Objective: This preliminary study aimed to examine the smoking rate among Puerto Rican cancer survivors and identify correlations with demographic, clinical, and psychological factors. Methods: We performed a secondary analysis using baseline data from 384 cancer survivors in Puerto Rico, collected between January 2018 and March 2023. Participants were recruited through community support groups and hospital settings. Data were analyzed on sociodemographic characteristics, type of cancer, treatments, psychological distress (evaluated using the Patient Health Questionnaire-8 for depression and Generalized Anxiety Disorder-7 for anxiety) and behaviors related to smoking. The significant associations with smoking were then examined using a logistic regression model, adjusted for all significant correlations. Results: 7.5% of the sample reported smoking in the last 6 months, with a median consumption of six cigarettes per day. Depression was the only significant factor correlated with smoking, with participants who smoked reporting higher levels of depression. Other variables, such as age, gender, type of cancer and treatments, showed no significant correlation with smoking behavior. In the logistic regression model, high depressive symptoms were significantly associated with a greater likelihood of smoking, with people who reported such symptoms 3.03 times more likely to smoke (95% CI [1.39, 6.63], P = .005). Other variables, such as age, gender, type of cancer, and treatments, showed no significant correlation with smoking behavior. Conclusion: Depressive symptoms are associated with smoking among Puerto Rican cancer survivors. This finding highlights the critical need to integrate mental health screening and support into smoking cessation programs adapted to this population.