Smokers are costing councils across Leicestershire and Rutland more than £18.536 million a year, according to new a report.
The figures have been compiled by Action on Smoking Health (ASH) - the campaigning public health charity.
Deputy city mayor, Councillor Rory Palmer, has warned it is a cost that is likely to rise in the next few years.
He has also called for more to be done to bring in plain packaging for cigarettes.
The new research by ASH puts the cost of social care for smokers in Leicestershire at £12.3 million while in the city it is running at £5.6 million.
It reveals that current smokers over 50 are twice as likely to need help with day to day living and on average need care nine years earlier that non-smokers.
Coun Palmer, who is also chairman of the city's health and well being board, said: "For every person who dies from smoking, 20 are living with a smoking related illness.
"This research allows us to quantify that impact, not just on local authority funded services but also on our local communities.
"Smokers not only die younger but need care on average nine years earlier than non-smokers."
He added: "These figures are a reminder of the social and economic cost of smoking which is the single biggest cause of preventable illness.
"They are also a powerful reminder of the importance of investment in smoking cessation services.
"In the past year we have spent £1.2 million on smoking cessation. We have a good service and I hope that will be money well spent in the future.
"I hope we can also improve the service to reach more and to persuade young people not to start smoking."
Coun Palmer, who is also vice chairman of the East Midlands Councils Health and Wellbeing Board chairman's network, said he would like more to be done to bring in plain packaging for cigarettes.
He said: "I do believe plain packaging with minimal text would help.
"Even with the pictures of lungs currently on packets the manufacturers try to make the packets look attractive."
Latest figures from the stop smoking service run by the Leicestershire Partnership NHS Trust show that between April 1, 2013 and March 31, 2014, a total of 13,111 people used the service and 6,971 were recorded to have successfully quit at four weeks.
Coun Ernie White, chairman of the health and well being board at Leicestershire County Council, added: "More evidence that smoking is bad news and the range of support services for people wanting to quit is essential."
Deborah Arnott, chief executive of ASH, said the supporting people to quite smoking "will have to be high on the list of preventative measures to enable councils to cut their social care bills in the future."