If you want to do this painlessly, Spybot basically allows you to do it at the click of a button. I've been using their hosts file for some time, just updating it now and then. It does add an extra layer of protection against malicious websites.
I've recently started using the MVPS hosts file (which seems to be the one everyone recommends), assisted by a little program called HostsMan that was recommended by a couple of excellent contributors to the Defender newsgroup. This too makes the process almost painless - not so easy as Spybot, but still pretty straightforward, with a simple updating process. If you want to try it, you can get HostsMan here:
http://www.abelhadigital.com/