While previous studies have examined smoking trajectories from adolescence into early adulthood (Chassin, Presson, Pitts, & Sherman, 2000), to our knowledge, this is the first to investigate trajectories of smoking across the adult lifespan. Results suggest that low users were at reduced risk for lung diseases compared to late quitters and had a lower probability of death compared to both middle and late quitters. Early quitters were similar to low users in disease and mortality, had a lower lifetime prevalence of lung disease than middle and late quitters, and lived longer than middle and late quitters. Late quitters lived significantly shorter lives than early quitters and low users. Comparing the survival curves of middle and late quitters shows that, by age 81 to 85, late quitters were more likely to have died than middle quitters. Though this difference was not significant in the present sample, it is possible that with a larger sample a significant difference would be observed.