I make all first posts on our forums moderated by making the Registered Users a moderated group. After a day, or after one post, the users get moved to an Unmoderated Registered Users group - I do this through Usergroup > Promotions. This keeps most of the spam from actually getting posted on the site. Occassionally, some spammer sets up and account and comes back in a few days when he is no longer moderated and then posts his stuff, but I'd say 99.9% of these guys get stopped by this method.
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