Purpose <p>The purpose of this study is to examine smoking-related work productivity loss among working-age cancer survivors.</p> Methods <p>The National Health Interview Survey (NHIS; 2013–2019 and 2022–2023) data were used to identify cancer survivors ages 18–64&#xa0;years. The sample was stratified by smoking status (currently smoke, formerly smoked, and never smoked). Multivariable generalized linear regressions were conducted to examine the associations of smoking status and work productivity loss measures, including labor force participation, inability to work due to health, and any missed workdays (logistic models), and number of missed workdays (negative binomial models). All analyses controlled for sociodemographic characteristics, survey year, and region, accounting for the complex survey design.</p> Results <p>In total, 8203 (weighted <i>n</i> = 7,048,624) cancer survivors were identified, of whom 1793 (weighted <i>n = </i>1,387,882; 19.7%) currently smoke, 2189 (weighted <i>n</i> = 1,889,235; 26.5%) formerly smoked, and 4221 (weighted <i>n</i> = 3,771,507; 53.5%) never smoked. In adjusted analyses, the labor force participation rate was similar by smoking status. Survivors who currently smoke were more likely to report an inability to work due to health reasons than those who never smoked (23.9% vs. 18.0%, <i>p</i> &lt; 0.001). Among working cancer survivors (<i>n</i> = 5320), those who currently smoke were more likely to report any missed workdays than those who never smoked (59.7% vs. 53.8%, <i>p</i> = 0.016) and experienced a higher number of missed workdays than those who formerly smoked (13.1 vs. 9.9&#xa0;days, <i>p = </i>0.043).</p> Conclusions <p>About one-fifth of working-age cancer survivors report currently smoking, and smoking status is associated with health-related work productivity loss.</p> Implications for cancer survivors <p>Smoking cessation efforts can improve health and reduce productivity loss among working-age cancer survivors.</p>