Always paper & pencil first. That has been my drawing breath since I was 4. However, my high school art program taught me well in the way of the photoshop/pen tablet. It's not too difficult to adjust, it simply takes practice.
Albeit my inking is not the best because my hand is not steady in any way, shape or form- still, it looks better inked by Manga Studio than scanned in. (Especially since my scanner is back at home in America -_-) One day, maybe I'll afford a Cintiq. Then my inking ability would be revolutionized... my current pen tablet is really buggy.
Also, because of my unsteady hand a.k.a. wobbly lines, my handwriting is poop too. So there's no way I'd post a comic with my own handwriting and consider it good enough. Aiyaaa....