I’ve started playing hardcore characters recently and I noticed a couple of things regarding damage/healing that are not especially balanced.
First of all, healing occurs much too rapidly in hardcore characters. You can regain almost all your health with just a few hours of sleep. Presumably because sleep heals just as quickly for hardcore characters who have much lower health, but my presumption about hardcore characters is that they don’t just have lower health; everything else is just more dangerous. Which makes the fast healing a little excessive.
All healing also seems to have not been adjusted for hardcore, and a first aid kit even with almost no medical skill can pretty much bring a near-dead character up to near-full health. This kinda makes the first-aid skill somewhat useless except for bionics.
Second is smoke damage.
I was actually kind of glad to see that smoke was nerfed in 0.8, but nonetheless, my recent (hardcore) character who was doing very well for herself still coughed herself to death after just a relatively short exposure to smoke, despite wearing a dust mask the entire time.
Taking damage from smoke inhalation long after you’ve left the smoke area is a pain in the ass and it makes it pretty much impossible to predict how much smoke exposure is going to be ‘safe’ for a hardcore character with little margin for error. Mouth protection is supposed to help but it’s impossible to tell how much it is helping. The smoke/damage system is very opaque right now and as a game mechanic in a roguelike that can be monumentally frustrating.
One suggestion; put a limit on how much damage you can take from coughing unless you are still inside the smoke. For example, your character coughs. First it checks whether or not you are in smoke currently. If you are, damage is applied. If not, then it checks your health; are you above 25% health? If yes, then it damages you. If not, then it does not damage you.
Another suggestion; scale smoke damage for hardcore characters. Right now, thanks to the fact that it is extremely difficult to kill smokers with projectiles, they are nearly unassailable on hardcore without a full gas mask. A small amount of smoke exposure can pretty much kill a hardcore character, which is kinda wacky. This smoke is pretty much more effective than sarin gas where it comes to hardcore characters.
Yet another suggestion; make the inhaler reduce coughing. Although I can’t find any research or information on the subject of using an inhaler to treat smoke inhalation/exposure, I think it’s not an unreasonable leap to make for the game. Inhalers relax the smooth muscles in the lungs, increasing surface area and allowing the lungs to extract more oxygen from breathed air. Although I can envision a scenario where this might be very bad for you if you have a lot of smoke particles in your lungs, I think for the purpose of the game it would make a sensible treatment option. And give some use to inhalers, which are right now reserved for asthmatics alone.
Generally, my point is, if Hardcore is meant to be a relatively complete difficulty-level above and beyond the normal Cata difficulty, perhaps a little extra work should be put into balancing out damage and healing where it makes sense.