To systematically review the instrumental and discursive barriers and facilitators that have influenced standardised packaging (SP) policies for tobacco, emphasising contextual, institutional, legal, political and rhetorical dynamics.
We searched PubMed, Embase and Web of Science for peer-reviewed studies published in English between January 2005 (post-Framework Convention on Tobacco Control enforcement) and October 2025. Search terms combined tobacco and packaging concepts (eg, ‘tobacco’, ‘standardised packaging’) with policy process terms (eg, ‘barrier’, ‘facilitator’). Reference lists of included studies were also screened.
Of 967 records identified, 41 met the inclusion criteria. Eligible studies examined barriers or facilitators to any phase of the SP policy process (preadoption, implementation or postimplementation). Screening was conducted by one reviewer and verified by two others; discrepancies were resolved by consensus.
Data were extracted into a framework integrating the Policy Dystopia Model, Multiple Streams Theory and Strategic Action Typologies. Extracted elements included instrumental (action-based) and discursive (argument-based) strategies, policy stage, actor type, design/data collection methods. Quality was assessed using an adapted Critical Appraisal of Research Evidence tool.
Industry-led legal, economic and framing strategies were consistent barriers, while governmental legal preparedness, coordination and strategic framing enabled progress, mainly in high-income countries. Evidence on low and middle-income countries and postimplementation processes remains scarce. Research relies heavily on secondary or descriptive designs, underscoring the need for longitudinal, process-oriented analyses.
SP success depends on navigating political, institutional and discursive arenas as much as technical design. Strengthening legal capacity, coordination and framing is vital to sustain implementation globally.