the game is incredibly good. The rest of this comment is about my thoughts on the game outside of it being really cool and fun
the main problem I have with this game is that cigar feels too obvious to use, why wouldn't you use cigar? it has absolutely no downside to using it. (ignoring the cases where it won't work) I feel like every items demand a bit more thinking than just using it after losing health. I also think it does not feel good when I go out of my way to deal damage to dealer then he just heals it right back up with the cigar.
a minor problem would be beer being the weakest (or maybe hardest to use) and magnifying glasses being the strongest item, but I'm ok with there being a bit of meta in the items, and don't think it's problem big enough to be prioritized solving. It's just a thought I had
I think a "custom mode" where the player can decide what items can appear in the box, the maximum amount of shells that can be in the gun, the amount of item player gets per load, and amount of charges per round would be a great addition.
also it would be really cool if you added new items in the future.