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It's also an interpretation I like for his character because it could symbolize how he's chasing after his own downfall. He's constantly trying to get stronger, trying to defeat Atsushi for Dazai's approval despite the toll it takes on his body. He knows he doesn't have long left and even after getting into a coma, he doesn't stop fighting no matter how much it harms his body.
And I just like to draw him with a cigarette cause it looks cool on him.
It’s so funny when people draw aku smoking like guys, please, he’s literally dying