I use it regularly… I do as you have above in my print stylesheets: any external links are going to begin with “http://” so any anchors with that in their href will take the whole url and post it after the link text, in bold, with ()'s around them, for just the reason you present.
The second rule is to prevent Gecko from getting too confuzeld. This is not a good idea as a blanket statement, but on my small sites all links are fine. Sometimes there are links you do no good showing the title on (always always test your links with keyboard!!!). But this was great when the manager insisted on flag icons instead of links to language names. Users with a mouse got the name of the language in the tooltip, but that left out keyboarders.
What sucks is :focus doesn’t work on <abbr> tags. Arg.
You could also use it to show links as “next” and “previous” where they may have that text in rel attributes.
attr(rel).
The only other time I’ve used it is the same idea - to spell out the title of abbr/acronyms in the print stylesheet, because people won’t get the benefit of the tooltip.