This skeleton with a lit cigarette in its mouth is a juvenile joke. Van Gogh painted it in early 1886, while studying at the art academy in Antwerp. The painting shows that he had a good command of anatomy.
Drawing skeletons was a standard exercise at the academy, but painting them was not part of the curriculum. He must have made this painting at some other time, between or after his lessons.

This coin is currently available at the exhibitions in Leicester, London, York, Milan, Naples and Brussels.
The coin is only available for the duration of the exhibition.