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Parul, who is just out of university and working as a social-media coordinator, started smoking at 17

But more than anything, Washington uses each piece of his environment to create a character, and that includes cigarettes

The CCG said: "Smokers and obese patients that need routine surgery, but do not wish to access the support services or fail to meet the criteria will not be denied their operation, but it could mean they have to wait longer than they otherwise would have done." CCG clinical lead Dr Shaun O'Connell, who is also a local GP, heralded the plans as bringing patients the "best possible health outcomes in the long term" while helping to protect finances

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