Background Smoking behavior changes over time in old age, and smoking patterns differ by sex and age. However, the sex-stratified smoking trajectories of older adults are not often examined. The purpose of this study was to examine the smoking trajectories of older adults and their associated factors by sex. Methods Data were drawn from a nationally representative longitudinal study of a sample of Taiwanese adults aged 50-66 years (n = 2097). The samples were followed from 1996 to 2007. Group-based trajectory analysis was performed. Results Three smoking trajectories were identified in men: non/rare smokers (42.6%), quitting smokers (16.5%), and chronic smokers (40.9%). Among men, quitting smokers were more likely to be lower educated than non/rare smokers. The male chronic smokers were more likely to be older, lower educated, and living in rural areas than the male non/rare smokers. Two smoking trajectories were identified for females: non/rare smokers (95.9%) and smokers (4.1%). Women of mainlander ethnic groups were more likely to be smokers. Conclusion There are sex differences in the smoking trajectories and related factors among older adults. Tobacco control programs should be sensitive to the sex of the target population.
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