I'd seen a photoshop of a skull showing through a human face and I'd always remembered the original Terminator film too when Arnie gets part of his robot face shot off so wanted to try create my own version. When looking for suitable images online of a human face I came across the smoking girl and decided to try create an edgy anti-smoking composition.
Having sourced the image of the smoking girl and a skull that was at a similar angle I overlaid them both until the facial features matched roughly. I then warped the skull over the face more precisely. I then masked out the eyes and nose areas making sure to give the skin edges a "burnt" look and some shadowing. To finish off I overlaid a cloud texture and darkened the photo a bit to make it all look smoky, unhealthy and dank. I added some unhealthy looking bruising to the skin also, some smoke rising as well as some custom smoky text at the top.