Smoking increases risks for several diseases, including heart disease, lung disease, and some types of cancer. Smoking also increases the risk for bad outcomes of pregnancy, including miscarriage, low birthweight, and early delivery. Quitting smoking can be very difficult. Helping patients to stop smoking is an important activity for physicians. This process begins with counseling, a skill that requires the ability to evaluate the patient's readiness to quit and to motivate patients into effective action. For some patients, nicotine replacement and other drugs can help them quit. In 2003, the USPSTF concluded that the benefits of smoking cessation interventions by primary care settings outweighed their risks. The USPSTF wanted to see if new studies would change its recommendations.