That one is quite simple.
As you know, you get a "sureshot" if you have twice or more the attack of your opponent.
Hence, in a round with 2 cards with equals powers, if you put one pillz when your opponent doesnt put anything: you get a sureshot At the cost of only 1 pillz, it's worth it, no?
This one pillz can be very powerfull
Its because you where in a random room...... highlight the word RANDOM which means that cards win at RANDOM unless you have twice as much atk power as your opponent which would result in a sureshot. i hope you now understand the theory of RANDOM rooms and why people dont like to play in them... just look for rooms with a small dice with blood on it under the name of the room (e.g danger zone) for NON-RANDOM rooms where the player with the highest attack always wins, even if its just 1 more atk point.
People seem to misunderstand this strategy so let me Elaborate further.
say i played a smokey on my first turn as a bluff (so no pillz) and my opponent has seen through this and played a Vladimir with no pillz. In a non-random room that means you would have sacrificed a decent card and lost 7 health, so now your opponent is in total control of the game and the chance of you winning is slim. However if you played the smokey with just 1 pill, you would have had a total of 9 atk, which is high enough to beat the vladmir. this means you would have a total of 14 pillz, while your opponent has 12 and they have lost a good card.
The same concept applies the other way around. If your opponent has just played a Kolos, but has an Ielena Tanaereva and lulabee waiting behind it and you have a damage reducer and a SOA card in your hand than this is an obivous bluff. So instead of playing one of those cards like you opponent would expect you to do, you could play for example your Sheitane with one pill which would poison you opponent, and you would have saved your better cards for latter on in the game.
you should now understand that this strategy is ONLY for bluffing and counter-bluffing. of course you don't send out a card with one pill randomly in a game! This game is all about maths! if some has played a card with a +/- atk effect and also has a Hugo in their hand then for goodness sake don't just use 1 pill on a card!