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The active ingredient is fenethylline (sometimes spelled fenetylline), which is both a codrug and prodrug of (meaning it is both composed of and metabolizes into) amphetamine and theophylline

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Burning wood for home heating also continues to be a major source of PM 2.5

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Some toxins remain suspended in the rising smoke, predominantly affecting the upper lung fields, while others exist as particulate matter that falls and settles in the lower lung regions. Upper Lung Fields:Emphysema (Alveolar Destruction) Centrilobular pattern due to alveolar macrophage-driven proteolysisRespiratory Bronchiolitis-Associated Interstitial Lung Disease (RB-ILD) Small airway and peribronchiolar fibrosisPulmonary Langerhans Cell Histiocytosis (PLCH) Granulomatous disease of the small airways Lower Lung Fields:Chronic Bronchitis Mucus hypersecretion and airway obstructionRespiratory Bronchiolitis (RB) Smokers macrophage accumulation in small airwaysRespiratory Bronchiolitis-Associated Interstitial Lung Disease (RB-ILD) Inflammatory fibrosis extending to the interstitiumDesquamative Interstitial Pneumonia (DIP) Diffuse alveolar macrophage accumulation, primarily in the lower lobesEditorial Comment:The dual nature of cigarette toxinsfloating gaseous irritants and falling particulate carcinogensexplains their widespread destructive impact on the respiratory system