Toronto City Council asked embattled Mayor Rob Ford to take a break from hisjob to deal with "personal issues".
The non-binding vote followed his admission that he bought illegal drugs and smoked crack cocaine.
Mr Ford’s opponents and former allies interrogated him on his suitability to lead Canada's largest city.
Mr Ford insisted that he would not quit.
"I am not an addict of any sort, so I am not quite sure why you are saying that I need help," Mr Ford told councillors.
Speaking after the vote, he issued the latest in a string of apologies, and added: "I really effed up."
Mr Ford, elected in 2010 on a promise to end the City Hall "gravy train", admitted last week that he had smoked crack cocaine in "one of my drunken stupors".
He insisted today that he has zero tolerance for drugs and gangs.
But asked if he had bought illegal drugs in the past twoy ears, he paused for several seconds and replied somberly: "Yes,I have."
Councillors voted 37-5 in favour of a formal, but non-binding, motion urging Mr Ford to take a leave of absence, and also urged him to apologise for "misleading" Toronto residents.
"There's no question that the residents of this city are pposed to the mayor's behaviour. I am, you are, we are," Councillor Karen Stintz said.
"Because of the mayor's behaviour, I'm explaining to my nine-year old what crack cocaine is. Because of my mayor I'm explaining that it's not okay to lie and then apologise when you get caught."
Council has no power to force the mayor to step down or take a break from his job unless he is convicted of a crime.
Mr Ford insists he has no plans to go, or to seek treatment.
As the questions continued at council, hundreds of protesters gathered outside City Hall, many of them calling on Mr Ford to step down.
An Ipsos-Reid poll conducted for several TV and radio stations showed that 76% of Toronto voters think he should step down or take a leave of absence, while only 24% agreed with his insistence on staying in his job.
The scandal of the crack-smoking mayor broke six months ago, when the Toronto Star newspaper and media blog Gawker said they had been shown a video of the mayor smoking crack, an allegation that Mr Ford spent six months denying.
Toronto Police Chief Bill Blair has since confirmed the video exists, and Mr Ford admitted earlier this month that he had indeed smoked crack.
Asked today if more embarrassing revelations could come, Mr Ford said: "As far as I know... you don't know if people are videoing this or doing that. I don't know what's out there right now. But everything that I'm aware of is out there."
Last week, the Star bought a separate video that showed Mr Ford in an expletive-laden rant, making threats to unspecified persons and pounding his hands together.
Mr Ford apologised anda dmitted he was "extremely inebriated".
But he may soon face more questions about his conduct.
A Superior Court judge has ordered the release of moredetails from a police investigation that resulted in drug-trafficking and extortion charges against Mr Ford's friend and part-time driver Sandro Lisi.
A heavily redacted 474-page file released two weeks ago showed police had had the mayor under close surveillance for months, and had recorded evidence of numerous meetings with Mr Lisi.
The judge ruled that some of the redacted portions should be made public.
The police file includes a widely circulated photo of a grinning Mr Ford with three young men, one of whom was shot dead in Toronto earlier this year.
The other two have been charged in a massive Toronto drug and guns sweep known as "Project Traveler".
Mr Ford said he had not met the three men before the photo was taken.
He also said that his lawyer had advised him not to speak to the police about their investigations.