Smokers could be denied routine operations on the NHS unless they quit a month before surgery.

Health managers are considering the move after research showed that smokers take longer to recover from surgery and are more prone to hospital-acquired infections such as MRSA.

Although emergency surgery would not be affected, smokers awaiting routine operations such as hip and knee replacements could be refused treatment until they kick the habit.

The proposals, which have been drawn up by Leicester City West Primary Care Trust, could be extended to other areas.

The Leicester plans would involve smokers being given counselling and nicotine patches to help them stop. But the patients would have to give a blood sample to prove they had quit before being put on the waiting list and admitted for elective non-emergency surgery.

Doctors would decide whether to operate if the patient failed to give up.

The Leicester trust will launch a consultation on the proposals to coincide with the smoking ban that comes into force in England on July 1.

Its plans were welcomed yesterday by health charities but condemned by smoking groups which said they were part of a drive to save money and turn England's 10 million smokers into pariahs.

The proposals came only days after the Government announced that smokers would be liable for an £80 on-the-spot fine for stubbing out cigarettes in the street when the ban comes into force.

In a further blow to smokers it emerged yesterday that European Union officials are considering banning them from lighting up outside office doorways, at bus shelters and on train platforms.

Rod Moore, the assistant director of public health at Leicester City West Primary Care Trust, said it should become the norm for patients to stop smoking before all routine surgery.

"If people give up smoking prior to planned operations it will improve their recovery," he said.

"It would reduce heart and lung complications and wounds would heal faster. Our purpose is not to deny patients access to operations but to see if the outcomes can be improved."

He added: "This will not be a blanket ban on them receiving surgery.

"We are not saying no to surgery under any circumstances. The final decision will be down to clinicians but we are looking at a general assurance that people should give up before surgery."

Norfolk Primary Care Trust has already taken the radical step of removing smokers from waiting lists because it claims they are more expensive to treat.

The Government's medicine advisory agency has previously ruled that smokers should be denied treatment if their habit meant the treatment was likely to fail.

In guidance ssued two years ago, the National Institute of Clinical Excellence said that in some cases the "self inflicted" nature of an illness should be taken into account. Amanda Sandford, the research manager at Action on Smoking and Health, the anti-smoking charity, welcomed Leicester's proposals.

"If it is going to improve the chances of recovery and encourage people to quit then it must be a good thing," she said. "But we don't want to see smokers being denied life-saving surgery."

Simon Clark, the director of Forest (Freedom Organisation for the Right to Enjoy Smoking Tobacco), said it was wrong for the NHS "to play God".

"I accept that the success of an operation may be compromised if someone is a heavy smoker but that is the price the individual must pay," he said. "Smokers contribute a lot to the NHS through tobacco taxation on top of income tax and national insurance and it would be quite disgraceful for them to be denied treatment."

Michael Summers, from the Patients Association, added: "These measures are clearly being driven by finance and not by clinical need. It's a way for hospitals to save money and it's very wrong."

A Department of Health spokesman said: "It is up to individual primary care trusts if they want to introduce such a policy. Clinical need must be the main determinant when prioritising patients."