There have been instances of a smoking skull image throughout history. "Skull of a Skeleton with Burning Cigarette" is a painting by Vincent van Gogh. The smoking skull was also used for the WWF Championship belt worn by "Stone Cold" Steve Austin.
Van Gogh's painting has been used on postcards and book covers. The painting itself can be seen in the Van Gogh Museum located in Amsterdam as of 2014. Mick Foley and "The Rock" were the other two wrestlers to hold the smoking skull belt. Skulls are a common tattoo design, and in Russian prisons, a skull tattoo symbolizes murder. It is unknown if a smoking skull is a unique symbol in Russia.