Plans to ask smokers to quit before going in for surgery are not a form of "health fascism", the government says.
Health Minister Lord Hunt was urged to overrule the plans by local NHS trusts, which peers say could be seen as part of an anti-smoking "witch-hunt".
But independent Labour peer Lord Stoddart said smokers paid high taxes and were entitled to treatment.
Lord Hunt said it was a judgement for doctors, in the patients' interests, and did not amount to a ban on smokers.
On Monday, it emerged that Leicestershire City NHS Primary Care Trust was considering asking smokers to get help to give up, before they went in for surgery.
High taxes
Managers said it would improve recovery times and the final decision on whether to operate would rest with the clinician.
But on Wednesday, Conservative Lord Naseby said it was one example of several similar proposals for smokers, as well as those which targeted obese people.
"There is an impression that there is a witch-hunt against smokers in particular"
He asked by what right "25% of adults who smoke, and the millions who are technically obese - all of them have paid their taxes and national insurance - are to be denied certain NHS surgery".
And he asked Lord Hunt to use the NHS Acts to overrule the "discriminatory action".
Lord Stoddart added: "There is an impression that there is a witch-hunt against smokers in particular.
"And there are all sorts of activities which, if stopped, would save the NHS money and ensure that people got better treatment."
Faster healing
He said smokers already paid "a high premium" in tax on cigarettes and were "entitled to at least the same treatment as others".
In response, Lord Hunt said the proposal had been drawn up by doctors, and was yet to be approved by the trust - but would have to go out to full consultation first.
He said it could mean fewer heart and lung complications, faster wound healing, faster bone fusion and shorter stays in hospital.
"This is not health fascism, it's not about discrimination against smokers, this is about what's best in the interest of the patient in terms of clinical judgement, and that is how it should remain."
Lord Tebbit asked whether the minister would consider it acceptable if similar requirements were applied to people whose sexual habits "make them vulnerable to particularly unpleasant sexually transmitted diseases".
Lord Hunt dismissed the question as "quite ridiculous" adding: "This is a completely different issue".
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