows that otherwise healthy men with impotence show signs of early atherosclerosis in the coronary arteries of the heart. In another study we saw that men with impotence evince a higher incidence of high blood pressure, high blood fat, abdominal fat, and other traditional risk factors for heart disease," he says.

The conclusion is that men with impotence problems should seek care as soon as possible, since both their impotence and the possible threat of heart disorders can be counteracted with early intervention. The first priority involves changes in life style, such as quitting smoking, exercise, and altered diet, and then if these are insufficient, medication for lowering blood pressure and blood fat and also pharmacological therapy for treatment of the impotence as such.

"It's probably easier to get men to accept changes in their life style if you can point out that they alleviate impotence, rather than talking about the risk of a heart attack sometime down the road. And there are studies that show that potency improves rather quickly in those who quit smoking and lose weight," says Rasmus Borgquist.

The notion that there is a connection between impotence and heart disease was put forward in the mid 1980s. But this connection has been studied seriously only in recent years.

"Today there is a greater interest in these issues, both among the public and at drug companies," claims Rasmus Borgquist. "On the one hand, several new drugs have appeared to combat cardiovascular diseases and their risk factors, and, on the other hand, potency drugs like Viagra, Cialis, and Levitra have led many more men to seek help for impotence."

There is still a certain "awkwardness factor" that makes some patients reluctant to seek help, and some physicians are hesitant to take up the matter. But in Rasmus Borgquist's experience, once the physician has broached the subject, patients tend to respond frankly.

VETENSKAPSRÃ…DET (THE SWEDISH RESEARCH COUNCIL)
Regeringstgatan 56
103 78 Stockholm
http://www.vr.se
This is a part of article Impotence Indicates Risk Of Heart Disease Taken from "Soft Viagra Sildenafil Citrate" Information Blog