When smoking cannabis in a circle, a person may become so overwhelmed (by a coughing fit, or even from the effects of the plant itself) that they are unable or unwilling to take a hit when the bowl or bong is passed to them.
In this case, the afflicted person may have someone "pinch hit" for them on this round.
"*cough* *cough* *hack* Hey man, you wanna *cough* *wheeze* take a pinch hit *cough* for me?"
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