This isn't about drinking, but a very similar mentality is at work:

"In one of the first programmes of its kind in the country, Herts GPs have supported recommendations by NHS Hertfordshire, the county primary care trust (PCT), that force obese people to lose weight and encourage smokers to quit before they are allowed orthopaedic surgery.

Patients with a body mass index (BMI) of more than 30 will not be given knee or hip replacements until they have lost weight through a programme supported by GPs and other services. A healthy BMI - a calculation of weight to height - for adults is 18.5 to 25.

Tony Kostick, joint chairman of the clinical executive committee at NHS Hertfordshire and a Stevenage GP, said the move was aimed at reducing the need for surgery, as well as decreasing complications and increasing recovery rates.

"There is good evidence that weight loss can reduce symptoms and may avoid the need for surgery later. For patients who already have arthritis, weight loss will reduce the risk of complications that arise from having surgery and will help them have better results.

"Weight loss clearly takes time and if patients are really unable to make progress over a reasonable amount of time then they could still be offered surgery."

Smokers needing routine orthopaedic surgery are now asked to go on at least one session with a trained advisor to receive advice on quitting before being they are added to a waiting list.