Smokers will be denied surgery in order to slash health care costs and reduce recovery time and surgical complications, reports Action on Smoking and Health (ASH), a national antismoking organization which has long championed making smokers bear the consequences of their habit. The new restrictions are set to begin this summer in the UK, initially under the Leicester City Primary Care Trust, but the requirements are expected to spread quickly throughout the country. Under the rules, smokers are to be denied operations under the Health Service unless they give up cigarettes for at least four weeks beforehand, and doctors will require patients to take a blood test for nicotine residue to prove they have not been smoking. Medical research shows that smokers take far longer, on the average, to recover from operations, and are far more likely to suffer serious medical complications. This not only greatly increases the cost of providing surgery to smokers, but also ties up beds and hospital facilities urgently needed by other patients. The Trust says that "if people give up smoking prior to planned operations it will improve their recovery. It would reduce heart and lung complications and wounds would heal faster." Thus it is a "perfectly legitimate clinical decision." Professor John Banzhaf, Executive Director of ASH, notes that some physicians in the US have refused to perform operations on smokers, and that potential recipients may be denied life-saving organ transplants if they smoke, just like patients who abuse alcohol or use recreational drugs. "Smoking not only causes many very serious and very expensive diseases, but also exacerbates many existing medical problems and complicates recovery from virtually all operations. Thus a smoker who sufferers a broken leg while skiing -- a condition obviously not caused by his smoking -- is much more likely to suffer respiratory complications and/or infections as a result of the surgery, and to take far longer to heal," says Banzhaf. "Generally, since most health insurance companies charge smokers the same rates and provide them with the same benefits, these added costs and delays in providing services to others are absorbed by the great majority of patients who are nonsmokers. This is manifestly unfair. One remedy is to charge smokers more for their health insurance, a policy the federal government recently recommended and approved. Another is to deny smokers certain services, especially if their smoking is likely to impair their outcome." Action on Smoking and Health (ASH)

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