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The problem is that he keeps spitting into cups and bottles with a horrible gagging sound that really takes you out of the game

doi:10.1080/14622203710001649696

Chronic Obstructive Pulmonary Disease (COPD): COPD is a group of lung diseases, that includes emphysema and chronic bronchitis

The Journal of Industrial Economics 17(2):145-150

has used alcohol and/or marijuana in the past 30 days

2016 in New Mechanisms and Perspectives in Nicotine Withdrawal. Diagnosing nicotine addiction consists of assessing behavioral patterns, dependency levels, and withdrawal symptoms through tools like the Fagerstrm Test for Nicotine Dependence