Wayne,
here's a cut n' paste from an older post about the smoke effect found using the search function.
"Rick,
the effect is in the RTMM Medical Facilities LibraryTEMP.zip. download the library from the medical page and unzip it and then follow the instructions in the IMPORTANT Read Me.txt.
the fx_OrangeSmoke.fx file in the Effects folder of the unzipped library has to be copied into the Effects folder of FSX. If your not seeing any fire effects either perhaps you have not installed the library itself into FSX.?"
For Admin:
Perhaps this object and effect needs to be placed on one of our regular libraries if that has not already been done.