Some hospitals in the UK say they plan to save money by encouraging smokers to quit before undergoing routine operations.
Health officials in Norfolk plan to adopt a programme trialed in Newcastle-under-Lyme, Staffordshire and hope the move will improve general health and as well as cut hospital costs.
Doctors say research shows that smokers take more time to recover from surgery, are more likely to suffer complications and therefore have longer and more expensive stays in hospital.
The Norfolk Primary Care Trust (PCT), which is in debt to the tune of £50m, says smokers scheduled for routine surgery will first be referred to a smoking cessation clinic and given a target time in which to break the habit, but say anyone needing urgent surgery will not be affected.
Other health authorities are thought to be considering similar schemes.
Critics say smokers will be denied life-changing operations unless they agree to kick the habit, after it was revealed that smokers will not be given treatments such as hip and knee replacements until they try to give up.
They fear those who fail or refuse to give up could be denied treatment all together.
Critics also accuse the PCT of putting finance before the health of patients.
Last year East Suffolk health authorities barred obese patients from the operating theatre until they tried to lose weight.
Dr. John Battersby, the trust's director of public health, in defence of the move, says that one in four people smoke, the same proportion of people coming through for surgery and there is increasing evidence that smokers have three times the number of complications as non-smokers.
He is proposing that someone who smokes be deferred for surgery, and referred to a smoking cessation clinic, with three months to quit smoking.