I will give my ideas, reactions, to this painting. Because I cant upload anything at this moment, I'd much rather pretend I have nothing artistic to reply to this with and write something potentially useless, for reaction of course.
I think this painting would be wonderful on an anti-tobacco commercial, it might not have been ment to express the same thing, but I think that the cigarette and the skull would be perfect to demote cigarettes. I mean, think about what they could say, even in van gogh's age, they knew tobacco could kill you.
The other thought it brings me is that old habits never die, addictions are forever. Even in death, the skull is still smoking, his habit, his addiction. The thought of still being a slave to any addiction by the time you are dead is about as scary as some people consider this painting.
I find that chained inspiration is a hard task, but I will keep trying... respond with an update, please.