HealthSmart could be said to be abstinence based, depending on which units a school chooses to teach at the secondary level. It is not an "abstinence only" program.
Grades K–5 are abstinence based, and do not introduce content around STIs or pregnancy prevention. The puberty/sexual health section in Grade 5 includes one lesson (Lesson 37) on sexual abstinence, framed as one of the choices students can make to protect their health during puberty. This is the first time sexual abstinence is introduced as a concept within the program.
At the middle school and high school levels, HealthSmart offers two different sexual health units: one is abstinence based and the other covers contraception and safer sex practices in addition to abstinence as a means of preventing HIV, other STIs, and pregnancy. Many schools teach both units as part of comprehensive sexual health education. Schools in districts or states that mandate abstinence-based sexual health education can choose to teach only the Abstinence unit, which focuses on benefits of sexual abstinence for teens, and also provides inclusive and skills-based instruction to help students support a choice to be abstinent.