Scotland’s second largest health board, NHS Lothian, will not be giving further treatment to smokers for non-urgent cases, with referrals from GPs being refused.

Dr. Zahid Raza said: “In Edinburgh, we will not see patients at the clinic that are still smoking. Evidence shows that they would not do well with the treatment.” He also went onto say: “We try to avoid intervention and, in around 80 percent of cases, a smoker’s condition will improve just simply by stopping smoking and smoking other lifestyle changes.”

Dr Jean Turner of the Scotland Patients Association said that she was “extremely disappointed”, adding: “I’m really quite shocked. You should not refuse to see anybody and certainly not penalise patients who are smoking.

“It is very God like and highly unfair to refuse to see anybody referred…Doctors are there to see if they can help and relieve symptoms.”

NHS Lothian is by no means unique. NHS Hertfordshire back in January 2012 also withdrew treatment to smokers and, as an ominous sign of the slippery slope, those with a Body Mass Index (BMI) of over 30 – i.e. the obese – are refused services too.

Smokers may well have a case of righteous indignation.

The average smoker smoking a packet a day will contribute £2,000 a year in additional taxation in VAT, income tax and National Insurance.  That contribution amounts to £3,000 year, hence smokers pay nearly twice over. The aggregate total of tobacco taxes are £12.3 billion in 2012-2013.

It is also estimated that 70-80,000 people are directly and indirectly employed in the tobacco industry, adding a further £10 billion to government coffers.

Also, successive governments not only raised tobacco taxation in excess of inflation but also specifically ring fenced it to be spent on the NHS.

Despite the best endeavours of the anti smoking lobby, what is little known is that the only objective research done into the lifetime costs of treating smokers compared to other lifestyles was completed in 2008 by the Dutch Health Ministry.

The results calculated by actuaries found the lifetime cost from the age of twenty was the following:

Healthy: €281,000

Obese: €250,000

Smokers: €220,000

Yes, smokes are 22 percent cheaper to treat throughout their lifetime, mainly from premature mortality.

Smokers probably have every right to be aggrieved. Given how much they contribute to UK PLC, being denied services seems outrageous. Maybe they should have the option of opting out of the NHS and going private and being able to buy a packet of cigarettes free of taxation.

A £7.00 pack will drop to less than a £1.00. Also, perhaps the NHS can do some sums in offering a refund to smokers, while taking away the cost of treating them so far. It seems they will have handsome refunds.

Also, smokers may well be also unhappy that they are being victimised, although as I hinted the obese are discriminated against too. Why should other groups like drug addicts, people with sports injuries, alcoholics and people infected from sexual contact be exempt?  Especially in the context of the NHS paying for non-life threatening services such as tattoo removal, boob jobs and IVF.

In addition, is this not a contravention of the Hippocratic Oath?

The NHS has a lot of explaining to do.