The following is unfeasible with today's technology, but I don't think it's too far off. It's also probably overkill for dealing with forum spam, but could be useful for account sign-ups, or any situation where you wanted to be really sure you were dealing with humans and they would be prepared for it to take a few minutes to complete the process.
Have 2 users who are trying to prove themselves human connect to each other via their webcams and ask them if the person they are seeing is human and live (i.e. not a recording), by getting them to, for example, mirror each other's movements, or write something on a piece of paper. Get everyone to do this a few times with different users, and throw a few recordings into the mix which they also have to identify correctly as such.