SMOKERS may have hospital surgery delayed or even cancelled unless they kick the habit.

Obese patients are also being warned they could face delays unless they lose weight.

Surgeons at the Royal Bolton Hospital say those who smoke or are obese face more risks than healthier patients.

Doctors in Bolton have already delayed orthopaedic operations by several months for very overweight patients. They were told they could not be operated on until they lost weight because they would not benefit from the surgery. Ron Hopkins, the medical director of the Royal Bolton Hospital, said: "Patients who smoke heavily or are morbidly obese have a significantly higher risk of complications, failure and poor outcomes from surgery. They also have a greater risk of death.

"Elective, non life-threatening surgery may be delayed to enabled the patient to modify their lifestyle and therefore reduce their risk of surgical complications or failure, and to improve the likelihood of a better outcome from the surgery or treatment.

"In very occasional cases, surgical treatment may be deferred if the risks of the non urgent surgery are deemed to be greater than not having the surgery or treatment performed. If appropriate, alternatives would be discussed."

Smokers could have their surgery delayed because there is evidence to show non-smokers recover more quickly following surgery.

Non-smokers are also less likely to have complications from the anaesthetic and spend less time in the recovery room.

In smokers, wound healing is slower because of the harmful substances in cigarette smoke.

Doctors could delay planned surgery, such as knee or hip replacements, until the patient loses weight or quits smoking and in some cases operations can be deferred indefinitely.

Community health bosses, anti-smoking groups and GPs have backed the hospital, but say surgery must never be cancelled because of a patient's lifestyle choices.

Jan Hutchinson, director of public health for the Primary Care Trust, said: "I'm uncomfortable with the idea that there could be a blanket ban on treatment, but we would encourage people to give up smoking and lead healthy lifestyles, not just because surgery is more risky, but because it would improve their health overall."

Amanda Sandford, from ASH, the anti-smoking group, said: "Each case should be viewed on individual merits, but in the case of smoking and smoking related illness the smoker would clearly benefit from quitting and failing to do so could undermine the effectiveness of the treatment, but there should never be a fixed policy on who to treat and who not to treat."

Dr Ian James from the Spring House Surgery, in Chorley Old Road, Bolton, has known obese patients have their surgery delayed for several months while they lose weight.

He said: "People who smoke and those who are obese are a greater anaesthetic risk. It's just common sense to make these changes, not only from a risk sense but also because the outcome of the operation might well not be as beneficial."

But smokers' rights group, FOREST, is furious at the move.

Spokesman Neil Rafferty said: "It's clear these doctors are abandoning their professional duty. Smokers have paid their tax and national insurance like everyone else and they're entitled to treatment.

"This sets a dangerous precedent, allowing doctors to refuse treatment on a whim."