The essential idea behind the movie is that life, any life, is valuable. The characters learn empathy and kindness toward each other and only experience trouble when true love gets in the way of their destinies. Eventually the characters learn that, even though they may only have a short time on earth, their experiences are just as important as those with much longer lives.
There's some anger and raging, and a boy accidentally slaps a girl. Also a couple of somewhat gory hospital scenes. And there's a general sense of unease around the lives of these young people, who are trapped within the rules of a sinister organization.
At all of the three different ages they're shown -- preteens, teens, and twentysomethings -- these characters think and talk a great deal about sex. The preteens fall in love, hold hands, kiss, wonder about sex, and pine for each other. As teens, they actually do have sex (there's moaning and one partial naked breast), and they ponder the meaning of an adult relationship. A teen girl also looks through a nudie magazine that has several photos of naked female breasts.
Teens order Cokes in a diner.
Some cigarettes are found on the school grounds, and there's speculation that some of the preteens may have smoked them.