Well, smoking would lessen the chances of a full recovery if we operated on your broken ankle. Since you're having trouble quitting, you can just have a bunch of morphine and listen to the broken bones rub together while you walk. We don't want to pay for something that might not work, you know...
Are you kidding?? The guy doesn't quit smoking permanently so he's going to never have his ankle set? After he's paid into the insurance his whole working career? It hardly seems fair.
And I know from personal experience that quitting smoking is tough, but I can't think of too much better motivation than hearing your bones rub together as you walk, or having to take morphine all the time. Can't you just quit for a couple weeks and start after the operation? Hey, that's just the kind of Christian that I am that I think of these things.