My guess would be they are sketching them out on paper first to get the basic design then working them up on the computer as both vector and bitmaps using a drawing tablet. It really depends on the design and what you are doing. A few years ago I created a font and worked out the letters on paper first then using a tablet created them in the computer. Sometimes I have a good picture in my head and just start working on a blank page. So it comes down to what works best for you. In the end vector will give you more flexibility in what you can produce from the design, print, cut or both
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