"Just say no" is Uncle Sam's new message to American teens.
But the issue at hand is sex, not drugs.
At Congress's behest, the federal government is launching a $50 million-per-year grant program for states to fund programs that preach sexual abstinence to teens - with no mention of birth control.
But there's no conclusive proof that the "abstinence-only" approach delays the onset of teen sexual activity or reduces teen pregnancy, says Doug Kirby, a leading researcher who has just published a report on pregnancy-prevention programs.
Groups that favor a "comprehensive" approach to teen sex education - one that discusses both abstinence and contraception - are in an uproar that so much federal money is going toward an unproven approach. They're concerned that the new federal grant program, which requires the states to contribute matching funds, will siphon state money from existing comprehensive sex-ed programs.
At its root lies the same ideological battle - chastity versus condoms - that for years has divided activists on teen sexuality. But in 1997, it threatens to shatter the unity of the president's National Campaign to Prevent Teen Pregnancy.
In response, members of Congress are reintroducing legislation to earmark $3.5 million over three years to evaluate teen-pregnancy programs and give $10 million in grants to effective ones.
"We need to know what works, what doesn't, and why," says Rep. Nita Lowey (D) of New York, a sponsor of the bill. The expectation is that a variety of teen-pregnancy programs would be studied.
President Clinton highlighted unwed teen pregnancy in his 1995 State of the Union address, and the national campaign - a privately funded venture - was launched in 1996. It aims to cut the US teen-pregnancy rate - the highest among Western industrialized countries - by one-third by 2005.
The costs to society of teen childbearing are staggering: at least $6.9 billion annually in lost tax revenues and spending on public aid, health care for children, foster care, and other costs, says Dr. Kirby, citing figures just for 15- to 17-year-olds.
Statistics like these impelled Congress to focus on teen pregnancy in the recent welfare-reform legislation. The law contains incentives to states that reduce out-of-wedlock births and earmarks the $50 million in abstinence-education money.
To make sure the states stick to a message of abstinence and don't discuss birth control, the legislation prescribes eight guidelines for the content of the message. (See examples above.)
During the welfare-reform debate, the abstinence-only provision got little attention. But as critics raise objections, defenders are coming forward.
In a paper, Ron Haskins and Carol Bevan, staffers on the House subcommittee that drafted the provision, acknowledge there's little evidence "that any particular policy or program will reduce the frequency of nonmarital births." But they argue that government has a history of launching programs with no guarantee of their outcome, such as civil rights legislation and Head Start.
Another federal program - the Adolescent Family Life program, which promotes abstinence and helps unwed teen mothers - has also been directed to spend $9 million of its $14.2 million budget on abstinence-only education and follow the eight abstinence-only guidelines.
Proponents of comprehensive sex-ed say abstinence-only fails to acknowledge that many teens will become sexually active no matter what and that they need information on how to protect themselves.
Abstinence-only proponents argue that discussing birth control with teens sends a signal that premarital sex is OK. They also argue that the US already funds discussion of birth control with teens on Medicaid and in family-planning clinics, so abstinence-only money levels the playing field.
"That's comparing apples and oranges," says Barbara Huberman of Washington-based Advocates for Youth. "We're talking about comprehensive sexuality education, not just visits to clinics."
Following are four of the eight guidelines that programs must follow to qualify for a new federal "abstinence education" grant:
* Teach the social, psychological, and health gains to be realized by abstaining from sexual activity.
* Teach that abstinence is the only certain way to avoid out-of-wedlock pregnancy and sexually transmitted diseases.
* Teach that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity.
* Teach young people how to reject sexual advances and how alcohol and drug use increase their vulnerability.
Source: US Department of Health and Human Services