Image copyright Dmitry Gudkov

An altered image of US President Barack Obama with a cigarette in his mouth has been spotted in Russia as part of an anti-smoking campaign.

"Smoking kills more people than Obama," one advert spotted in Moscow says.

Dmitry Gudkov, an MP and critic of the Kremlin, posted the image saying: "I am disgusted and ashamed of what appears on the streets of the Russian capital."

It is not the first time the US president has been targeted in negative ads, amid rising US-Russia tensions.

According to the Moscow Times, a pro-Kremlin art group hung a banner of President Obama with the caption "killer" opposite the US embassy in Moscow.

And in December a major Russian supermarket chain apologised after selling a chopping board with the US president pictured as a chimpanzee.

It is not clear who was behind the latest advert, which contrasts the number of deaths from smoking to people "killed by President Obama".

"Smoking kills more people than Obama, although Obama kills a lot of people," the ad copy reads. "Don't smoke. Don't be like Obama."

Struggled to quit

Barack Obama famously gave up smoking in 2010, but admitted to "falling off the wagon" several times after entering the White House.

His wife, Michelle, later said he kicked the habit to set a good example to his two daughters.

Relations between the US and Russia have deteriorated in recent years over the Kremlin's support for Syrian President Bashar al-Assad and its role in neighbouring Ukraine, which culminated with the annexation of the Crimean Peninsula in 2014.

Last week, Russian Prime Minister Dmitry Medvedev said strains between Russia and the West had pushed the world "into a new cold war".