I'd attack it by making a brush. Bare with me this is my first tutorial...
Start with a 300 Soft edge brush
Set brush mode to Linear Dodge
Set that opacity somewhere between 10 - 30%
I normally start lower and work my way up depending...
in the Brush presets... Shape Dynamics leave it alone at 'default' but make sure that "Other Dynamics" is turned on.
and use these settings Opacity Jitter 0% With Control set to pen pressure (if you use a pen like I do) Flow Jitter should be 0% and control turned off.
Thats brush one. Save it as a new brush preset and name it 'smoke' or what have you.
Brush two you're going to make will add the 'realistic' part of the smoke.
This next brush will be a textured brush. I love and use this brush exclusively for my cloud/smoke making.
Start with the smoke brush.
Click Texture in the presets.
you can use one of the B&W ones given to you by PS. OR you can find a good outside source like a piece of granite or other interesting rock surface (make sure its really large and B&W) and import that by using the marquee tool Selecting an area. and going Edit>Define Pattern.
now take that pattern and add these settings in the Texture preset. Scale 90-100%. Mode Color Burn. Depth 100%.
Save this brush preset as clouds.
this brush can be used with a normal mode setting or the Linear Dodge depending on the background you're working with. also mess with the opacity and switch between black & white to create desired effect. Will take some getting used to and some experimentation. but you'll love the end result. And best of all, you didn't use a filter to create it. YOU created the smoke!!
examples I've used these two brushes in
http://photoshopcontest.com/view-entry/94777/last-day-at-work.html
http://photoshopcontest.com/view-entry/134242/asteroid-3141592653589.html
http://photoshopcontest.com/view-entry/122740/to-heaven.html
http://photoshopcontest.com/view-entry/127795/love-at-first-bite.html
http://photoshopcontest.com/view-entry/115750/dilemma.html
http://photoshopcontest.com/view-entry/128581/dawn-breaks-at-the-swamp.html
http://photoshopcontest.com/view-entry/127261/land-shark.html
http://photoshopcontest.com/view-entry/126885/get-out-gif.html
http://photoshopcontest.com/view-entry/128618/mission-to-titan.html
makes good surf too
http://photoshopcontest.com/view-entry/113261/escape-plan.html
if you can't figure something out in my really bad tutorial... PM me and I'll try to work you through it.
Cheers!