Objectives: To determine whether or not different smoking behavior would have different effects on the elderly, we used the disablement process model to examine the associations between smoking, smoking cessation, and physical functional disability among middle-aged and elderly persons. Methods: This study was based on a longitudinal study design, applying data obtained from the “Survey of Health and Living Status of Middle Aged and Elders in Taiwan,” which had been conducted in 1989, 1993, 1996, 1999, 2003, and 2007 by the Health Promotion Administration of the Ministry of Health and Welfare. The study populations were middle-aged and elderly persons > 50 years of age, and physically functional independent in Taiwan. Logistic regression and Cox’s proportional hazards model were performed to examine the relationship between the independent and dependent variables after controlling for confounding factors. Results: There was a positive association between smoking, smoking cessation, and physical functional disability among middle-aged and elderly persons. Smokers had higher risks of physical functional disability than never-smokers after controlling for other factors. There were no significant differences on physical functional disability between former smokers and never smokers. Whether former smokers or smokers, a longer duration of smoking was associated with poorer physical performance. No significant differences existed between former smokers who had quit smoking > 15 years, former smokers who had quit smoking under 60 years of age, and never smokers. Conclusions: Different smoking status and different smoking cessation behavior leads to different effects on physical performance. Based on the results of this study we suggest that the Health Promotion Administration of the Ministry of Health and Welfare should recommend people not to smoke, encourage smokers to quit smoking as soon as possible, and be committed to promoting a smoke-free environment.