If we want more evidence-based practice, we need more practice-based evidence.*

If we want more evidence-based practice, we need more practice-based evidence.*

CHAPTER 5:

EDUCATIONAL AND ECOLOGICAL ASSESSMENT OF FACTORS AFFECTING HEALTH-RELATED BEHAVIOR AND ENVIRONMENTS - Archived Headlines

An Estimated 46.8 Million U.S. Drivers Each Year Drive After Using Alcohol and/or Drugs. (CESAR Fax < www.cesar.umd.edu >, February 22 1999, Vol.8, Issue 8). An Analysis of data from the National Household Survey on Drug Abuse has found that over one-fourth of U.S. drivers—an estimated 46.8 million drivers—have driven within two hours of drug and/or alcohol use in the past year. Twenty-three percent of drivers reported driving after alcohol use and 5% after drug use (either alone or in combination with alcohol). [Adapted by CESAR from "Driving After Drug or Alcohol Use: Findings from the 1996 National Household Survey on Drug Abuse;" copies of the report are available from the National Clearinghouse for Alcohol and Drug Information at www.health.org.]

SMOKING CAUSES MALE SEXUAL IMPOTENCE : BMA CALLS FOR HEALTH WARNINGS (London, British Medical Assn. & Action on Smoking and Health, June 2, 1999)- "Smoking causes male sexual impotence." That is the stark warning that the BMA and ASH want to see on cigarette packets. The British Medical Association and Action on Smoking and Health today publish a report Smoking and Male Sexual Problems warning that smoking is responsible for impotence in 120,000 UK men aged 30 to 49. Although the link between smoking and impotence is well-established scientifically, very few smokers are aware of the risks they are taking with their sex lives. A MORI poll conducted for ASH shows that 88 per cent of smokers failed to make the link. The BMA believes that raising public awareness will provide a powerful incentive to men to give up smoking. Health warnings on cigarette packets are a simple, very direct way of bringing the message home to smokers. The BMA is therefore asking the UK Government and the European Union to add a new health warning that smoking causes male sexual impotence to tobacco packaging.
    The damage caused by smoking is cumulative. If men smoke heavily during their teens and twenties, they risk developing erectile dysfunction in their thirties and forties. The achievement of an erection is dependent on blood flow in the arteries and veins of the penis. Smoking damages the blood flow to the penis in much the same way that it damages heart vessels, by the long term build up of fatty deposits in the arteries. There is an additional acute effect of nicotine on blood flow into and out of the penis. The build up of nicotine in penile tissue causes venous dilation making it difficult to maintain the erection. Smoking therefore makes it difficult to achieve and sustain an erection. Commenting on the report, Dr Bill O'Neill, Tobacco Adviser to the BMA, says: "Although impotence is often the subject of jokes and banter, it is a very distressing condition for men and their partners. It is staggering that so few smokers realise that there is a link. I think a stark warning on cigarette packets could really play an important role in motivating male smokers to give up cigarettes. Young men are notoriously resistant to health warnings and think they will have given up smoking long before cancer or heart disease catches up with them. But the prospect that they could also wreck their sex lives might just make them stop and think." Full text available on the ASH website at: http://www.ash.org.uk/papers/impotent.html .
    Polling conducted by MORI [2] for ASH showing that 88% of smokers fail to identify smoking as a cause of impotence when asked without prompting. Even when prompted with a list of possible answers, 67% of smokers fail to identify the risk. Ref: MORI Social Research, Smoking and Impotence – Public Awareness: a quantitative survey among the general public. Research undertaken in March 1999. A summary of the polling and results is available at the MORI web site at: www.mori.com/polls/1999/ashmar99.shtml.

Evidence-Based Medicine Reviews (EBMR) at McMaster University. (Hamilton, Ont., Feb. 4, 1999). The Canadian Cochrane Network and Centre is pleased to announce that Evidence-Based Medicine Reviews (EBMR), which includes the Cochrane Database of Systematic Reviews, is now available through McMaster University's HSLinks System. The HSLinks system is available free of charge and can be accessed from any of the 13 workstations within the Health Sciences Library, or from any personal computer with an Internet connection (using a Telnet program). The introduction of EBMR at McMaster will greatly assist the Canadian Network and Centre in the major effort of dissemination and application of Cochrane Reviews. 

Information about the Journal of Medical Internet Research is available at www.symposion.com/jmir/termin.htm