I use the Human Verification Options using "Question & Answer Verification". The answers to the questions I have created are only likley to be known by people who have knowledge of the subject matter for the forum (a particular make of car).
This means that bots can't sign up and as a consequence of this I have virtually no spam at all. The forum has about 500 registered users.
You could use the promotion system in conjunction with this so that the new user's posts are moderated until they have say 4 or 5 posts then they automatically get promoted to a user groupl which allows them to post without moderation.
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