Introduction:
According to “Action on Smoking and Health Foundation Thailand 2018”, smoking was the cause of death for 51651 individuals and costed about 2.2 million THB of medical expenses per person. Based on 2018 census, there were 13973 smokers in Muang district, Lopburi province.

Objective:
The objective of this study was to investigate the efficacy of Low Frequency Transcutaneous Electrical Nerve Stimulation or Lo-TENS on smoking cessation in Muang district, Lopburi province, Thailand.

Methods:
Subjects were 62 smokers who were divided into a Lo-TENS stimulation group (n=31) and a control group (n=31). Participants in both groups received behavior-changing programs for smoking abstinence from the Network of Physical Therapists for Smoke-free Thai Society. In addition, participants in the experimental group received an electrical stimulation (Lo-TENS) at Zu-San-Li acupuncture-point for 30 minutes, once a week for 4 weeks. The Fagerstrom test for nicotine dependence (FTND), pulmonary test, and 6-minute walk test (6MWT) were assessed at baseline and 6-weeks, 6-months and 12-month follow-ups.

Results:
The results showed that 24 of 31 participants (77%) in the experimental group successfully quitted smoking, compared to 4 of 31 participants (13%) in the control group. The 6MWT for the experimental group increased significantly from 404.7±79.5 to 484.4±81.3 meters (p<0.001), whereas the 6MWT for the control group was unchanged, i.e. from 402.87±65.59 to 428.81±65.47 meters (p>0.05). The experimental group showed significant improvement in FVC from 1.82±0.83 to 2.81±0.79 liters (p<0.001) and FEV1 from 1.54±0.68 to 2.46±0.67 liters (p<0.001). There were no significant changes in FVC or FEV1 in the control group.

Conclusion(s):
In summary, Lo-TENS in combination with behavior-changing program for smoking abstinence led to greater smoking cessation rate than behavior-changing program for smoking abstinence alone.