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In countries where smoking prevalence has decreased, a corresponding decline in lung cancer incidence has been observed ( Despite these achievements, new alternatives to traditional tobacco have emerged, including vaping devices, nicotine replacement products (such as gums and patches), heated tobacco products (HTPs), and electronic cigarettes (e-cigarettes), with or without nicotine ( Since their introduction, e-cigarettes have evolved rapidly in both design and technology, from early cig-a-like models resembling traditional cigarettes to vape pens, pod systems, and heat-not-burn (HnB) devices ( Although initially marketed as a harm-reduction tool, mounting evidence indicates that e-cigarettes pose significant health risks, especially for children and adolescents