John,
The forums I was running were over a year ago, and yest I did use what was available at the time to prevent as much span as I could. Not in the form of plug-ins as most of the BB's at that time had many features built in to prevent spam. I tried a variety of different platforms over the years but it seemed like all of them had issues with spam of some sort. If a knucklehead wants to get access to your system they will find a weak link and find a way to get in.
There are more tools now, I agree, but it is probably still and issue of some sort. The Google reCAPTCHA was a good tool when it first came out but there are even ways around that. I did not implement that in my forums as most users find it annoying and it cuts down on the user interaction in the forums. I did have a group of good moderators that had a good focus on the topics. It just became too much to manage for all of us. We were spending as much time trying to keep it clean as we were responding to questions and that defeated the purpose.
I have found that using the email system allows us to answer questions on a more personal level and we can usually go back and forth to find the solution for the user. Of course the disadvantage there is that we have no repository for the users to look through and find solutions, one of the big advantages a well run forum. And we do end up answering the same types of questions many times. But it is what it is. I do what I can to support the users as best I can.
Forums can be very successful as is obvious by this one. This is an excellent forum and very well run. If I try it again I think I will stay away from the big platforms like phpBB, Simple Machines, Vanilla Forums, etc. I think the more popular the platform the more people are trying to access it. I have thought about writing my own, then you could have some serious security implemented in it, but that is a lot of work to write a well rounded platform that would supply most of the features of a larger platform.
It is a give and take. You have to weigh the good with the bad. In my case the majority of my focus I wanted to be on developing good video tutorials on web development, and I found that I was spending more time on the forums security then on the tutorials themselves. I was getting away from the focus of the site. If your focus is to run a forum and that is the main reason for the site, then it would probably be a lot less of a headache.
There are plenty of people here that can help you regardless of what way you decide to go. I'll help all I can also.
I hope this helps.