I have two emails: super_private@gmail.com which is only handed out to people I know in real life...I've had this one since 2004 and I still get zero unwanted emails on that address. Then, I have another address, super_public@gmail.com which mass forwards all mail to my super_private email, which then filters it according to the rules I've set up.
The reason I have the extra layer of indirection is because it wouldn't by very user friendly to force someone you know to email you with a plus sign and then some junk. This way I can give a 'normal' email address to normal people, and my filtering email address to auto signups and things like that.
2. You're right - I guess I'm not too worried about a profile being built for me, but this definitely would not handle that issue. I also use anonymous remailers like getnada.com if I am signing up for something which I think is particularly embarrassing if it gets out, but that is rare.